Prevalence et clinical meaningfulness of respiratory virus detection (excluding SARS-CoV-2) in severe community-acquired pneumonia

Abstract

Respiratory viruses are a heterogeneous group of viral species that share a tropism for the entire respiratory tract and a common symptomatology. The availability in clinical routine of multi-target genomic testing (multiplex PCR) has allowed to demonstrate their key role in the epidemiology of severe community-acquired pneumonia in adults, and highlighted the negative impact of virus-bacteria co-infection. However, the clinical interpretation of multiplex PCR can be tricky for clinicians, as results could be equivocal. A negative result does not necessarily rule out an episode of viral excretion, while a positive result does not necessarily mean that the clinical picture is attributable to the respiratory virus detected. If necessary, clinicians can repeat the test or, if available, use confirmatory molecular tools. To date, the therapeutic impact of viral detection (except for SARS-CoV-2) is narrow, and mainly concerns the implementation of measures to limit the transmission risk, the initiation of anti-viral treatment in case of influenza detection, and a warning regarding the use of systemic corticosteroids.