1
Table 4, online. Clinical outcome in patients with virus positive and virus negative respiratory swabs.
Virus-positive patients (n=23) / Clinical outcome / Virus-negative patients (n=32)15 (65%) a / Improved / 18 (56%)
1 (4%) b / Unchanged / 1 (3%) c
2 (9%) d / Transferred to other ICU / 3 (9%) e
5 (22%) f / Died / 10 (31%) g
Improved, patients were transferred to general ward; ICU, intensive care unit
a Six patients had influenza A virus (INFV A), 7 coronavirus (CoV), 2 rhinovirus (RV), 1 respiratory syncycial virus A (RSV A), and 1 patient had human metapneumovirus.
b The patient whose health status remained unchanged at the end of study period had Pseudomonas aeruginosa sepsis and RV with the two last swabs being negative for respiratory viruses.
c Unchanged health status was present in a patient with ventriculits.
d Both patients were transferred to another intensive care unit (ICU) due to logistic reasons. One of them had pneumonia and tested positive for CoV, but the consecutive swab two days prior to transfer was negative; the other with RSV A was only admitted for one night stay after coronary bypass surgery and had no respiratory symptoms.
e All three patients deteriorated. Two of them were transferred to surgical units (one with epidural abscess needed surgery due to gastrointestinal hemorrhage, the other was transferred for surgical management of infective endocarditis), while one patient with pneumonia who suffered from ischemic cerebrovascular insult was transferred to neurological ICU.
f In all five patients who died, INFV A was detected. Three of them died of septic shock without pulmonary involvement (Stapylococcus aureus was the causing organism in two patients, bacterial cultures were negative in one case), in two patients respiratory failure was the leading cause of death (in the patient, who died of pneumonia, apart from INFV A detected in two consecutive swab samples, RV was also detected on the third occasion, three days pre-mortem. Prior to and concomitantly with INFV A detection he was treated for Serratia marcescens pneumonia. In the second case with asthma exacerbation, no concomitant bacterial pathogen was found). In two out of five patients with INFV A-positive respiratory swabs who died of sepsis, autopsy was performed. In the case of S. aureus sepsis, INFV A was not found in any of the tissues taken post-mortem. In the case of sepsis of unknown etiology, INFV A was detected in one of four lung samples examined post-mortem but in none of 7 extra-pulmonary specimens.
g In none of the 10 virus-negative patients who died was lower respiratory tract infection the leading cause of death.