Community Acquired Pneumonia

This data set is from two public (one each secondary and tertiary) and two private (one secondary and one tertiary) health care facilities at Delhi, Kolkata, Pune and Chennai. All patients aged ≥60 years admitted in medicine, pulmonary and geriatric wards of the selected facilities between 4th December 2018 to 20th March 2020 were screened using an operational definition modified from 2009 update of British Thoracic Society (BTS) guidelines , described as new onset cough within last 10 days along with at least one lower respiratory tract symptom (dyspnea, chest pain), and at least one systemic feature (sweating, fevers, shivers, aches and pains and/or temperature of 38° C or more) and tachypnea with a respiratory rate> 20/min or a physician diagnosed pneumonia. Patients who had been hospitalized for > 48 hours in the hospital or any other facility for the same episode of illness were not enrolled to exclude possible nosocomial illnesses. At the time of enrollment, trained project nurses collected data about age, sex, influenza vaccination in past one year, history of current smoking and use of alcohol and pre-existing chronic morbidity by interviewing participants. Details of clinical assessment, diagnostic tests results of hemogram, blood urea, blood glucose, X-ray and use of medications were gathered by reviewing medical records using a standard data collection tool on open data kit (ODK) modules on handheld tablets. The enrolled participants' nasal and oropharyngeal specimens were collected within 48 hours of admission using the standard protocol. These combined swabs were placed immediately into viral transport media (VTM) on ice or ice pack, triple-sealed for transportation. All the specimens were transported to the respective virology laboratory of the institute on the same day. Viral RNA was extracted using the QiAmp Viral RNA kit (Qiagen, Germany) as per the manufacturer’s protocols. We used U.S. Centers for Disease Control and Prevention (CDC) approved one-step Real Time-PCR protocol and primers and probes for influenza and RSV virus to detect the influenza (A and B) and RSV virus. All samples were also tested for human metapneumovirus (hMPV), parainfluenza viruses (PIV), rhinoviruses and adenoviruses using a multiplex kit developed by National institute of Virology .The study team visited the hospitals every alternate day to enroll new patients and evaluate the existing ones till discharge. Any change in status of the patient or admission to the ICU was noted. After discharge, participants were followed up telephonically on day 7 and day 30 from the date of discharge to collect data on their outcome status. During telephonic follow-up, if a participant could not be contacted on first attempt, two more attempts were made to contact within next 7 days, before categorizing a participant as lost to follow-up. The outcomes were categorized as alive and at home, alive and readmitted, dead, or lost to follow-up.本数据集来源于印度德里、加尔各答、浦那及金奈的4所医疗机构，其中公立、私立各2所，且各包含1所二级医疗机构和1所三级医疗机构。 2018年12月4日至2020年3月20日期间，入住所选医疗机构内科、呼吸科及老年科病房、年龄≥60岁的患者，采用基于2009年版英国胸科学会（British Thoracic Society, BTS）指南修订的操作定义进行筛查：近10日内新发咳嗽，且至少合并1项下呼吸道症状（呼吸困难、胸痛）、1项全身症状（出汗、发热、寒战、全身疼痛，和/或体温≥38℃），以及呼吸急促（呼吸频率＞20次/分）或经医师诊断的肺炎。因同一病情在本院或其他医疗机构住院超过48小时的患者不予入组，以排除可能的院内感染病例。 入组当日，经过培训的项目护士通过访谈收集患者的年龄、性别、过去1年流感疫苗接种史、当前吸烟史、饮酒史及既往慢性病史。通过手持平板设备上的开放数据套件（Open Data Kit, ODK）模块标准数据采集工具，查阅病历收集临床评估详情、血常规、血尿素、血糖、X线检查结果及用药情况。 入组患者于入院48小时内采集鼻拭子及口咽拭子标本，采用标准操作流程。合并拭子样本立即置于冰上或冰袋保存的病毒转运培养基（viral transport media, VTM）中，三重密封后运输。所有标本于当日送至对应机构的病毒学实验室。使用德国凯杰公司的QiAmp病毒RNA提取试剂盒（QiAmp Viral RNA kit, Qiagen, Germany），按照厂商说明书提取病毒RNA。采用美国疾病控制与预防中心（U.S. Centers for Disease Control and Prevention, CDC）批准的一步法实时荧光定量PCR方案及引物、探针，检测流感病毒（A型、B型）及呼吸道合胞病毒（respiratory syncytial virus, RSV）。同时使用印度国家病毒研究所开发的多重检测试剂盒，对人类偏肺病毒（human metapneumovirus, hMPV）、副流感病毒（parainfluenza viruses, PIV）、鼻病毒及腺病毒进行检测。 研究团队每隔一日前往各医院入组新患者并评估现有入组者，直至患者出院。记录患者病情变化及转入ICU的情况。患者出院后，分别于出院后第7日及第30日进行电话随访，以收集转归数据。若首次电话随访未能联系到受试者，则在后续7日内追加2次尝试，若仍无法联系则归类为失访。最终转归分为四类：居家存活、再次入院存活、死亡或失访。