Impacto de los virus respiratorios en adultos hospitalizados: carga asistencial, descompensación de comorbilidades e infecciones nosocomiales

Abstract

Objective: To characterize the clinical presentation of hospitalized adults with respiratory viruses (RV). Methods: Prospective observational study of hospitalized adults with RV confirmed by multiplex respiratory PCR test, a molecular diagnostic assay to simultaneously detect and identify multiple res- piratory viruses from a single specimen of nasopharyngeal swab. Results: 167 cases were admitted. 52.7% were women, mean age 64.7. Eighty-sevenpercent were non-influenza RVs. 96% had > 1 comor- bidity (CM), and decompensation of these patients accounted for 16.7% of admissions. There were 92 cases with pneumonia, and severity criteria such as CURB-65 and PSI had poor sensitivity. Rhinovirus and RSV were associated with pneumonia and intensive care unit (ICU) requirements. There were 50 nosocomial infections that had longer hospitalizations. Clinical manifestations were less evident in the elderly. Hospital stay was longer in parainfluenza patients. Fifteen cases died. The factors associated with mortality included advanced age, CM, ICU, invasive mechanical ventilation, sepsis, use of corti- costeroids, cancer, and smoking. Conclusions. RVs cause hospitalizations, CM decompensation, and nosocomial infections. RVs other than influenza cause more hospitalizations, longer stays, and greater resource consumption.