Volume 30, Number 6—June 2024
Synopsis
Severe Human Parainfluenza Virus Community- and Healthcare-Acquired Pneumonia in Adults at Tertiary Hospital, Seoul, South Korea, 2010–2019
Table 1
Patient characteristics in study of severe HPIV community- and healthcare-acquired pneumonia in adults at a tertiary hospital in Seoul, South Korea, 2010–2019*
| Characteristics | All HPIV infections | Community-acquired HPIV | Hospital-acquired HPIV | p value |
|---|---|---|---|---|
| No. patients |
143 |
80 |
63 |
|
| Sex | 0.27 | |||
| M | 89 (62.2) | 53 (66.3) | 36 (57.1) | |
| F |
54 (37.8) |
27 (33.7) |
27 (42.9) |
|
| Mean age, y (+SD) |
61.6 (+14.0) |
66.0 (+11.6) |
55.9 (+14.9) |
<0.001 |
| HPIV serotype† | 0.25 | |||
| HPIV-3 | 94 (65.7) | 41 (51.2) | 53 (84.1) | |
| HPIV-1 | 23 (16.1) | 18 (22.5) | 5 (7.9) | |
| HPIV-4 | 21 (14.7) | 16 (20.0) | 5 (7.9) | |
| HPIV-2 |
5 (3.5) |
5 (6.3) |
0 (0) |
|
| Underlying disease/condition | 139 (97.2) | NA | NA | NA |
| Structural lung disease | 30 (21.0) | 23 (28.7) | 7 (11.1) | 0.01 |
| Chronic obstructive lung disease | 14 (9.8) | 13 (16.3) | 1 (1.6) | 0.003 |
| Interstitial lung disease | 8 (5.6) | 6 (7.5) | 2 (3.2) | 0.47 |
| Bronchiectasis | 7 (4.9) | 5 (6.3) | 2 (3.2) | 0.47 |
| Tuberculosis-destroyed lung | 1 (0.7) | 0 (0) | 1 (1.6) | 0.44 |
| Hematologic malignancy | 50 (35.0) | 15 (18.8) | 35 (55.6) | <0.001 |
| Diabetes mellitus | 34 (23.8) | 22 (27.5) | 12 (19.0) | 0.24 |
| Solid cancer | 22 (15.4) | 18 (22.5) | 4 (6.3) | 0.008 |
| End-stage renal disease | 7 (4.9) | 6 (7.5) | 1 (1.6) | 0.10 |
| Chronic renal failure, no hemodialysis | 6 (4.2) | 3 (3.8) | 3 (4.8) | >0.99 |
| Liver cirrhosis | 4 (2.8) | 2 (2.5) | 2 (3.2) | >0.99 |
| Congestive heart failure | 4 (2.8) | 2 (2.5) | 2 (3.2) | >0.99 |
| Cerebrovascular attack | 6 (4.2) | 4 (5.0) | 2 (3.2) | 0.69 |
| Solid organ transplant‡ | 6 (4.2) | 4 (5.0) | 2 (3.2) | 0.69 |
| Hematopoietic stem cell transplant | 14 (9.8) | 6 (7.5) | 8 (12.7) | 0.30 |
| Immunocompromised status§ | 88 (61.5) | 40 (50.0) | 48 (76.2) | 0.001 |
| Receipt of immunosuppressant | 42 (29.4) | 15 (18.8) | 27 (42.9) | 0.002 |
| Recent chemotherapy | 56 (39.2) | 22 (27.5) | 34 (54.0) | 0.001 |
| Active smoker | 11 (7.7) | 9 (11.3) | 2 (3.2) | 0.07 |
| Surgery within 1 mo of ICU admission | 11 (7.7) | 3 (3.8) | 8 (12.7) | 0.046 |
| Neutropenia¶ |
39 (27.3) |
14 (17.5) |
25 (39.7) |
0.003 |
| Clinical manifestations | ||||
| Mean APACHE II score (+SD) | 25.4 (+7.0) | 24.6 (+7.3) | 26.4 (+6.5) | 0.13 |
| Mean SOFA score (+SD) | 9.9 (+4.0) | 9.15 (+4.1) | 10.8 (+ 3.7) | 0.01 |
| Septic shock at admission | 75 (52.4) | 43 (53.8) | 32 (50.8) | 0.73 |
| Mechanical ventilation |
138 (96.5) |
75 (93.8) |
63 (100.0) |
0.07 |
| Treatment | ||||
| Oral ribavirin# | 67 (46.9) | 31 (38.8) | 36 (57.1) | 0.03 |
| IVIG | 36 (25.2) | 15 (18.8) | 21 (33.3) | 0.046 |
*Values are no. (%) except as indicated. APACHE II, acute physiology and chronic health evaluation II; HPIV, human parainfluenza virus; IQR, interquartile range; IVIG, intravenous immunoglobulin; NA, not applicable; SOFA, sequential organ failure assessment. †Serotypes are listed according to prevalence. ‡Patients with lung (n = 1) or kidney (n = 5) transplants. §Defined as either daily receipt of immunosuppressants (including corticosteroids), human immunodeficiency virus infection, solid organ or hematopoietic stem cell transplant recipients, receipt of chemotherapy for underlying malignancy during the previous 6 months, or underlying immune deficiency disorder. ¶Absolute neutrophil count of <500/mm3. #Use of oral ribavirin for >2 days.
1These authors contributed equally to this article.