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腺病毒感染住院儿童重症的危险因素及胸部CT特征

Risk factors of severe conditions in hospitalized children with adenovirus infection and chest CT features.

作者信息

Wang Shaofang, Kang Shichao, Guo Lili, Zhou Shuchang, Zhao Yanjie, Shen Huifen, Jin Shourui, Guan Hanxiong, Xia Liming, Hu Qiongjie

机构信息

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Dadao 1095(#), Wuhan, 430030, People's Republic of China.

Department of Radiology, Shenzhen Maternity & Child Healthcare Hospital, Affiliated to Southern Medical University, Hongli, Shenzhen, 518028, China.

出版信息

BMC Pediatr. 2024 Dec 18;24(1):812. doi: 10.1186/s12887-024-05296-8.

Abstract

BACKGROUND

Children infected with human adenovirus (HAdV) were at particularly high risk of developing severe disease, but the risk factors of severe conditions are poorly understood.

OBJECTIVES

To explore the risk factors for developing into severe conditions in pediatric patients with HAdV infection by analyzing baseline epidemiological data, clinical characteristics, and computed tomography (CT) imaging features.

METHODS

In this retrospective study, 267 children with HAdV infection were included between October 2016 and September 2021 at Tongji Hospital, Wuhan, China. A descriptive analysis was conducted on the epidemiological and clinical data, as well as patient outcomes. CT manifestations were semi-quantitatively scored based on the presence of consolidation, ground-glass opacities, and emphysema in each lung lobe.

RESULTS

Our analysis revealed that there was a statistically significant difference in the rate of abnormalities observed on chest CT imaging (P = 0.007) and the imaging characteristics of chest CTs (P = 0.002) when comparing severe and mild cases. We found that co-infection with two or more additional pathogens occurred more frequently in severe cases. Additionally, the proportion of lymphocytes in laboratory tests was significantly lower in patients with severe conditions. Furthermore, both the proportions and scores of consolidations were markedly higher in each lung lobe among the severe cases.

CONCLUSIONS

Our findings may assist in identifying children hospitalized with HAdV who are at increased risk for severe conditions, thereby facilitating more aggressive treatment and care strategies.

摘要

背景

感染人腺病毒(HAdV)的儿童发生重症疾病的风险特别高,但重症的危险因素尚不清楚。

目的

通过分析基线流行病学数据、临床特征和计算机断层扫描(CT)影像特征,探讨HAdV感染儿科患者发展为重症的危险因素。

方法

在这项回顾性研究中,纳入了2016年10月至2021年9月在中国武汉同济医院感染HAdV的267名儿童。对流行病学和临床数据以及患者结局进行了描述性分析。根据每个肺叶实变、磨玻璃影和肺气肿的情况对CT表现进行半定量评分。

结果

我们的分析显示,比较重症和轻症病例时,胸部CT影像观察到的异常率(P = 0.007)和胸部CT的影像特征(P = 0.002)存在统计学显著差异。我们发现,重症病例中合并感染两种或更多其他病原体的情况更常见。此外,重症患者实验室检查中淋巴细胞比例显著更低。而且,重症病例各肺叶实变的比例和评分均明显更高。

结论

我们的研究结果可能有助于识别因HAdV住院且重症风险增加的儿童,从而促进更积极的治疗和护理策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3b2/11658393/8f6bd476e837/12887_2024_5296_Fig1_HTML.jpg

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