Purpose The purpose of the study is to describe the role of human metapneumovirus (hMPV) infection in critical illness and acute respiratory distress syndrome (ARDS). Materials and methods We collected clinical and demographic information from a retrospective chart review, comparing patients with and without an intensive care unit (ICU) admission. Among patients admitted to the ICU, we assessed whether hMPV was “unlikely,” “possibly,” or “likely” the reason for ICU admission, based on a prespecified definition, and whether the patient met criteria for ARDS. Results We identified 128 hospitalized adults with hMPV infection. Forty hospitalized patients (31%) with hMPV infection required admission to the ICU. Among patients cared for in the ICU, hMPV was “possibly” the reason for ICU admission in 55% of patients and “likely” the reason in 38%. Forty-eight percent of ICU patients met criteria for ARDS. Although most patients admitted to the ICU had significant comorbidities or were immunosuppressed, 6 patients requiring ICU admission had more minor comorbidities and no underlying immunosuppression. Conclusions Although most patients hospitalized with hMPV had chronic cardiac or pulmonary disease, hMPV can also be associated serious respiratory illness and ARDS in adult patients without significant comorbidities or immunosuppression.
BACKGROUND: Most children are exposed to human metapneumovirus (HMPV) by the age of 5 y. This study aimed to describe the morbidity associated with HMPV infections in a cohort of children in the Midwest of the United States. METHODS: This was a retrospective 2-center cohort study including children (0-17 y old) hospitalized with HMPV infections at 2 tertiary care pediatric hospitals from 2009 to 2013. Demographics, chronic medical conditions, viral coinfections, and hospitalization characteristics, including the need for respiratory support, highflow nasal cannula, CPAP, bi-level positive airway pressure, invasive mechanical ventilation, pediatric ICU admission, acute kidney injury (AKI), use of extracorporeal membrane oxygenation, and length of stay, were collected. RESULTS: In total, 131 subjects were included. Those with one or more comorbidities were older than their otherwise healthy counterparts, with a median age of 2.8 y (interquartile range [IQR] 1.1-7.0) compared to 1.3 y (IQR 0.6-2.0, P < .001), respectively. Ninety-nine (75.6%) subjects required respiratory support; 72 (55.0%) subjects required nasal cannula, simple face mask, or tracheostomy mask as their maximum support. Additionally, 1 (0.8%) subject required high-flow nasal cannula, 1 (0.8%) subject required CPAP, 2 (1.5%) subjects required bi-level positive airway pressure, 15 (11.5%) subjects required invasive mechanical ventilation, 4 (3.1%) subjects required high-frequency oscillatory or jet ventilation, and 4 (3.1%) subjects required extracorporeal membrane oxygenation. Fifty-one (38.9%) subjects required pediatric ICU admission, and 16 (12.2%) subjects developed AKI. Subjects with AKI were significantly older than those without AKI at 5.4 y old (IQR 1.6-11.7) versus 1.9 y old (IQR 0.7-3.5, P 5 .003). After controlling for the presence of at least one comorbidity and cystic fibrosis, each year increase in age led to a 16% increase in the odds of AKI (P 5 .01). The median length of stay for the entire cohort was 4.0 d (IQR 2.7-7.0).
Background Despite the disproportionate morbidity and mortality experienced by American Indian and Alaska Native (AI/AN) persons during the COVID-19 pandemic, few studies have reported vaccine effectiveness (VE) estimates among these communities. Methods We conducted a test-negative case-control analysis among AI/AN persons aged ≥12 years presenting for care from January 1, 2021 through November 30, 2021 to evaluate effectiveness of mRNA COVID-19 vaccines against COVID-19-associated outpatient visits and hospitalizations. Cases and controls were patients with ≥1 symptom consistent with COVID-19-like illness; cases were defined as those test-positive for SARS-CoV-2 and controls were defined as those test-negative for SARS-CoV-2. We used unconditional multivariable logistic regression to estimate VE, defined as 1 minus the adjusted odds ratio for vaccination among cases versus controls. Results The analysis included 207 cases and 267 test-negative controls. Forty-four percent of cases and 78% of controls received two doses of either BNT162b2 or mRNA-1273 vaccine. VE point estimates for two doses of mRNA vaccine were higher for hospitalized participants (94.6% [88.0–97.6]) than outpatient participants (86.5% [63.0–95.0]), but confidence intervals overlapped. Conclusions Among AI/AN persons, mRNA COVID-19 vaccines were highly effective in preventing COVID-associated outpatient visits and hospitalizations. Maintaining high vaccine coverage, including booster doses, will reduce the burden of disease in this population.
and Turkey. Methods: An open label, prospective cohort, active device-associated infection (DAI) surveillance study was conducted on adult, pediatric and neonatal patients admitted to tertiary-care ICUs. DAI rates were collected from 166 ICUs, and were recorded by using CDC-NNIS definitions. Microorganism profile, bacterial resistance, LOS and mortality data were collected in 128 out of the 166 ICUs. Data were collected from patients with and without DAI using the INICC protocol, forms and methods, which provided researchers with a general view of patients' outcomes, allowing researchers to suspect DAI and avoid possible DAI omissions if no cultures were done. Patients with and without DAI can be matched to calculate LOS, costs, and extra mortality. Data were uploaded and analyzed at INICC office. Statistical analysis was performed using Chi-square test. P < 0.05 was considered significant. Results: We collected data from 01/02 to 11/08, representing 563,322 CL days. The pooled CLAB rate was 8.06 per 1000 CL days; data stratified by ICU type are shown in Table. Overall 17.1% of all CLAB were caused by Staphylococcus aureus (83.1% were MRSA); 17.1% by Coagulase-negativestaphylococci (80.1% were methicilin resistant); 13.9% by Acinetobacter sp (83.3% were Piperaciline-Tazobactam resistant); and 11.8% by Pseudomonas sp (42.2% were Imipenem resistant). The LOS of patients without DAI was 5.3 days; and of patients with CLAB, 16.7 days (RR, 3.14), representing 11.4 extra days. 7,464 out of 52,549 (14.2%) patients without any DAI died; 397 out of 1,305 patients (30.4%) with CLAB died, the extra mortality being 16.2% (RR, 2.14, 95% CI, 1.94-2.37, P, 0.0001). Conclusion: Pooled CLAB rate of 8.02 per 1000 CL days was higher than the 2.0 rate (medical surgical ICUs) per 1000 CL days published by CDC-NNIS. Patients with CLAB had a significantly higher LOS, with 11.4 extra days, and extra mortality of 16.2%.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.