Relationship Between Severity Of Adenovirus Pneumonia And Viral Load In Children

Purpose:To understand the dynamic changes of adenoviral load in nasopharyngeal aspirate specimens of children with severe adenovirus pneumonia,and to explore the relationship between the two,and provide a new reference for clinical evaluationMethod:1.From April 2017 to December 2018,children admitted to the intensive care unit(PICU)of the Children's Hospital of Hunan Provincial People's Hospital for severe cases of adenovirus pneumonia were studied.2.Nasopharyngeal aspirates(NPAs)specimens were collected daily and the adenoviral DNA copy number was detected by real-time fluorescence quantitative polymerase chain reaction(RT-FQ-PCR).3.Statistical analysis was performed in combination with the status of assisted breathing,oxygenation index(P/F),PCIS score,acute respiratory distress syndrome(ARDS),and childhood organ dysfunction(MODS).Result:1.A total of 34 hospitalized children with severe adenovirus pneumonia admitted to PICU.A total of 321 NPAs were collected.The children were youngest for 5 months and the maximum was 13 years old.The age group was between 6 months and 2 years old,and 23 males.There are 11 females.Spring and summer seasons are frequent.2.By dynamically monitoring the copy number of adenovirus in NPAs of 34 children,it was found that the adenoviral load gradually increased from the 6th day of the disease,reached the peak on the 10 th day,then gradually decreased,and remained at a higher level for 3 weeks.Level.3.The comparison of 24 cases of invasive ventilation group with 9cases of non-invasive ventilation group showed that the mean copy number of adenovirus in the invasive ventilation group was higher than that in the non-invasive group(8.85±9.04 VS 8.23±8.30,P=0.04).Adenovirus copy number was different between the two groups on the fourth day of the disease course(P = 0.00).4.34 children were divided into four groups according to P/F value(>300,200~300,100~200,?100).There were differences in adenovirus copy number between the four groups(P=0.025),and 100~200 groups.More than >300 groups and 200-300 groups(P=0.042,P=0.033).5.According to the PCIS score,there were three groups(>80 points,71~80 points,?70 points).There were differences in the copy number of adenovirus in NPAs among the three groups(P=0.000).Compared with the two groups,the copy number of >80 group adenovirus was less than71 ~ 80 group and ?70 group(P=0.022,P=0.00),and there was no difference between 71~80 group and ?70 group(P= 0.84).6.ARDS occurred in 20 of the 34 patients,and the number of ADV copies in the ARDS group was higher than in those without ARDS(P =0.001).According to the diagnostic criteria of ARDS,it was divided into four groups: no,mild,moderate and severe.The copy number of adenovirus was compared between the four groups.It was found that the degree of ARDS was different,and the copy number of adenovirus was also significantly different(P=0.00).There were no significant differences between the four groups in the ARDS group and the mild and moderate group(P=0.004,P=0.000).The severe group had higher copy number than the mild group(P= 0.008).7.MODS was present in 18 of the 34 patients.The copy number of adenovirus in the combined MODS group was significantly higher than that in the non-MODS group(P=0.024).According to the number of system involvement,the number of ADV copies was also different(P=0.001).The copy number of adenovirus in one system affected group was significantly different from that in the two system groups and four system affected groups(P=0.02,P=0.05).conclusion:The adenoviral load in nasopharyngeal aspirate in children with severe adenovirus pneumonia varies with the course of the disease and is associated with the severity of the disease.