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Systematic review of respiratory viral pathogens identified in adults with community-acquired pneumonia in Europe

Alimi, Y.; Lim, W.S; Lansbury, Louise E.; Leonardi-Bee, Jo; Nguyen-Van-Tam, Jonathan S.

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Y. Alimi

W.S Lim

Professor of Evidence Synthesis

Jonathan S. Nguyen-Van-Tam


Community-acquired pneumonia (CAP) is an important respiratory disease and the fifth leading cause of mortality in Europe. The development of molecular diagnostic tests has highlighted the contributions of respiratory viruses to the aetiology of CAP, suggesting the incidence of viral pneumonia may have been previously underestimated. We performed a systematic review and meta analysis to describe the overall identification of respiratory viruses in adult patients with CAP in Europe, following PRISMA guidelines (PROSPERO; CRD42016037233). We searched EMBASE, MEDLINE, CINAHL, WHOLIS, COCHRANE library and grey literature sources for relevant studies, and screened these against protocol eligibility criteria. Two researchers performed data extraction and risk of bias assessments, independently, using a piloted form. Results were synthesised narratively, and random effects meta-analyses performed to calculate pooled estimates of effect; heterogeneity was quantified using I2.Twenty-eight studies met inclusion criteria of which 21 were included in the primary meta-analysis. The pooled proportion of patients with identified respiratory viruses was 22.0% (95% CI: 18.0%-27.0%), rising to 29.0% (25.0%–34.0%) in studies where polymerase chain reaction (PCR) diagnostics were performed. Influenza virus was the most frequently detected virus in 9% (7%-12%) of adults with CAP. Respiratory viruses make a substantial contribution to the aetiology of CAP in adult patients in Europe; one or more respiratory viruses are detected in about one quarter of all cases.

Journal Article Type Article
Acceptance Date Jul 31, 2017
Online Publication Date Aug 5, 2017
Publication Date Oct 31, 2017
Deposit Date Aug 1, 2017
Publicly Available Date Aug 6, 2018
Journal Journal of Clinical Virology
Print ISSN 1386-6532
Electronic ISSN 1873-5967
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 95
Keywords Community; Acquired; Pneumonia; Virus; Etiology; Pathogen
Public URL
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