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

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. 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. 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. 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. 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.