Retrospective Analysis Of Clinical Characteristics Of 185 Children With Adenovirus Pneumonia

Objective:Objective to investigate the clinical characteristics of adenovirus pneumonia in children,and to provide guidance for the diagnosis and treatment of adenovirus pneumonia in children.Method:Methods the clinical data of 185 children with adenovirus pneumonia hospitalized in Jiangxi Children’s Hospital from January 1,2018 to December 31,2019 were retrospectively analyzed.Objective to summarize the epidemiological,clinical,laboratory and imaging features of 185 children with adenovirus pneumonia.According to the severity of the disease,185 cases of adenovirus pneumonia were divided into severe group and common group.Result:1.Epidemiological characteristics: 185 cases of adenovirus pneumonia in children,124 boys(67.03%),61 girls(32.97%),male to female ratio 2.03:1.There were 24 cases(12.97%)from 0 to 6 months(including 6 months),89 cases(48.10%)from 6 to 24 months,22 cases(11.89%)from 24 to 36 months,36 cases(19.46%)from 36 to 60 months,and 14 cases(7.56%)greater than 60 months.There were 85cases(45.94%)in spring,58 cases(31.35%)in summer,7 cases(3.78%)in autumn and 35 cases(18.92%)in winter;There were 109 mild cases(58.91%)and 76 severe cases(41.08%).2.Clinical manifestations: among 185 cases of adenovirus pneumonia,172 cases(92.97%)had fever,177 cases(95.67%)had cough,97 cases(52.43%)had asthma,and other manifestations were shortness of breath,cyanosis,drowsiness,diarrhea,abdominal pain and rash.There was no significant difference in the constituent ratio of fever and cough between severe adenovirus pneumonia(SAP)and mild adenovirus pneumonia(P > 0.05),but there was significant difference in the constituent ratio of fever peak and cough time at admission,and the constituent ratio of fever,asthma and shortness of breath after admission(P < 0.05).3.Laboratory examination: white blood cell(WBC)of all children with adenovirus pneumonia was(3.5-10)× 85 cases(45.94%)were in the range of 109 / L.There were 95 cases(51.35%)with elevated serum C-reactive protein(CRP)and 171cases(92.43%)with elevated serum amyloid A(SAA)(χ 2=77.25,P<0.05)。There were 176 cases(95.14%)with elevated LDH,103 cases(55.68%)with elevated AST and 12 cases(6.48%)with elevated CK-MB.There was no significant difference in WBC and SAA levels between mild and severe adenovirus pneumonia children(P >0.05),but there were significant differences in serum CRP,LDH,AST and CK-MB levels(P < 0.05).In terms of pathogens,107 cases(57.84%)were infected with adenovirus alone,63 cases(34.05%)were infected with one pathogen,14 cases(7.57%)were infected with two pathogens,and 1 case(0.54%)were infected with three pathogens;Atypical pathogens(Mycoplasma pneumoniae,Chlamydia pneumoniae,Legionella)were the most common pathogens,followed by viruses,bacteria and fungi were the least.4.Lung imaging features: 25 cases(13.51%)underwent chest X-ray examination,the other 160 cases(86.49%)underwent lung CT examination.There were 23 cases(92%)of X-ray examination and 122 cases(76.52%)of CT examination.In addition,there were many imaging changes,such as pulmonary consolidation,atelectasis,pleural effusion,pulmonary bullae,subcutaneous emphysema and atelectasis.5.Bronchoscopic lavage: 77 cases(41.61%)underwent bronchoscopic lavage(BAL),which indicated endobronchial infection.Among 76 cases of sap,56 cases(73.68%)underwent BAL,and the average length of stay was(13.48%)± 65)d,and the average length of hospital stay was(16.88 4 ± The difference was statistically significant(P < 0.05).Conclusion:1.Children’s adenovirus pneumonia often occurs in the age range of June to 24 months.It occurs all the year round,especially in spring and summer.2.Fever and cough are common clinical manifestations of adenovirus pneumonia,as well as diarrhea,bloody stool,abdominal pain and rash.3.The level of WBC in peripheral blood of children with adenovirus pneumonia is normal or high,CRP level can be normal or high,SAA level is high in most children;there is no significant difference in the level of WBC and SAA between mild and severe adenovirus pneumonia,but there is significant difference in the level of CRP,LDH,AST,CK-MB.4.Most children with adenovirus pneumonia were infected with atypical pathogens,followed by virus infection.5.In addition to the basic imaging changes of pneumonia,children with adenovirus pneumonia can also have many imaging changes,such as pulmonary consolidation,atelectasis,bullae,subcutaneous emphysema,atelectasis and so on.6.Most of adenovirus pneumonia under bronchoscope is inflammatory change of intima.BAL has certain effect on the treatment of severe adenovirus pneumonia in children,and can shorten the hospitalization time of SAP children.