Scientific article
Open access

One year after ICU admission for severe community-acquired pneumonia of bacterial, viral or unidentified etiology. What are the outcomes?

Published inPLOS ONE, vol. 15, no. 12, e0243762
Publication date2020

Introduction: Multiplex polymerase chain reaction (mPCR) for respiratory virus testing is increasingly used in community-acquired pneumonia (CAP), however data on one-year outcome in intensive care unit (ICU) patients with reference to the causative pathogen are scarce. Materials and methods: We performed a single-center retrospective study in 123 ICU patients who had undergone respiratory virus testing for CAP by mPCR and with known one-year survival status. Functional status including dyspnea (mMRC score), autonomy (ADL Katz score) and need for new home-care ventilatory support was assessed at a one-year post-ICU follow-up. Mortality rates and functional status were compared in patients with CAP of a bacterial, viral or unidentified etiology one year after ICU admission. Results: The bacterial, viral and unidentified groups included 19 (15.4%), 37 (30.1%), and 67 (54.5%) patients, respectively. In multivariate analysis, one-year mortality in the bacterial group was higher compared to the viral group (HR 2.92, 95% CI 1.71-7.28, p = 0.02) and tended to be higher compared to the unidentified etiology group (p = 0.06); but no difference was found between the viral and the unidentified etiology group (p = 0.43). In 64/83 one-year survivors with a post-ICU follow-up consultation, there were no differences in mMRC score, ADL Katz score and new home-care ventilatory support between the groups (p = 0.52, p = 0.37, p = 0.24, respectively). Severe dyspnea (mMRC score = 4 or death), severe autonomy deficiencies (ADL Katz score ≤ 2 or death), and major adverse respiratory events (new home-care ventilatory support or death) were observed in 52/104 (50.0%), 47/104 (45.2%), and 65/104 (62.5%) patients, respectively; with no difference between the bacterial, viral and unidentified group: p = 0.58, p = 0.06, p = 0.61, respectively. Conclusions: CAP of bacterial origin had a poorer outcome than CAP of viral or unidentified origin. At one-year, impairment of functional status was frequently observed, with no difference according to the etiology.

  • Activities of Daily Living
  • Aged
  • Aged, 80 and over
  • Community-Acquired Infections/microbiology/mortality/pathology/virology
  • Dyspnea/etiology
  • Female
  • Functional Status
  • Hospitalization
  • Humans
  • Intensive Care Units
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Pneumonia, Bacterial/diagnosis/microbiology/mortality/pathology
  • Pneumonia, Viral/mortality/pathology
  • Proportional Hazards Models
  • Respiration, Artificial
  • Retrospective Studies
  • Severity of Illness Index
Citation (ISO format)
SANGLA, Frédéric et al. One year after ICU admission for severe community-acquired pneumonia of bacterial, viral or unidentified etiology. What are the outcomes? In: PLOS ONE, 2020, vol. 15, n° 12, p. e0243762. doi: 10.1371/journal.pone.0243762
Main files (1)
Article (Published version)
ISSN of the journal1932-6203

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