ArticleOpen forum infectious diseases2026
Acute Respiratory Failure and Ventilatory Support in Hospitalized Adults With Viral Respiratory Infection: A Retrospective Cohort Study.
Article in Open forum infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: This retrospective cohort study compares the risk and severity of acute respiratory failure (ARF) among adults hospitalized with different respiratory viruses. Methods: We included 4927 adults admitted to Akershus University Hospital, Norway, from 2012 to 2021 with polymerase chain reaction-confirmed viral infection with influenza A/B, respiratory syncytial virus (RSV), parainfluenza virus (PIV), human metapneumovirus, or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). ARF was defined as the use of high-flow oxygen, noninvasive ventilation, or mechanical ventilation during the hospital admission. Logistic regression models estimated adjusted probabilities of respiratory failure and ventilatory support, using influenza A/B as the reference, with adjustment for age, sex, National Early Warning Score 2 (NEWS2), weighted Charlson Comorbidity Index, and other covariates. Results: Overall, 11.8% of patients (n = 583) met the criteria for ARF. Compared with influenza A/B, all other virus groups except human metapneumovirus were associated with a higher adjusted probability of ARF. SARS-CoV-2 showed the highest risk, followed by PIV and RSV (all Conclusions: SARS-CoV-2, PIV, and RSV were associated with increased risk of ARF in hospitalized adults compared with influenza A/B. SARS-CoV-2 strains circulating during the early pandemic showed the greatest risk, while RSV and PIV also conferred a substantial excess ARF risk. These findings underscore the need for clinical vigilance and preventive strategies in patients admitted with viral respiratory tract infections.
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