Zheng Lingling, Liao Weiyao, Liang Feng, Li Kuanrong, Li Ling, Liang Huiying
Clinical Data Center, The Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
Front Pediatr. 2021 Nov 15;9:599500. doi: 10.3389/fped.2021.599500. eCollection 2021.
To identify the differences of clinical characteristics and outcomes of severe pneumonia in children under 5 years old with and without adenovirus infection. A retrospective cohort study was conducted in three pediatric hospitals in Guangzhou, China. In total, 1,595 children under the age of 5 with WHO-defined severe pneumonia had adenovirus testing performed between January 1, 2009 and December 31, 2019. Demographics, complications, the first routine laboratory findings, therapeutic records, and clinical outcome were collected from electronic medical records. We compared characteristics of children with and without adenovirus infection. Adenovirus was detected in 75 (4.7%) out of 1,595 children with severe pneumonia. Cases with adenovirus infection were more likely to be boys (74.7 vs. 63.0%), older than 1 year old (78.7 vs. 25.1%), but less likely to have mixed virus infections (25.3 vs. 92.9%) and combined with cardiovascular disease (12.0 vs. 39.7%), and had more abnormal laboratory results than cases without adenovirus infection. Antiviral therapy (4.9%) was rarely used in children with severe pneumonia, but antibiotic therapy (65.3%) was commonly used, especially in cases with adenovirus infection (91.9%). Children infected with adenovirus (9.3 vs. 2.5%) were also hospitalized longer and had a higher mortality within 30 days of hospitalization. Children with severe pneumonia under 5 years old with adenovirus infection had more abnormal laboratory findings and more severe clinical outcomes than cases without adenovirus infection. More attention should be focused on the harm caused by adenovirus infection.
为了确定5岁以下患重症肺炎的儿童有无腺病毒感染时临床特征及预后的差异。在中国广州的三家儿科医院进行了一项回顾性队列研究。2009年1月1日至2019年12月31日期间，共有1595名5岁以下符合世界卫生组织定义的重症肺炎儿童接受了腺病毒检测。从电子病历中收集人口统计学资料、并发症、首次常规实验室检查结果、治疗记录及临床结局。我们比较了有和没有腺病毒感染儿童的特征。1595名重症肺炎儿童中有75名（4.7%）检测出腺病毒。腺病毒感染病例更可能为男孩（74.7%对63.0%）、年龄大于1岁（78.7%对25.1%），但混合病毒感染（25.3%对92.9%）及合并心血管疾病（12.0%对39.7%）的可能性较小，且实验室检查结果异常比无腺病毒感染的病例更多。重症肺炎儿童很少使用抗病毒治疗（4.9%），但常用抗生素治疗（65.3%），尤其是腺病毒感染病例（91.9%）。感染腺病毒的儿童住院时间也更长，住院30天内死亡率更高。5岁以下患重症肺炎且感染腺病毒的儿童比未感染腺病毒的病例有更多异常实验室检查结果及更严重的临床结局。应更多关注腺病毒感染造成 的危害。
