Prevalence and clinical impact of VIral Respiratory tract infections in patients hospitalized for Community-Acquired Pneumonia: the VIRCAP study

  • P. TatarelliEmail author
  • L. Magnasco
  • M. L. Borghesi
  • C. Russo
  • A. Marra
  • M. Mirabella
  • G. Sarteschi
  • R. Ungaro
  • C. Arcuri
  • G. Murialdo
  • C. Viscoli
  • V. Del Bono
  • L. A. Nicolini


Prevalence and clinical impact of viral respiratory tract infections (VRTIs) on community-acquired pneumonia (CAP) has not been well defined so far. The aims of this study were to investigate the prevalence and the clinical impact of VRTIs in patients with CAP. Prospective study involving adult patients consecutively admitted at medical wards for CAP and tested for VRTIs by real-time PCR on pharyngeal swab. Patients’ features were evaluated with regard to the presence of VRTI and aetiology of CAP. Clinical failure was a composite endpoint defined by worsening of signs and symptoms requiring escalation of antibiotic treatment or ICU admission or death within 30 days. 91 patients were enrolled, mean age 65.7 ± 10.6 years, 50.5% female. 62 patients (68.2%) had no viral co-infection while in 29 patients (31.8%) a VRTI was detected; influenza virus was the most frequently identified (41.9%). The two groups were similar in terms of baseline features. In presence of a VRTI, pneumonia severity index (PSI) was more frequently higher than 91 and patients had received less frequently pre-admission antibiotic therapy (adjusted OR 2.689, 95% CI 1.017–7.111, p = 0.046; adjusted OR 0.143, 95% CI 0.030–0.670, p = 0.014). Clinical failure and antibiotic therapy duration were similar with regards to the presence of VRTI and the aetiology of CAP. VRTIs can be detected in almost a third of adults with CAP; influenza virus is the most relevant one. VRTI was associated with higher PSI at admission, but it does not affect patients’ outcome.


Viral respiratory tract infections Community-acquired pneumonia Influenza Pneumonia severity index 



The authors declare no funding foundation.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Regional Ethics Committee (Regional Ethics Committee of Liguria Region, Registry Number 357RE62016).

Informed consent

Participants signed specific informed consent.


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Copyright information

© Società Italiana di Medicina Interna (SIMI) 2019

Authors and Affiliations

  • P. Tatarelli
    • 1
    • 2
    Email author
  • L. Magnasco
    • 1
  • M. L. Borghesi
    • 1
  • C. Russo
    • 1
  • A. Marra
    • 3
  • M. Mirabella
    • 1
  • G. Sarteschi
    • 1
  • R. Ungaro
    • 1
  • C. Arcuri
    • 4
  • G. Murialdo
    • 3
  • C. Viscoli
    • 1
  • V. Del Bono
    • 5
  • L. A. Nicolini
    • 1
  1. 1.Division of Infectious Diseases, Department of Health Sciences (DiSSal)San Martino Polyclinic Hospital and IRCCS, University of GenoaGenoaItaly
  2. 2.Department of Infectious DiseasesOspedale Santa Maria Delle CrociRavennaItaly
  3. 3.Second Clinic of Internal Medicine, Department of Internal MedicineSan Martino Polyclinic Hospital and IRCCS, University of GenoaGenoaItaly
  4. 4.Department of Health Sciences (DiSSal)University of GenoaGenoaItaly
  5. 5.Infectious Diseases UnitAzienda Ospedaliera S. Croce E CarleCuneoItaly

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