ArticleCritical care (London, England)2025
The Landscape of lower respiratory tract herpesviruses in severe pneumonia patients: a multicenter, retrospective study with prospective validation.
Article in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Histological proof of pulmonary herpesvirus presence in patients with COVID-19- or influenza-related ARDS.Critical care (London, England) · 2026Article
- Metagenomics reveals pathogenic diversity and temporal dynamics in severe pneumonia among patients in adult intensive care unit.BMC infectious diseases · 2026Article
- Characterization of multiple herpes viremia via next-generation sequencing in patients with lower respiratory tract infections: a retrospective cohort study.BMC infectious diseases · 2026Article
- Clinical characteristics and prognostic impact of streptococcal colonization in critically ill patients with severe pneumonia.Frontiers in cellular and infection microbiology · 2026Observational
- Herpes Simplex Virus Infection With Multiple Cerebral Hemorrhages: A Case Report.Clinical case reports · 2026Article
- Blood mNGS-Detected Epstein-Barr Virus in ICU Patients with Pneumonia: Associations with Disease Severity Markers and Inflammatory Burden.Infection and drug resistance · 2026Article
- Phage characterization analysis in respiratory samples from infected patients based on metagenomic next-generation sequencing.Frontiers in cellular and infection microbiology · 2026Article
- Article
- Distinct pathogen spectrum in immunocompromised patients with severe pneumonia.Critical care (London, England) · 2025Article
- Identification of subtypes and construction of a predictive model for novel subtypes in severe community-acquired pneumonia based on clinical metagenomics: a multicenter, retrospective cohort study.Frontiers in cellular and infection microbiology · 2025Article
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28 authors.
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Abstract
objectiveHerpesviruses are widely distributed in the lower respiratory tract, yet no study has comprehensively characterized their clinical features and prognostic impact in severe pneumonia.
methodIn this multicenter, retrospective study, we included severe pneumonia patients who underwent bronchoalveolar lavage fluid (BALF) metagenomic testing in intensive care units across 17 medical centers from January 2019 to June 2023. Based on metagenomic results, patients were categorized into herpesvirus-negative, HSV-1, EBV, CMV, HHV-6B, and HHV-7 groups. Propensity score matching and multivariable Cox regression were used to compare mortality between herpesvirus-positive and -negative patients. Interaction analyses were conducted to assess the impact of co-detection of different herpesviruses. Besides, main findings were validated using data from a prospective multicenter cohort.
resultsAmong 1,737 enrolled patients, the 28-day mortality rate was 41.3% (718/1,737). Herpesviruses were detected in 828 patients. Detection frequencies were: HSV-1 (26.8%), CMV (17.8%), EBV (16.6%), HHV-7 (5.3%), HHV-6B (2.2%), and VZV (0.5%). Clinical characteristics varied across herpesvirus groups. No single herpesvirus was independently associated with increased mortality compared to the negative group. However, co-detection of HSV-1 and CMV was significantly associated with higher 28-day mortality (vs. both negative: adj-HR = 1.439, 95% CI: 1.093-1.894, P = 0.009). This finding was validated in a prospective cohort (adj-HR = 1.656, 95% CI: 1.061-2.585, P = 0.026).
conclusionsHerpesviruses are frequently detected in the lower respiratory tract of patients with severe pneumonia, with distinct clinical features across virus types. Co-detection of HSV-1 and CMV was associated with increased 28-day mortality.
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