Clinical characteristics and outcomes of patients with severe acute respiratory infections (SARI): results from the Egyptian surveillance study 2010-2014

Ashraf Hatem, Sherif Mohamed, Usama E Abu Elhassan, Eman A M Ismael, Magda S Rizk, Amany El-Kholy, Mohamed El-Harras, Ashraf Hatem, Sherif Mohamed, Usama E Abu Elhassan, Eman A M Ismael, Magda S Rizk, Amany El-Kholy, Mohamed El-Harras

Abstract

Background: Respiratory viral and atypical bacterial infections data in Egyptian patients are sparse. This study describes the clinical features and outcomes of patients with severe acute respiratory infections (SARI) in hospitalized patients in Egypt.

Methods: SARI surveillance was implemented at Cairo University Hospital (CUH) during the period 2010-2014. All hospitalized patients meeting the WHO case definition for SARI were enrolled. Nasopharyngeal/oropharyngeal (NP/OP) swabs were collected and samples were tested using RT-PCR for influenza A, B, respiratory syncytial virus (RSV), human metapneumovirus (hMPV), parainfluenza virus (PIV 1,2,3,4), adenovirus, bocavirus, coronavirus, enterovirus, rhinovirus, and atypical bacteria. Data were analyzed to calculate positivity rates for viral pathogens and determine which pathogens related to severe outcomes or resulted in death.

Results: Overall, 1,075/3,207 (33.5%) cases had a viral etiology, with a mean age of 5.74 (±13.87) years. The highest rates were reported for RSV (485 cases, 45.2%), PIV (125, 11.6%), and adenovirus (105, 9.8%). Children had a higher viral rate (981, 91.2%) compared to 94 (8.8%) cases in adults. Patients with identified viruses had significantly lower rates for ICU admission, hospital stay, mechanical ventilation, and overall mortality than those without identified viruses. No infections were independently associated with severe outcomes.

Conclusions: Viral pathogens were encountered in one-third of hospitalized adult and pediatric Egyptian patients with SARI, while atypical bacteria had a minor role. Highest rates of viral infections were reported for RSV, PIV, and adenovirus. Viral infections had neither negative impacts on clinical features nor outcomes of patients with SARI in our locality.

Keywords: Clinical; Egypt; Outcomes; SARI; Surveillance; Viral.

Conflict of interest statement

The study protocol was approved by the Institutional Review Board at the NAMRU-3, as well as the ethical committee of Cairo University Hospital (CUH), in compliance with all applicable federal U.S. regulations governing the protection of human subjects. Informed written consent was obtained from the patients (in the case of adult patients) or patients’ parent/legal guardian (in the case of pediatric patients).Not applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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