학술논문
Clinical description and outcome of overall varicella-zoster virus-related organ dysfunctions admitted in intensive care units: the VAZOREA cohort study
Document Type
article
Author
Jolan Malherbe; Pierre Godard; Jean-Claude Lacherade; Valentin Coirier; Laurent Argaud; Hervé Hyvernat; Francis Schneider; Julien Charpentier; Florent Wallet; Juliette Pocquet; Gaëtan Plantefeve; Jean-Pierre Quenot; Pierre Bay; Agathe Delbove; Hugues Georges; Tomas Urbina; David Schnell; Charlène Le Moal; Matthieu Stanowski; Corentin Muris; Maud Jonas; Bertrand Sauneuf; Olivier Lesieur; Amaury Lhermitte; Laure Calvet; Ines Gueguen; Damien du Cheyron
Source
Annals of Intensive Care, Vol 14, Iss 1, Pp 1-11 (2024)
Subject
Language
English
ISSN
2110-5820
Abstract
Abstract Background Due to aging population and increasing part of immunocompromised patients, a raise in life-threatening organ damage related to VZV can be expected. Two retrospective studies were already conducted on VZV in ICU but focused on specific organ injury. Patients with high-risk of VZV disease still must be identified. The objective of this study was to report the clinical features and outcome of all life-threatening VZV manifestations requiring intensive care unit (ICU) admission. This retrospective cohort study was conducted in 26 French ICUs and included all adult patients with any life-threatening VZV-related event requiring ICU admission or occurring in ICU between 2010 and 2019. Results One-hundred nineteen patients were included with a median SOFA score of 6. One hundred eight patients (90.8%) were admitted in ICU for VZV disease, leaving 11 (9.2%) with VZV disease occurring in ICU. Sixty-one patients (51.3%) were immunocompromised. Encephalitis was the most prominent organ involvement (55.5%), followed by pneumonia (44.5%) and hepatitis (9.2%). Fifty-four patients (45.4%) received norepinephrine, 72 (60.5% of the total cohort) needed invasive mechanical ventilation, and 31 (26.3%) received renal-replacement therapy. In-hospital mortality was 36.1% and was significantly associated with three independent risk factors by multivariable logistic regression: immunosuppression, VZV disease occurring in ICU and alcohol abuse. Hierarchical clustering on principal components revealed five phenotypically distinct clusters of patients: VZV-related pneumonia, mild encephalitis, severe encephalitis in solid organ transplant recipients, encephalitis in other immunocompromised hosts and VZV disease occurring in ICU. In-hospital mortality was highly different across phenotypes, ranging from zero to 75% (p