Table 1 Baseline clinical and treatment characteristics of the entire cohort and the subgroups (low/high viral load)
Variables | All patients | Low viral load (103–105 HSV copies/mL) | High viral load (> 105 HSV copies/mL) | ||||||
|---|---|---|---|---|---|---|---|---|---|
Untreated (n = 24) | Treated (n = 65) | p | Untreated (n = 14) | Treated (n = 16) | p | Untreated (n = 10) | Treated (n = 49) | p | |
Age (years) | 72 [67–76] | 69 [59–76] | 0.274 | 69 [61–77] | 65 [46–75] | 0.308 | 73 [71–76] | 71 [60–76] | 0.187 |
Female | 12 (50) | 23 (35) | 0.230 | 9 (64) | 4 (25) | 0.063 | 3 (30) | 19 (39) | 0.729 |
Charlson score | 4 [3–6] | 4 [2–6] | 0.281 | 4 [3–6] | 3 [3–5] | 0.179 | 4 [3–6] | 4 [2–6] | 0.743 |
Intubation (days) | 9 [6–12] | 13 [8–17] | 0.017 | 9 [6–12] | 12 [7–18] | 0.324 | 10 [7–11] | 14 [9–17] | 0.109 |
Lung disease | 15 (62) | 31 (48) | 0.241 | 9 (64) | 10 (63) | 1 | 6 (60) | 21 (43) | 0.488 |
COPD | 12 (50) | 13 (20) | 0.008 | 7 (50) | 2 (13) | 0.046 | 5 (50) | 11 (22) | 0.116 |
Active smoker | 6 (25) | 18 (28) | 1 | 4 (29) | 5 (31) | 1 | 2 (20) | 13 (27) | 1 |
Dialysis | 7 (29) | 19 (29) | 1 | 5 (36) | 7 (44) | 0.722 | 2 (20) | 12 (24) | 1 |
Diabetes | 6 (25) | 13 (20) | 0.771 | 4 (29) | 3 (19) | 0.675 | 2 (20) | 10 (20) | 1 |
Malignant diseases | 3 (12) | 10 (15) | 1 | 2 (14) | 2 (13) | 1 | 1 (10) | 8 (16) | 1 |
Quantitative polymerase chain reaction results | |||||||||
BAL performed | 18 (75) | 45 (69) | 0.793 | 12 (86) | 13 (81) | 1 | 6 (60) | 32 (54) | 0.733 |
HSV—copies/mL ×105 | 0.13 [0.05–2.18] | 10.78 [1.01–60.15] | < 0.001 | 0.06 [0.04–0.09] | 0.16 [0.04–0.40] | 0.085 | 2.84 [1.80–6.80] | 30.69 [7.26–12.42] | < 0.001 |
BAL: HSV—copies/mL ×105 | 0.09 [0.04–1.22] | 10.50 [0.41–41.55] | < 0.001 | 0.05 [0.04–0.09] | 0.13 [0.03–0.27] | 0.205 | 2.37 [1.45–2.89] | 28.30 [6.77–83.50] | 0.005 |
TBS: HSV—copies/mL ×105 | 3.19 [0.61–15.79] | 19.29 [6.50–143.9] | 0.108 | 0.14 [0.10–0.19] | 0.55 [0.34–0.76] | 0.400 | 12.08 [3.92–39.63] | 44.85 [10.5–169.2] | 0.247 |
Pulmonary infiltrates | |||||||||
Infiltrates | 16 (66) | 54 (83) | 0.143 | 11 (79) | 13 (81) | 1 | 5 (50) | 41 (84) | 0.033 |
Questionable but pathologic brochoscopy | 4 (17) | 5 (8) | 0.244 | 1 (7) | 1 (6) | 1 | 3 (30) | 4 (8) | 0.087 |
No infiltrates but pathologic bronchoscopy | 4 (17) | 6 (9) | 0.449 | 2 (14) | 2 (13) | 1 | 2 (20) | 4 (8) | 0.266 |
Days from detection of infiltrates to HSV detection | 7 [3–11] | 8 [5–14] | 0.318 | 6 [2–8] | 8 [5–13] | 0.126 | 12 [8–15] | 8 [5–14] | 0.444 |
Clinical score at day of HSV detection | |||||||||
APACHE II score | 31 [25–37] | 27 [22–33] | 0.081 | 31 [25–37] | 26 [21–34] | 0.219 | 31 [28–36] | 27 [22–33] | 0.223 |
SOFA score | 11 [7–13] | 10 [6–11] | 0.091 | 11 [8–14] | 10 [6–11] | 0.325 | 10 [8–13] | 9 [6–11] | 0.294 |
LIS score | 2 [1.4–2.8] | 2.3 [1.9–3] | 0.050 | 2 [1.5–2.8] | 2.2 [2.0–3.0] | 0.134 | 1.8 [1.1–2.6] | 2.3 [1.8–3] | 0.123 |
CPIS score | 5 [3–6] | 5 [3–6] | 0.455 | 5 [4–5] | 4 [3–5] | 0.519 | 6 [3–7] | 5 [3–6] | 0.402 |
Antiviral treatment and relevant medication | |||||||||
Acyclovir | – | 63 (97) | – | – | 14 (88) | – | – | 49 (100) | – |
Ganciclovir | – | 3 (5) | – | – | 2 (13) | – | – | 1 (2) | – |
Hours from HSV detection to treatment | – | 46 [30–68] | – | – | 48 [31–95] | – | – | 44 [30–67] | – |
Acyclovir + antibiotics | – | 44 (68) | – | – | 11 (69) | – | – | 33 (67) | – |
Steroids at baseline | 4 (17) | 13 (20) | 1 | 2 (14) | 6 (38) | 0.226 | 2 (20) | 7 (14) | 0.641 |
Antibiotic classes | 4 [2–5] | 5 [3–6] | 0.025 | 4 [2–6] | 6 [5–6] | 0.051 | 4 [2.0–5] | 5 [3–6] | 0.124 |
Antibiotics (days) | 15 [9–23] | 18 [14–28] | 0.046 | 20 [7–26] | 26 [18–37] | 0.094 | 12 [10–17] | 17 [13–25] | 0.045 |
Catecholamines | 23 (96) | 63 (97) | 1 | 13 (93) | 15 (94) | 1 | 10 (100) | 48 (98) | 1 |
Catecholamines (days) | 10 [5–13] | 10 [7–19] | 0.523 | 11 [4–12] | 8 [6–20] | 0.847 | 8 [6–14] | 11 [8–18] | 0.505 |
Diagnoses at ICU admission | |||||||||
Respiratory insufficiency | 22 (92) | 58 (89) | 1 | 14 (100) | 14 (88) | 0.485 | 8 (80) | 44 (90) | 0.338 |
Sepsis | 14 (58) | 26 (40) | 0.153 | 9 (64) | 9 (56) | 0.722 | 5 (50) | 17 (35) | 0.477 |
Renal failure | 9 (38) | 15 (23) | 0.188 | 7 (50) | 2 (13) | 0.046 | 2 (20) | 13 (27) | 1 |
Cardiac arrest | 2 (8) | 4 (6) | 0.659 | 1 (7) | 1 (6) | 1 | 1 (10) | 3 (6) | 0.535 |
Reasons for mechanical ventilation | |||||||||
Sepsis | 15 (63) | 35 (54) | 0.631 | 9 (64) | 11 (69) | 1 | 6 (60) | 24 (49) | 0.731 |
Heart failure | 4 (17) | 14 (22) | 0.769 | 3 (21) | 0 | 0.090 | 1 (10) | 14 (29) | 0.427 |
COPD exacerbation | 6 (25) | 7 (11) | 0.104 | 3 (21) | 2 (13) | 0.642 | 3 (30) | 5 (10) | 0.126 |
Postoperative respiratory insufficiency | 2 (8) | 3 (5) | 0.609 | 1 (7) | 0 | 0.467 | 1 (10) | 3 (6) | 0.535 |
Intensive care unit stay and length of hospitalization | |||||||||
Surgical ICU | 4 (17) | 7 (11) | 0.475 | 1 (7) | 1 (6) | 1 | 3 (30) | 6 (12) | 0.17 |
Medical ICU | 20 (83) | 58 (89) | 0.475 | 13 (93) | 15 (94) | 1 | 7 (70) | 43 (88) | 0.17 |
Total days ICU | 16 [10–28] | 26 [17–32] | 0.009 | 17 [6–31] | 25 [16–32] | 0.328 | 15 [12–17] | 26 [17–32] | 0.006 |
Death on ICU | 12 (50) | 25 (38) | 0.344 | 6 (43) | 6 (38) | 1 | 6 (60) | 20 (34) | 0.311 |
Total days hospital | 26 [17–38] | 41 [26–56] | 0.004 | 31 [19–43] | 38 [26–51] | 0.176 | 24 [16–34] | 42 [26–56] | 0.008 |
Death in hospital | 13 (54) | 30 (46) | 0.634 | 7 (50) | 7 (44) | 1 | 6 (60) | 23 (47) | 0.506 |