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

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

Abstract

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.

Keywords

Ethical Statement

Ethics Committee Approval: The ethics approval was granted for a broader retrospective project evaluating the clinical, radiologic, and prognostic characteristics of respiratory viral infections in patients followed in the pulmonary ward and medical ICU. The present manuscript represents an ICU-focused subgroup analysis of this ethics-approved parent cohort. The study was approved by the Marmara University Faculty of Medicine Non-Interventional Clinical Research Ethics Committee (Date: July 2025, Protocol Code: 09.2025.25-0670). The study was conducted in accordance with the Declaration of Helsinki. Informed Consent: Because the study was designed retrospectively and used routinely collected clinical data, the requirement for written informed consent was waived by the ethics committee.

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Details

Primary Language

English

Subjects

Chest Diseases, Intensive Care

Journal Section

Research Article

Authors

Erdem Yalçınkaya ^*
0000-0002-1293-3719
Türkiye

Umut Sabri Kasapoğlu
0000-0003-2869-9872
Türkiye

Hüseyin Arıkan
0000-0001-8837-2527
Türkiye

Fatma Betül Yıldırım
0009-0001-6243-597X
Türkiye

Sait Karakurt
0000-0002-6699-5798
Türkiye

Publication Date

October 25, 2026

Submission Date

May 19, 2026

Acceptance Date

September 30, 2026

Published in Issue

Year 2026 Volume: 7 Number: 5

IZ

https://izlik.org/JA88GU27SE

Cite

RIS / Bibtex

APA

Yalçınkaya, E., Kasapoğlu, U. S., Arıkan, H., Yıldırım, F. B., & Karakurt, S. (2026). Viral etiology, organ support requirements, and 28-day mortality in critically ill patients with PCR-confirmed respiratory viral pneumonia. Journal of Medicine and Palliative Care, 7(5), 1098-1110. https://izlik.org/JA88GU27SE

AMA

1.Yalçınkaya E, Kasapoğlu US, Arıkan H, Yıldırım FB, Karakurt S. Viral etiology, organ support requirements, and 28-day mortality in critically ill patients with PCR-confirmed respiratory viral pneumonia. J Med Palliat Care / JOMPAC / jompac. 2026;7(5):1098-1110. https://izlik.org/JA88GU27SE

Chicago

Yalçınkaya, Erdem, Umut Sabri Kasapoğlu, Hüseyin Arıkan, Fatma Betül Yıldırım, and Sait Karakurt. 2026. “Viral Etiology, Organ Support Requirements, and 28-Day Mortality in Critically Ill Patients With PCR-Confirmed Respiratory Viral Pneumonia”. Journal of Medicine and Palliative Care 7 (5): 1098-1110. https://izlik.org/JA88GU27SE.

EndNote

Yalçınkaya E, Kasapoğlu US, Arıkan H, Yıldırım FB, Karakurt S (October 1, 2026) Viral etiology, organ support requirements, and 28-day mortality in critically ill patients with PCR-confirmed respiratory viral pneumonia. Journal of Medicine and Palliative Care 7 5 1098–1110.

IEEE

[1]E. Yalçınkaya, U. S. Kasapoğlu, H. Arıkan, F. B. Yıldırım, and S. Karakurt, “Viral etiology, organ support requirements, and 28-day mortality in critically ill patients with PCR-confirmed respiratory viral pneumonia”, J Med Palliat Care / JOMPAC / jompac, vol. 7, no. 5, pp. 1098–1110, Oct. 2026, [Online]. Available: https://izlik.org/JA88GU27SE

ISNAD

Yalçınkaya, Erdem - Kasapoğlu, Umut Sabri - Arıkan, Hüseyin - Yıldırım, Fatma Betül - Karakurt, Sait. “Viral Etiology, Organ Support Requirements, and 28-Day Mortality in Critically Ill Patients With PCR-Confirmed Respiratory Viral Pneumonia”. Journal of Medicine and Palliative Care 7/5 (October 1, 2026): 1098-1110. https://izlik.org/JA88GU27SE.

JAMA

1.Yalçınkaya E, Kasapoğlu US, Arıkan H, Yıldırım FB, Karakurt S. Viral etiology, organ support requirements, and 28-day mortality in critically ill patients with PCR-confirmed respiratory viral pneumonia. J Med Palliat Care / JOMPAC / jompac. 2026;7:1098–1110.

MLA

Yalçınkaya, Erdem, et al. “Viral Etiology, Organ Support Requirements, and 28-Day Mortality in Critically Ill Patients With PCR-Confirmed Respiratory Viral Pneumonia”. Journal of Medicine and Palliative Care, vol. 7, no. 5, Oct. 2026, pp. 1098-10, https://izlik.org/JA88GU27SE.

Vancouver

1.Erdem Yalçınkaya, Umut Sabri Kasapoğlu, Hüseyin Arıkan, Fatma Betül Yıldırım, Sait Karakurt. Viral etiology, organ support requirements, and 28-day mortality in critically ill patients with PCR-confirmed respiratory viral pneumonia. J Med Palliat Care / JOMPAC / jompac [Internet]. 2026 Oct. 1;7(5):1098-110. Available from: https://izlik.org/JA88GU27SE