![]() ![]() In this population viral pneumonias are typically more severe and associated with higher mortality rates, compared to healthy subjects. ![]() Regardless of viral testing accuracy, immunocompromised patients, especially those who have undergone hematopoietic stem cell or solid organ transplantation or patients under chemotherapy for leukaemia, demonstrate a significantly higher incidence of viral pneumonias. Moreover, even when viral testing is undertaken, the true incidence of viral pneumonias remains unclear and probably underestimated as upper respiratory sampling (nasal swab, nasopharyngeal swab) is most commonly performed compared to the most sensitive but less easy lower respiratory sampling, ,, , ]. The variability of the reported proportion of viral pneumonias from various studies may be explained by differences in study populations and the testing rigor for viruses. It is estimated that viruses are responsible for 15%–56% of CAP in hospitalized immunocompetent patients, either by themselves or as co-pathogens with bacteria, ,, ]. In this article, we review concurrently the epidemiological, clinical and radiological features of pathogens causing viral pneumonia. Accurate and early diagnosis of the various viral pathogens through a multimodality approach is crucial, as specific therapies are available against certain viruses. However, imaging plays a significant role in patient management, as it is necessary for determining the severity and extension of the infection. presence of viral epidemics in the community and seasonality of viral pathogens) and laboratory findings, including molecular detection techniques. Diagnosis of viral pneumonia depends on clinical criteria, epidemiological factors (e.g. The fatal burden of viral outbreaks throughout human history, as well as the fact that new respiratory viruses have been discovered during the past decade, highlight the pathogenic role of viruses in respiratory disease, including community acquired pneumonia (CAP). In 2012 another coronavirus strain (“Middle East respiratory syndrome – MERS coronavirus”) emerged and has been responsible for some hundreds of deaths so far, , ]. Since 2003 sporadic cases of H5N1 influenza (Asian Avian Influenza A) have occurred, whereas in 2009–2010 and in 2015 H1N1 flu pandemics (“Swine flu”) resulted in thousands of fatal cases worldwide. During the 21 st century new viral outbreaks were reported: SARS that surfaced in 2002, caused by the SARS coronavirus strain 1 (SARS-CoV-1), resulted in hundreds of deaths, mostly in China and Hong Kong. Influenza type A virus pandemic (H1N1 subtype), known as the “Spanish flu”, was the most devastating leading to approximately 100,000,000 deaths worldwide from 1918 to 1920. Since then, multiple epidemics caused by other viruses have been recorded. Epidemics of smallpox in the Roman Empire and Japan during the first century AD are among the first known outbreaks of viral diseases. ![]() Throughout human history, outbreaks of respiratory diseases due to viruses have commonly been reported. The emergence of the novel Coronavirus disease in December 2019 (Covid-19) in Wuhan (Hubei, China), caused by SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) and the ongoing pandemic as a result of the viral spread, have once more drawn physicians’ attention to respiratory viruses and have re-emphasized the role of viral pathogens as cause of severe pneumonia.
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