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Clinical characteristics and potential biomarkers predicting disease progression in severe adenoviral pneumonia: A pediatric intensive care unit experience

Year: 2025

Type: article

Abstract: Background Respiratory tract infections (RTIs) are a major global threat to children, with adenovirus being a leading cause of severe RTIs in this age group. Treatment options are limited, and understanding the factors affecting mortality is essential for developing effective management strategies. This study aims to analyze adenovirus infections in critically ill children and identify biomarkers associated with a poor outcomes. Methods This prospective observational study was conducted in children aged 1 month to 14 years with severe adenoviral RTI. Demographic information and clinical data were collected; polymerase chain reaction (PCR) testing was conducted on nasopharyngeal swabs. Survival and non-survival groups were compared using the Mann-Whitney U test and independent sample t tests. Associations with outcomes were evaluated using the chi-square test, and diagnostic evaluation was conducted using receiver operating characteristics (ROC) analysis. Results In 70 children with severe adenoviral infection, common symptoms included fever, cough, and respiratory distress. Most patients required respiratory support, including invasive mechanical ventilation support. Chest radiograph findings revealed patchy infiltration and right upper lobar consolidation. Forty percent of the cases resulted in death. Children with lower hemoglobin and lymphocyte counts and higher CRP, LDH, and ferritin levels had poorer outcomes. Hemoglobin (≤9 gm/dL), serum ferritin (>897 ng/mL), and serum LDH (>1172 U/L) showed high sensitivity and specificity, making them good outcome markers. Conclusion Low hemoglobin, high serum ferritin, and high LDH in the second week are markers of disease progression and poor prognostic markers in severe adenoviral infections, emphasizing further research and targeted interventions.

Source: Clinical Epidemiology and Global Health

DOI: 10.1016/j.cegh.2025.102026

Authors: Bijay Kumar Meher, Sovesh Ranjan Behera, Sarthak Naik, Pravakar Mishra, Deepti Damayanty Pradhan

Institution: Sriram Chandra Bhanja Medical College Hospital

Language: English

Topic: Respiratory viral infections research

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,000