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Vol. 3 No. 1 (2026)

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August 25, 2026
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August 26, 2026

Copyright (c) 2026 Hassan Ali Kaseb, Khalid Jadaan Alotaibi, Hassan Hasser Hassan Hassany, Riyadh Hassan Kaabi, Alhammadi, Omar Muteb, Shoroug Hamoud AlSawadi, Shaima Mohammed Madkhali, Rawan Bader Almutairi, Abdulaziz Mohammad Al Zahrani, Reem Morfoua Alshammari, Moneerah Shaman Fahid Aljuhani, Alaa Abdullatief Alduraihm

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Severe Acute Respiratory Failure Associated with Viral Respiratory Infections: A Multidisciplinary Approach to Diagnosis, Pharmacotherapy, Respiratory Support, and Critical Care Management

https://doi.org/10.64483/202631760
Hassan Ali Kaseb
Jazan University, Saudi Arabia
Khalid Jadaan Alotaibi
Medical City, King Saud University, King Khalid University Hospital, Saudi Arabia
Hassan Hasser Hassan Hassany
Public Health Authority, Jazan, Saudi Arabia
Riyadh Hassan Kaabi
King Abdullah bin Abdulaziz University Hospital, Riyadh,Ministry of Health , Saudi Arabia
Alhammadi, Omar Muteb
Azm Center, Riyadh, Ministry of Interior, Saudi Arabia
Shoroug Hamoud AlSawadi
King Abdulaziz Airbase Hospital,Ministry of Health , Saudi Arabia
Shaima Mohammed Madkhali
Jazan Health Cluster,Ministry of Health , Saudi Arabia
Rawan Bader Almutairi
Medical Cities Operation Program,Ministry of Health , Saudi Arabia
Abdulaziz Mohammad Al Zahrani
Prince Sultan Military Medical City, Riyadh,Ministry of Health , Saudi Arabia
Reem Morfoua Alshammari
Maternity and Children Hospital, Hafar Al-Batin,Ministry of Health , Saudi Arabia
Moneerah Shaman Fahid Aljuhani
Hafar Al-Batin Health Cluster, Maternity and Children Hospital,Ministry of Health , Saudi Arabia
Alaa Abdullatief Alduraihm
Thadiq General Hospital, Riyadh,Ministry of Health , Saudi Arabia

Corresponding Author(s) : Hassan Ali Kaseb

Memo245@gmail.com

Saudi Journal of Medicine and Public Health, Vol. 3 No. 1 (2026)

Abstract

Background: Severe acute respiratory failure caused by respiratory viruses is an important cause of intensive care unit admission and is associated with substantial morbidity and mortality. Advances in molecular diagnostics have increased the detection of respiratory viruses in lower respiratory tract infections, while also highlighting challenges in distinguishing true viral disease from asymptomatic carriage and bacterial-viral co-infection. Respiratory viruses can cause direct epithelial injury, dysregulated inflammation, alveolar damage, and systemic complications.


Aim: This narrative review aimed to summarize current evidence on the epidemiology, molecular diagnosis, pathophysiology, clinical consequences, outcomes, treatment, and prevention of severe respiratory viral infections causing acute respiratory failure in immunocompetent adults.


Methods: A narrative review of published clinical and experimental evidence was conducted. The review focused on respiratory viruses causing community-acquired severe respiratory infections in immunocompetent adults, excluding SARS-CoV-2 and herpesviruses. Evidence concerning molecular diagnostic techniques, respiratory support, antiviral therapy, immunomodulation, outcomes, and vaccination was synthesized.


Results: Multiplex PCR has improved detection of respiratory viruses and bacterial-viral co-infections, with reported viral detection rates varying according to the population and sampling method. Influenza, respiratory syncytial virus, and human metapneumovirus are important causes of severe disease. Viral epithelial injury, cell death, immune dysregulation, and diffuse alveolar damage contribute to respiratory failure. Bacterial co-infections and cardiovascular complications further increase mortality. Management remains primarily supportive, although oseltamivir remains central for severe influenza. Evidence for corticosteroids in viral pneumonia is limited and inconsistent. Vaccination provides an important strategy for reducing severe disease, particularly among older adults.


Conclusion: Respiratory viruses represent important causes of severe acute respiratory failure. Early molecular diagnosis, appropriate respiratory support, pathogen-directed treatment, prevention of co-infections, and vaccination are central to improving outcomes.

Keywords

Respiratory viruses; acute respiratory failure; viral pneumonia; intensive care unit; multiplex PCR; influenza; respiratory syncytial virus; antiviral therapy; vaccination.
Kaseb, H. A., Khalid Jadaan Alotaibi, Hassan Hasser Hassan Hassany, Riyadh Hassan Kaabi, Alhammadi, Omar Muteb, Shoroug Hamoud AlSawadi, … Alaa Abdullatief Alduraihm. (2026). Severe Acute Respiratory Failure Associated with Viral Respiratory Infections: A Multidisciplinary Approach to Diagnosis, Pharmacotherapy, Respiratory Support, and Critical Care Management. Saudi Journal of Medicine and Public Health, 3(1), 86–102. https://doi.org/10.64483/202631760
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