Risk factors of severe adverse in-hospital outcomes in adults hospitalized for parainfluenza infections: a territory-wide study

Background While parainfluenza virus infections are common, there is relatively little data on the impact and risk factors of parainfluenza virus infection on severe in-hospital outcomes. Methods This territory-wide retrospective study elucidated the risk factors for serious in-hospital outcomes among patients hospitalized due to parainfluenza infection. Data were retrieved from the Clinical Data Analysis and Reporting System managed by the Hospital Authority, Hong Kong, from 1 January 2016 to 30 June 2023. The main outcomes of interest were: (i) death during hospitalization; (ii) severe respiratory failure requiring invasive or non-invasive mechanical ventilation; (iii) secondary bacterial pneumonia; (iv) acute kidney injury. Results 2058 adult patients were hospitalized due to parainfluenza virus infection during the study period. 87 (4.2%) patients died during the index admission, 467 (22.7%) patients developed severe respiratory failure, 1355 (65.8%) patients developed secondary bacterial pneumonia, and 625 (30.3%) patients developed acute kidney injury. Risk factors for severe in-hospital outcomes included underlying cardiopulmonary and kidney diseases (especially those receiving renal replacement therapy) and advanced age. Conclusions Important risk factors for severe in-hospital outcomes among patients with parainfluenza infections include underlying age ≥65 years, cardio-pulmonary and kidney diseases. These at-risk patients may benefit from future vaccines and antiviral drugs. Key messages What is already known on this topic: Severe in-hospital outcomes among adult patients with parainfluenza infections are common What this study adds: The risk factors for severe in-hospital outcomes include underlying age ≥ 65 years, cardio-pulmonary, and kidney diseases How this study might affect research, practice, or policy: These at-risk patients may benefit from future vaccines and antiviral drugs.