Distribution characteristics of human herpes viruses in the lower respiratory tract and their impact on 30-day mortality in Community-Acquired Pneumonia patients

Reactivated human herpes virus (HHV) is commonly detected in community-acquired pneumonia (CAP) patients, attracting increased attention from clinical practitioners. However, the significance of reactivated HHV in bronchoalveolar lavage fluid (BALF) collected from CAP patients remains unclear. We retrospectively analyzed BALF samples from 64 CAP patients at the Kunming Third People's Hospital between August 2021 and December 2023, metagenomic next-generation sequencing (mNGS) was conducted on BALF samples during CAP onset. The reactivations of Epstein-Barr virus (EBV) and Cytomegalovirus (CMV) were prevalent in the CAP group, human herpes virus 7 (HHV-7) was the most susceptible reactivated virus in the sCAP group. Utilizing multivariate Cox regression analysis, adjusted for age, sex, length of hospital stay (LOS), HHV, HHV-7, and acute physiological Chronic Health Assessment II, revealed that neither HHV nor HHV-7 were independent risk factors for 30-day mortality in CAP patients (HHV: HR 0.574, p=0.6401; HHV-7: HR 2.137, p=0.2921). Consequently, EBV and CMV were the most prevalent in CAP patients. HHV-7 was the most susceptible reactivated virus in sCAP patients. However, neither HHV nor HHV-7 were independent risk factors for 30-day mortality in CAP patients. The findings offer important information for clinicians to guide timely interventions in treatment.