Outcomes of Herpes Simplex Virus Pneumonitis in Critically Ill Patients

• Published in: Viruses 2022-01, Vol.14 (2), p.205
• Main Authors: Chang, Wen-Jui, Wang, Hsin-Yao, Huang, Yu-Chen, Lin, Chun-Yu, Leu, Shaw-Woei, Hsieh, Meng-Jer, Huang, Chung-Chi
• Format: Article
• Language: English
• Subjects: Acute Physiology and Chronic Health Evaluation II (APACHE II) score; acute respiratory distress syndrome (ARDS); Adult; Aged; Aged, 80 and over; Bronchus; Critical Illness - mortality; Diabetes mellitus; diabetes mellitus (DM); Female; Herpes simplex; Herpes Simplex - etiology; Herpes Simplex - mortality; Herpes Simplex - virology; herpes simplex virus (HSV) pneumonitis; Herpes viruses; Hospital Mortality; Hospitals; Humans; Intensive care units; Intensive Care Units - statistics & numerical data; Investigations; Laboratories; Lavage; Length of Stay; Male; Middle Aged; Mortality; Patients; Pneumonia, Viral - etiology; Pneumonia, Viral - mortality; Pneumonia, Viral - virology; Pneumonitis; Polymerase chain reaction; Pre-existing conditions; Respiratory distress syndrome; Respiratory Distress Syndrome - complications; Retrospective Studies; Simplexvirus - genetics; Simplexvirus - physiology; Sputum; Ventilators
• ISSN: 1999-4915; 1999-4915
• DOI: 10.3390/v14020205

Critically ill patients, such as those in intensive care units (ICUs), can develop herpes simplex virus (HSV) pneumonitis. Given the high prevalence of acute respiratory distress syndrome (ARDS) and multiple pre-existing conditions among ICU patients with HSV pneumonitis, factors predicting mortality in this patient population require further investigation. In this retrospective study, the bronchoalveolar lavage or sputum samples of ICU patients were cultured or subjected to a polymerase chain reaction for HSV detection. Univariable and multivariable Cox regressions were conducted for mortality outcomes. The length of hospital stay was plotted against mortality on Kaplan-Meier curves. Among the 119 patients with HSV pneumonitis (age: 65.8 ± 14.9 years), the mortality rate was 61.34% (73 deaths). The mortality rate was significantly lower among patients with diabetes mellitus (odds ratio [OR] 0.12, 95% confidence interval [CI]: 0.02-0.49, = 0.0009) and significantly higher among patients with ARDS (OR: 4.18, 95% CI: 1.05-17.97, < 0.0001) or high (≥30) Acute Physiology and Chronic Health Evaluation II scores (OR: 1.08, 95% CI: 1.00-1.18, = 0.02). Not having diabetes mellitus (DM), developing ARDS, and having a high Acute Physiology and Chronic Health Evaluation II (APACHE II) score were independent predictors of mortality among ICU patients with HSV pneumonitis.