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Published in: BMC Infectious Diseases 1/2021

Open Access 01-12-2021 | Adenovirus | Research article

Adenovirus viremia may predict adenovirus pneumonia severity in immunocompetent children

Authors: Ruimu Zhang, Hongmei Wang, Shufeng Tian, Jikui Deng

Published in: BMC Infectious Diseases | Issue 1/2021

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Abstract

Background

Previous studies have demonstrated an association between adenovirus viremia and disease severity in immunocompromised children. However, few studies have focused on this association in immunocompetent children. This study explored the association between adenovirus viremia and adenovirus pneumonia severity in immunocompetent children.

Methods

We performed a retrospective, observational study of immunocompetent children with adenovirus pneumonia admitted to Shenzhen Children’s Hospital in Shenzhen, China. Pneumonia was classified as severe or mild based on the Chinese guideline for the classification of pneumonia severity. Serum samples from all the children included in the study were tested for adenovirus DNA with a quantitative polymerase chain reaction. Clinical manifestations, laboratory examinations, and disease severity were compared between children with severe and mild pneumonia.

Results

A total of 111 immunocompetent children with adenovirus pneumonia (60 severe, 51 mild) were included. The median age was 40 months, and 64 patients were male. Five patients were admitted to the intensive care unit, and two underwent endotracheal intubation. All patients were discharged after recovery or improvement. Univariate analysis and binary logistic regression analysis showed that leukocytosis (OR = 1.1; 95% CI: 1.0 to 1.2; P = 0.033), co-infection with Mycoplasma pneumoniae (OR = 5.0; 95% CI: 2.1 to 12.3; P <  0.001), and high blood viral load (OR = 1.5; 95% CI: 1.2 to 2.0; P = 0.001) may be risk factors for severe adenovirus pneumonia.

Conclusions

Leukocytosis, co-infection with Mycoplasma pneumoniae, and high blood viral load may be risk factors for severe adenovirus pneumonia in immunocompetent children. Blood viral load may predict pneumonia severity.
Literature
1.
go back to reference Munoz FM, Piedra PA, Demmler GJ. Disseminated adenovirus disease in immunocompromised and immunocompetent children. Clin Infect Dis. 1998;27:1194–200.CrossRef Munoz FM, Piedra PA, Demmler GJ. Disseminated adenovirus disease in immunocompromised and immunocompetent children. Clin Infect Dis. 1998;27:1194–200.CrossRef
2.
go back to reference Lankester AC, van Tol MJ, Claas EC, Vossen JM, Kroes AC. Quantification of adenovirus DNA in plasma for management of infection in stem cell graft recipients. Clin Infect Dis. 2002;34:864–7.CrossRef Lankester AC, van Tol MJ, Claas EC, Vossen JM, Kroes AC. Quantification of adenovirus DNA in plasma for management of infection in stem cell graft recipients. Clin Infect Dis. 2002;34:864–7.CrossRef
3.
go back to reference Lion T, Baumgartinger R, Watzinger F, et al. Molecular monitoring of adenovirus in peripheral blood after allogeneic bone marrow transplantation permits early diagnosis of disseminated disease. Blood. 2003;102:1114–20.CrossRef Lion T, Baumgartinger R, Watzinger F, et al. Molecular monitoring of adenovirus in peripheral blood after allogeneic bone marrow transplantation permits early diagnosis of disseminated disease. Blood. 2003;102:1114–20.CrossRef
4.
go back to reference Echavarria M, Forman M, van Tol MJ, Vossen JM, Charache P, Kroes AC. Prediction of severe disseminated adenovirus infection by serum PCR. Lancet. 2001;358:384–5.CrossRef Echavarria M, Forman M, van Tol MJ, Vossen JM, Charache P, Kroes AC. Prediction of severe disseminated adenovirus infection by serum PCR. Lancet. 2001;358:384–5.CrossRef
5.
go back to reference Leruez-Ville M, Minard V, Lacaille F, et al. Real-time blood plasma polymerase chain reaction for management of disseminated adenovirus infection. Clin Infect Dis. 2004;38:45–52.CrossRef Leruez-Ville M, Minard V, Lacaille F, et al. Real-time blood plasma polymerase chain reaction for management of disseminated adenovirus infection. Clin Infect Dis. 2004;38:45–52.CrossRef
6.
go back to reference National Health Commission of China. Guideline for diagnosis and treatment of adenovirus pneumonia in children (2019 version). Chin J Clin Infect Dis. 2019;12:161–6. National Health Commission of China. Guideline for diagnosis and treatment of adenovirus pneumonia in children (2019 version). Chin J Clin Infect Dis. 2019;12:161–6.
7.
go back to reference National Health Commission of China. Guideline for diagnosis and treatment of community-acquired pneumonia in Children (2019 version). Chin J Clin Infect Dis. 2019;12:6–13. National Health Commission of China. Guideline for diagnosis and treatment of community-acquired pneumonia in Children (2019 version). Chin J Clin Infect Dis. 2019;12:6–13.
8.
go back to reference Xie L, Zhang B, Zhou J, et al. Human adenovirus load in respiratory tract secretions are predictors for disease severity in children with human adenovirus pneumonia. Virol J. 2018;15:123.CrossRef Xie L, Zhang B, Zhou J, et al. Human adenovirus load in respiratory tract secretions are predictors for disease severity in children with human adenovirus pneumonia. Virol J. 2018;15:123.CrossRef
9.
go back to reference Schjelderup NH, Nordbo SA, Krokstad S, Dollner H, Christensen A. Human adenovirus in nasopharyngeal and blood samples from children with and without respiratory tract infections. J Clin Virol. 2019;111:19–23.CrossRef Schjelderup NH, Nordbo SA, Krokstad S, Dollner H, Christensen A. Human adenovirus in nasopharyngeal and blood samples from children with and without respiratory tract infections. J Clin Virol. 2019;111:19–23.CrossRef
10.
go back to reference Song E, Wang H, Leber A, Jaggi P. Human adenovirus (HAdV) Viremia in Immunocompetent children with HAdV infection in respiratory specimens: does Viremia predict severity of illness? Open Forum Infect Dis. 2017;4(Suppl 1):S358.CrossRef Song E, Wang H, Leber A, Jaggi P. Human adenovirus (HAdV) Viremia in Immunocompetent children with HAdV infection in respiratory specimens: does Viremia predict severity of illness? Open Forum Infect Dis. 2017;4(Suppl 1):S358.CrossRef
11.
go back to reference Shike H, Shimizu C, Kanegaye J, Foley JL, Burns JC. Quantitation of adenovirus genome during acute infection in normal children. Pediatr Infect Dis J. 2005;24:29–33.CrossRef Shike H, Shimizu C, Kanegaye J, Foley JL, Burns JC. Quantitation of adenovirus genome during acute infection in normal children. Pediatr Infect Dis J. 2005;24:29–33.CrossRef
12.
go back to reference Gu L, Qu J, Sun B, Yu X, Li H, Cao B. Sustained Viremia and high viral load in respiratory tract secretions are predictors for death in Immunocompetent adults with adenovirus pneumonia. PLoS One. 2016;11:e160777. Gu L, Qu J, Sun B, Yu X, Li H, Cao B. Sustained Viremia and high viral load in respiratory tract secretions are predictors for death in Immunocompetent adults with adenovirus pneumonia. PLoS One. 2016;11:e160777.
13.
go back to reference Chuang Y, Chiu CH, Wong KS, et al. Severe adenovirus infection in children. J Microbiol Immunol Infect. 2003;36:37–40.PubMed Chuang Y, Chiu CH, Wong KS, et al. Severe adenovirus infection in children. J Microbiol Immunol Infect. 2003;36:37–40.PubMed
14.
go back to reference Miao H, Rong L, Zhou F. Risk factors for poor prognosis in children with severe adenovirus pneumonia. Chin J Contemp Pediatr. 2017;19:159–62. Miao H, Rong L, Zhou F. Risk factors for poor prognosis in children with severe adenovirus pneumonia. Chin J Contemp Pediatr. 2017;19:159–62.
15.
go back to reference Mingyue L, Linying G, Dong Q, et al. Clinical analysis of children in hospital with adenovirus pneumonia in Beijing from 2015 to 2016. Chin J Exp Clin Virol. 2018;32:62–5. Mingyue L, Linying G, Dong Q, et al. Clinical analysis of children in hospital with adenovirus pneumonia in Beijing from 2015 to 2016. Chin J Exp Clin Virol. 2018;32:62–5.
16.
go back to reference Cimolai N, Wensley D, Seear M, Thomas ET. Mycoplasma pneumoniae as a cofactor in severe respiratory infections. Clin Infect Dis. 1995;21:1182–5.CrossRef Cimolai N, Wensley D, Seear M, Thomas ET. Mycoplasma pneumoniae as a cofactor in severe respiratory infections. Clin Infect Dis. 1995;21:1182–5.CrossRef
17.
go back to reference Gao J, Xu L, Xu B, Xie Z, Shen K. Human adenovirus Coinfection aggravates the severity of mycoplasma pneumoniae pneumonia in children. BMC Infect Dis. 2020;20:420.CrossRef Gao J, Xu L, Xu B, Xie Z, Shen K. Human adenovirus Coinfection aggravates the severity of mycoplasma pneumoniae pneumonia in children. BMC Infect Dis. 2020;20:420.CrossRef
Metadata
Title
Adenovirus viremia may predict adenovirus pneumonia severity in immunocompetent children
Authors
Ruimu Zhang
Hongmei Wang
Shufeng Tian
Jikui Deng
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2021
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-021-05903-4

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