{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T14:40:34Z","timestamp":1769179234227,"version":"3.49.0"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"1204","license":[{"start":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T00:00:00Z","timestamp":1756166400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Important risk factors for severe in-hospital outcomes among patients with parainfluenza infections include underlying age\u2009\u226565\u00a0years, cardio-pulmonary and kidney diseases. These at-risk patients may benefit from future vaccines and antiviral drugs.<\/jats:p>\n                    <jats:p>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\u2009\u2265\u200965\u00a0years, 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/postmj\/qgaf127","type":"journal-article","created":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T11:23:40Z","timestamp":1754306620000},"page":"196-202","source":"Crossref","is-referenced-by-count":0,"title":["Risk factors of severe adverse in-hospital outcomes in adults hospitalized for parainfluenza infections: a territory-wide study"],"prefix":"10.1093","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5611-1637","authenticated-orcid":false,"given":"Wang Chun","family":"Kwok","sequence":"first","affiliation":[{"name":"Department of Medicine, The University of Hong Kong, Queen Mary Hospital , 102 Pokfulam Road, Pokfulam, Hong Kong Special Administrative Region, 999077 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelvin Kai Wang","family":"To","sequence":"additional","affiliation":[{"name":"Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong , 102 Pokfulam Road, Pokfulam, Hong Kong Special Administrative Region, 999077 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isaac Sze Him","family":"Leung","sequence":"additional","affiliation":[{"name":"Department of Statistics, The Chinese University of Hong Kong , Shatin, New Territories, Hong Kong, SAR, 999077 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun Ka","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Medicine, The University of Hong Kong, Queen Mary Hospital , 102 Pokfulam Road, Pokfulam, Hong Kong Special Administrative Region, 999077 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James Chung Man","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Medicine, The University of Hong Kong, Queen Mary Hospital , 102 Pokfulam Road, Pokfulam, Hong Kong Special Administrative Region, 999077 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David Chi Leung","family":"Lam","sequence":"additional","affiliation":[{"name":"Department of Medicine, The University of Hong Kong, Queen Mary Hospital , 102 Pokfulam Road, Pokfulam, Hong Kong Special Administrative Region, 999077 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary Sau Man","family":"Ip","sequence":"additional","affiliation":[{"name":"Department of Medicine, The University of Hong Kong, Queen Mary Hospital , 102 Pokfulam Road, Pokfulam, Hong Kong Special Administrative Region, 999077 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuk Man","family":"Ngai","sequence":"additional","affiliation":[{"name":"Department of Medicine, The University of Hong Kong, Queen Mary Hospital , 102 Pokfulam Road, Pokfulam, Hong Kong Special Administrative Region, 999077 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Desmond Yat Hin","family":"Yap","sequence":"additional","affiliation":[{"name":"Department of Medicine, The University of Hong Kong, Queen Mary Hospital , 102 Pokfulam Road, Pokfulam, Hong Kong Special Administrative Region, 999077 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,8,26]]},"reference":[{"key":"2026012308321592700_ref1","doi-asserted-by":"publisher","first-page":"2186","DOI":"10.1073\/pnas.93.5.2186","article-title":"Peptides from conserved regions of paramyxovirus fusion (F) proteins are potent inhibitors of viral fusion","volume":"93","author":"Lambert","year":"1996","journal-title":"Proc Natl Acad Sci USA"},{"key":"2026012308321592700_ref2","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1002\/jhm.13320","article-title":"The burden of RSV, hMPV, and PIV amongst hospitalized adults in the United States from 2016 to 2019","volume":"19","author":"Bhasin","year":"2024","journal-title":"J Hosp Med"},{"key":"2026012308321592700_ref3","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1056\/NEJMra1413456","article-title":"Viral bronchiolitis in children","volume":"374","author":"Meissner","year":"2016","journal-title":"N Engl J Med"},{"key":"2026012308321592700_ref4","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1056\/NEJMoa1500245","article-title":"Community-acquired pneumonia requiring hospitalization among U.S","volume":"373","author":"Jain","year":"2015","journal-title":"Adults N Engl J Med"},{"key":"2026012308321592700_ref5","doi-asserted-by":"publisher","first-page":"2738","DOI":"10.1182\/blood-2011-08-371112","article-title":"The characteristics and outcomes of parainfluenza virus infections in 200 patients with leukemia or recipients of hematopoietic stem cell transplantation","volume":"119","author":"Chemaly","year":"2012","journal-title":"Blood."},{"key":"2026012308321592700_ref6","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1093\/cid\/ciy451","article-title":"Parainfluenza virus in hospitalized adults: a 7-year retrospective study","volume":"68","author":"Russell","year":"2019","journal-title":"Clin Infect Dis"},{"key":"2026012308321592700_ref7","doi-asserted-by":"publisher","first-page":"1570","DOI":"10.1093\/cid\/cix528","article-title":"Parainfluenza virus in the hospitalized adult","volume":"65","author":"Russell","year":"2017","journal-title":"Clin Infect Dis"},{"key":"2026012308321592700_ref8","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1016\/j.pharmthera.2007.11.002","article-title":"Understanding the mechanisms of viral induced asthma: new therapeutic directions","volume":"117","author":"Hansbro","year":"2008","journal-title":"Pharmacol Ther"},{"key":"2026012308321592700_ref9","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1513\/pats.200706-064TH","article-title":"The similarities and differences of epidemic cycles of chronic obstructive pulmonary disease and asthma exacerbations","volume":"4","author":"Johnston","year":"2007","journal-title":"Proc Am Thorac Soc"},{"key":"2026012308321592700_ref10","doi-asserted-by":"publisher","first-page":"1789","DOI":"10.1111\/ajt.16383","article-title":"Burden, epidemiology, and outcomes of microbiologically confirmed respiratory viral infections in solid organ transplant recipients: a nationwide, multi-season prospective cohort study","volume":"21","author":"Mombelli","year":"2021","journal-title":"Am J Transplant"},{"key":"2026012308321592700_ref11","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00042-19","article-title":"Community-acquired respiratory viruses in transplant patients: diversity, impact, unmet clinical needs","volume":"32","author":"Ison","year":"2019","journal-title":"Clin Microbiol Rev"},{"key":"2026012308321592700_ref12","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1016\/j.jcv.2018.08.004","article-title":"Characterization of human parainfluenza virus-3 circulating in Israel, 2012-2015","volume":"107","author":"Jornist","year":"2018","journal-title":"J Clin Virol"},{"key":"2026012308321592700_ref13","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2023-064748","article-title":"Safety and immunogenicity of an mRNA-based hMPV\/PIV3 combination vaccine in seropositive children","volume":"153","author":"Schnyder","year":"2024","journal-title":"Pediatrics."},{"key":"2026012308321592700_ref14","doi-asserted-by":"publisher","first-page":"ofac206","DOI":"10.1093\/ofid\/ofac206","article-title":"Safety and immunogenicity of an mRNA-based human metapneumovirus and parainfluenza virus type 3 combined vaccine in healthy adults. Open forum","volume":"9","author":"August","year":"2022","journal-title":"Infect Dis"},{"key":"2026012308321592700_ref15","doi-asserted-by":"publisher","first-page":"1941","DOI":"10.1007\/s15010-024-02213-0","article-title":"Outcome of human parainfluenza virus infection in allogeneic stem cell transplantation recipients: possible impact of ribavirin therapy","volume":"52","author":"Perez","year":"2024","journal-title":"Infection."},{"key":"2026012308321592700_ref16","doi-asserted-by":"publisher","first-page":"2128","DOI":"10.1038\/s41564-024-01722-w","article-title":"Functional and structural basis of human parainfluenza virus type 3 neutralization with human monoclonal antibodies","volume":"9","author":"Suryadevara","year":"2024","journal-title":"Nat Microbiol"},{"key":"2026012308321592700_ref17","doi-asserted-by":"publisher","first-page":"E28","DOI":"10.1111\/tid.12045","article-title":"DAS181 treatment of severe parainfluenza type 3 pneumonia in a lung transplant recipient","volume":"15","author":"Drozd","year":"2013","journal-title":"Transpl Infect Dis"},{"key":"2026012308321592700_ref18","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1086\/653621","article-title":"A recombinant sialidase fusion protein effectively inhibits human parainfluenza viral infection in vitro and in vivo","volume":"202","author":"Moscona","year":"2010","journal-title":"J Infect Dis"},{"key":"2026012308321592700_ref19","doi-asserted-by":"publisher","first-page":"5706","DOI":"10.1016\/j.vaccine.2013.09.046","article-title":"Safety and infectivity of two doses of live-attenuated recombinant cold-passaged human parainfluenza type 3 virus vaccine rHPIV3cp45 in HPIV3-seronegative young children","volume":"31","author":"Englund","year":"2013","journal-title":"Vaccine."},{"key":"2026012308321592700_ref20","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1586\/ers.11.32","article-title":"Progress in the development of human parainfluenza virus vaccines","volume":"5","author":"Schmidt","year":"2011","journal-title":"Expert Rev Respir Med"},{"key":"2026012308321592700_ref21","doi-asserted-by":"publisher","first-page":"e143","DOI":"10.1093\/jpids\/piu104","article-title":"Evaluation of a live-attenuated human parainfluenza type 1 vaccine in adults and children","volume":"4","author":"Karron","year":"2015","journal-title":"J Pediatric Infect Dis Soc"},{"key":"2026012308321592700_ref22","doi-asserted-by":"publisher","first-page":"1077","DOI":"10.1002\/pds.5638","article-title":"Validation of diagnostic coding for bronchiectasis in an electronic health record system in Hong Kong","volume":"32","author":"Kwok","year":"2023","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"2026012308321592700_ref23","doi-asserted-by":"publisher","first-page":"315","DOI":"10.2147\/JAA.S405297","article-title":"Validation of diagnostic coding for asthma in an electronic health record system in Hong Kong","volume":"16","author":"Kwok","year":"2023","journal-title":"J Asthma Allergy"},{"key":"2026012308321592700_ref24","doi-asserted-by":"publisher","first-page":"e045868","DOI":"10.1136\/bmjopen-2020-045868","article-title":"Linking cohort-based data with electronic health records: a proof-of-concept methodological study in Hong Kong","volume":"11","author":"Gao","year":"2021","journal-title":"BMJ Open"},{"key":"2026012308321592700_ref25","doi-asserted-by":"publisher","first-page":"R204","DOI":"10.1186\/cc2872","article-title":"Acute dialysis quality initiative w. acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the second international consensus conference of the acute dialysis quality initiative (ADQI) group","volume":"8","author":"Bellomo","year":"2004","journal-title":"Crit Care"},{"key":"2026012308321592700_ref26","doi-asserted-by":"publisher","first-page":"2089","DOI":"10.1111\/j.1523-1755.2005.00365.x","article-title":"Definition and classification of chronic kidney disease: a position statement from kidney disease: Improving global outcomes (KDIGO)","volume":"67","author":"Levey","year":"2005","journal-title":"Kidney Int"},{"key":"2026012308321592700_ref27","doi-asserted-by":"publisher","first-page":"e2316376121","DOI":"10.1073\/pnas.2316376121","article-title":"Human parainfluenza virus 3 vaccine candidates attenuated by codon-pair deoptimization are immunogenic and protective in hamsters","volume":"121","author":"Afroz","year":"2024","journal-title":"Proc Natl Acad Sci USA"},{"key":"2026012308321592700_ref28","doi-asserted-by":"publisher","first-page":"1083","DOI":"10.15585\/mmwr.mm7240a2","article-title":"Disease severity of respiratory syncytial virus compared with COVID-19 and influenza among hospitalized adults aged \u226560 years - IVY Network, 20 U.S. States, February 2022-May 2023","volume":"72","author":"Surie","year":"2023","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2026012308321592700_ref29","doi-asserted-by":"publisher","first-page":"985925","DOI":"10.3389\/fimmu.2022.985925","article-title":"Editorial: immune dysfunction in nephrotic syndrome - recent advances and new roads ahead","volume":"13","author":"Seitz-Polski","year":"2022","journal-title":"Front Immunol"},{"key":"2026012308321592700_ref30","doi-asserted-by":"publisher","first-page":"S70","DOI":"10.1093\/infdis\/jiad510","article-title":"Respiratory syncytial virus-associated hospitalization in adults with comorbidities in 2 European countries: a modeling study","volume":"229","author":"Osei-Yeboah","year":"2024","journal-title":"J Infect Dis"},{"key":"2026012308321592700_ref31","doi-asserted-by":"publisher","first-page":"e13103","DOI":"10.1111\/irv.13103","article-title":"Epidemiological and clinical characteristics of respiratory syncytial virus and influenza infections in hospitalized children before and during the COVID-19 pandemic in Central China","volume":"17","author":"Ren","year":"2023","journal-title":"Influenza Other Respir Viruses"},{"key":"2026012308321592700_ref32","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1007\/s00430-021-00720-7","article-title":"Influenza and RSV incidence during COVID-19 pandemic-an observational study from in-hospital point-of-care testing","volume":"210","author":"Stamm","year":"2021","journal-title":"Med Microbiol Immunol"}],"container-title":["Postgraduate Medical Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/102\/1204\/196\/64137703\/qgaf127.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/102\/1204\/196\/64137703\/qgaf127.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T13:32:24Z","timestamp":1769175144000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/pmj\/article\/102\/1204\/196\/8241310"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,26]]},"references-count":32,"journal-issue":{"issue":"1204","published-online":{"date-parts":[[2025,8,26]]},"published-print":{"date-parts":[[2026,1,23]]}},"URL":"https:\/\/doi.org\/10.1093\/postmj\/qgaf127","relation":{},"ISSN":["0032-5473","1469-0756"],"issn-type":[{"value":"0032-5473","type":"print"},{"value":"1469-0756","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,2]]},"published":{"date-parts":[[2025,8,26]]}}}