Elsevier

Journal of Clinical Virology

Volume 95, October 2017, Pages 26-35
Journal of Clinical Virology

Review article
Systematic review of respiratory viral pathogens identified in adults with community-acquired pneumonia in Europe

https://doi.org/10.1016/j.jcv.2017.07.019Get rights and content

Highlights

  • Respiratory viruses are potentially implicated in one quarter to one-third of adult cases of community-acquired pneumonia.

  • In such cases influenza is the most frequently detected viral pathogen.

  • Failure to test for respiratory viruses in hospitalised patients may lead to missed opportunities for early therapeutic intervention.

Abstract

Community-acquired pneumonia (CAP) is an important respiratory disease and the fifth leading cause of mortality in Europe. The development of molecular diagnostic tests has highlighted the contributions of respiratory viruses to the aetiology of CAP, suggesting the incidence of viral pneumonia may have been previously underestimated. We performed a systematic review and meta-analysis to describe the overall identification of respiratory viruses in adult patients with CAP in Europe, following PRISMA guidelines (PROSPERO; CRD42016037233). We searched EMBASE, MEDLINE, CINAHL, WHOLIS, COCHRANE library and grey literature sources for relevant studies, and screened these against protocol eligibility criteria. Two researchers performed data extraction and risk of bias assessments, independently, using a piloted form. Results were synthesised narratively, and random effects meta-analyses performed to calculate pooled estimates of effect; heterogeneity was quantified using I2. Twenty-eight studies met inclusion criteria of which 21 were included in the primary meta-analysis. The pooled proportion of patients with identified respiratory viruses was 22.0% (95% CI: 18.0%–27.0%), rising to 29.0% (25.0%–34.0%) in studies where polymerase chain reaction (PCR) diagnostics were performed. Influenza virus was the most frequently detected virus in 9% (7%–12%) of adults with CAP. Respiratory viruses make a substantial contribution to the aetiology of CAP in adult patients in Europe; one or more respiratory viruses are detected in about one quarter of all cases.

Keywords

Community
Acquired
Pneumonia
Virus
Aetiology
Pathogen

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