Clinical Characteristics Of 138 Cases Of Children With Adenovirus Infection

Objective:To explore the clinical features of children with adenovirus infection and risk factors of children with severe adenovirus pneumonia in Hengyang.Methods:Clinical data of children with adenovirus infection diagnosed by nasal/pharyngeal swab or airway secretions adenovirus nucleic acid test in pediatric inpatient department from January 2018 to December 2019 were retrospectively analyzed.Results:From January 2018 to December 2019,a total of 138 children with adenovirus infection were admitted to the inpatient ward in our hospital.The disease mainly occurred in May to August,and children aged1-6 years were at the age of good onset.Almost all the children had fever,mainly high fever,with an average peak of(39.7±0.52)℃.78.26%of the children developed dry cough,and 52.17%developed a small amount of sputum.70.29%of the children showed normal or slightly decreased white blood cells(15/138 cases decreased white blood cells,and 82/138cases normal white blood cells).50 children infected with adenovirus were also infected with mycoplasma.These children had higher peak fever temperature and longer hospital stay than the children with adenovirus infection alone(39.9±0.45℃vs.39.52±0.63℃,P=0.026;11.50±7.5 days vs.9.06±4.9 days,P=0.034).31.16%(43/138 cases)of the children presented severe adenovirus pneumonia.Among the CT manifestations of severe adenovirus pneumonia,10.14%(14/138 cases)of the children presented pleural effusion in the lungs.Univariate analysis found that children with severe adenovirus infection had longer fever duration and a higher incidence of dyspnea than children with normal adenovirus infection(fever duration 7.43±3.0 days vs.5.72±1.9 days,P=0.025;dyspnea rate 39.53%(17/43 cases)vs.8.42%(8/95 cases),P=0.001);had longer length of hospital stay(15.95±7.2 days vs.9.13±4.6 days,P<0.001)and higher incidence of complications(53.48%(23/43 cases)vs.16.84%(16/95 cases),P<0.001);with higher PCT value(1.41±3.3 ng/ml vs.0.26±0.4 ng/ml,P=0.045),lower white blood cell count(7.68±4.4×10~9/L vs 8.91±3.9×10~9/L,P=0.047);higher AST(66.19±56.7U/L vs 43.18±15.6U/L,P=0.013)and LDH(486.69±263.0U/L vs 324.97±105.1U/L,P=0.001).Logistic regression analysis showed that bacterial or mycoplasma infection,high PCT value,decreased white blood cells,fever duration≥1 week,plasma albumin<35 g/L,previous history of lower respiratory tract infection significantly increased the risk of severe adenovirus pneumonia.Conclusion:1.Summer is the main onset time in children with adenovirus infection and children aged 1-6 years are the main groups with high incidence.2.Combination of bacterial or mycoplasma infection,high PCT value,decreased white blood cells,fever duration of≥1 week,plasma albumin<35 g/L,previous history of lower respiratory tract infection are risk factors for severe adenovirus pneumonia.