Evaluation of respiratory tract viral infections in immunosuppressed patients admitted in the emergency department

Purpose: To assess the frequency of types of viruses causing lower respiratory tract infection and their effect on survey in immunosuppressed patients who admitted to emergency department. Materials and Methods: Institutional Review Board approval was obtained for this prospective study. 75 adult immunosuppressed patients (median age, 56,03±15,34 years; 42 men, 33 women) who admitted to emergency department due to respiratory tract infection were included in this study between November, 2012 and December, 2014. Age, sex, disease symptoms (fever, cough, throat pain, runny nose, nasal congestion, respiratory distress, chest pain, head ache, myalgia, nausea and vomiting, confusion, vertigo), medications (chemotherapy or immunosuppressant) and additional disease were noted. Nasopharyngeal specimen collections were analyzed using multiplex real-time PCR and Influenza A and B real time PCR tests to assess respiratory tract infection viruses. Results: Most frequent presentation symptoms were respiratory distress (% 84,0) and cough (% 82,7) and the less common symptom was diarrhea (% 6,7). 31 patients (% 41,3) were admitted with fever (38,5-40,9 °C). There was no virus determined in 26 patients (% 34.7); one, two and three types of viruses were determined in 29 (% 38,7), 12 (% 16,0) and 8 (% 10,7) patients, respectively. Coronavirus was the most frequent type (% 22,7) and the bocavirus was the less frequent type (% 5,3) of viruses. Respiratory syncytial virus (RSV) (% 26,3) and parainfluenza (% 26,3) were the most frequent viruses in patients with haematological malignancies. Coronavirus (% 29,6) was the most common virus type in patients with cancer. RSV, parainfluenza, coronavirus and rhinovirus (% 16,7) were the most frequent viruses in patients with immunosuppressant medication. 3 female (% 9,1) and 7 male (% 16,7) patients were dead and rhinovirus was the most common type of virus detected in these patients. Conclusion: Coronavirus was the most common type of virus in immunosuppressed patients with respiratory infection who admitted to emergency department. Sensitive and rapid tests are needed to avoid unnecessary antibiotic treatment in immunosuppressed patients with high mortality risk due to respiratory infection. Multi-instituional studies with large patient groups are needed to provide more detailed data and information.