Torque Teno Virus or Herpesviruses Detection By Metagenomic Next‐Generation Sequencing Predicts In‐Hospital Major Adverse Events in Critically Ill Patients With Severe Infections

Viral detection occurs frequently in critically ill patients. Patients with multiple viremic events had a higher ICU mortality. The highly sensitive mNGS technology has significantly enhanced viral pathogen detection rates. We enrolled 134 critically ill patients with severe infections who underwent mNGS testing during January 2019 to December 2021, at Qilu Hospital (Qingdao) of Shandong University. Viral pathogens were identified in 78 cases (58.2%). Torque teno virus (TTV) or herpesviruses (HVs) showed the highest detection rates (23.1% and 29.9%, respectively). The incidence of major adverse events (MAEs) in the hospital was 53.0%. Patients with TTV or HVs detection had more secondary nosocomial infections and stress ulcers, and the incidence of MAEs showed an increasing trend. Multivariate Logistic regression analysis showed that APACHE II score (OR: 1.10, 95%CI: 1.02-1.19, p = 0.018) and TTV or HVs detection by mNGS (OR: 2.40, 95% CI: 1.05-5.50, p = 0.038) were independent risk factors for MAEs. This study advocates the use of mNGS for detecting viruses in critically ill patients with severe infections, as it serves as a predictor for heightened risk of in-hospital MAE.