Journal of Pediatric Critical Care (Jan 2022)
Epidemiology, clinical presentation, and respiratory sequelae of severe adenoviral pneumonia in children admitted in a tertiary care pediatric intensive care unit from Eastern India: A single-center observational study
Abstract
Background: Adenovirus affects mainly the respiratory system, leading to life-threatening pneumonia. This study was aimed to describe the epidemiological, clinical, biochemical, and radiological profile and respiratory sequelae during follow-up among children with severe adenoviral pneumonia (ADVP) admitted in a tertiary care pediatric intensive care unit (PICU). Subjects and Methods: This is a single-center, prospective study conducted in PICU from eastern India from December 2018 to August 2021. Children less than 10 years of age, admitted with features suggestive of lower respiratory tract infection (LRTI)/pneumonia and positive for adenovirus by respiratory polymerase chain reaction during the study period were included. All children were managed symptomatically. Antibiotics were used in all children and respiratory support was given according to the severity as per standard management protocol. Results: Among 96 children with adenoviral pneumonia, 33 (34.4%) had severe ADVP and required PICU care. Among them, 28 (84.8%) were males and 24 (72.7%) had SPO2 <90% at the time of admission. Twenty (60%) children needed some respiratory support beyond simple oxygen therapy. Among 33 children, 9 (27.3%) died, 2 left against medical advice, and 22 (66.7%) survived and were discharged. Among discharged, 2 (9%) were lost in follow-up and 20 (91%) children were followed up for the next 2.5 years. During the follow-up, 18 (90%) had recurrent symptoms, and high-resolution computed tomography showed features suggestive of postinfective bronchiolitis obliterans in most of them. Conclusions: Unlike other respiratory viruses, ADVP had a longer course of illness, seemed to be more severe, and had more long-term sequelae.
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