DOI: 10.47582/jompac.1954749 ISSN: 2717-7505

Viral etiology, organ support requirements, and 28-day mortality in critically ill patients with PCR-confirmed respiratory viral pneumonia

Erdem Yalçınkaya, Umut Sabri Kasapoğlu, Hüseyin Arıkan, Fatma Betül Yıldırım, Sait Karakurt
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Aims: Respiratory viral pneumonia is an important cause of acute respiratory failure requiring intensive care unit admission. However, the clinical course of critically ill patients may be influenced not only by viral etiology but also by acute illness severity, organ support requirements, and microbiological co-detection. This study aimed to evaluate viral etiology, organ support requirements, microbiological findings, laboratory and radiologic characteristics, and 28-day mortality in critically ill patients with PCR-confirmed respiratory viral pneumonia. Methods: This single-center, record-based observational cohort study with retrospective data extraction included adult patients admitted directly from the emergency department to a tertiary-care medical ICU with acute respiratory failure, radiographic pneumonic infiltration, and PCR-confirmed respiratory viral pneumonia. Respiratory viral PCR samples were obtained during ICU admission using nasopharyngeal swabs. The primary outcome was 28-day all-cause mortality after ICU admission. Results: Seventy-nine patients were included. The median age was 72 years, and 46 patients were male. Twenty-eight-day mortality occurred in 26 patients (32.9%). Viral etiology was heterogeneous; influenza A was the most frequent pathogen, followed by rhinovirus/enterovirus and SARS-CoV-2. No statistically significant difference was observed between survivors and non-survivors according to individual viral categories; however, viral subgroup sizes were small. Non-survivors more frequently required invasive mechanical ventilation, vasopressor support, and continuous renal replacement therapy. Respiratory-source bacterial/fungal co-detection or infection was also more frequent among non-survivors. Baseline inflammatory biomarkers and parenchymal CT patterns did not differ significantly between survivors and non-survivors. Conclusion: In this small retrospective ICU cohort of patients with PCR-confirmed respiratory viral pneumonia, 28-day mortality was substantial. Non-survivors had higher rates of organ support requirements and respiratory-source bacterial/fungal co-detection or infection, while no significant mortality difference was observed across individual viral categories. These findings should be interpreted cautiously because of the retrospective design, small viral subgroups, and potential time dependent and confounding biases.

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