Viral non-SARS-CoV-2 etiology of community-acquired pneumonia (CAP) in Southeast Asia: a review and pooled analysis.

Community-acquired pneumonia (CAP) remains a leading cause of morbidity and mortality worldwide, including in Southeast Asia (SEA). While bacterial causes are well studied, viral etiologies are less characterized. The COVID-19 pandemic has underscored the significance of viral pneumonia, alongside ongoing concerns from zoonotic influenza, human metapneumovirus, and other outbreaks. This review identified 16 studies from SEA, encompassing 8421 CAP patients (2012-2023), describing the viral etiology of CAP. Influenza virus (IV), respiratory syncytial virus (RSV), and human rhinovirus/enterovirus (hRV/EV) were the most frequently tested viral pathogens in 16, 13, and 12 studies, respectively. The pooled positivity rates were 9.02% (hRV/EV), 7.28% (IV), and 5.17% (RSV). While viral etiologies of CAP in SEA align with global trends, data remain limited. Enhancing microbiology capacity in SEA is essential to strengthen CAP surveillance, optimize treatment strategies, inform vaccination policies, and improve pandemic preparedness.