Abstract
BackgroundAtopy may be associated with disease severity and a poor prognosis of human adenovirus (HAdV) pneumonia in children. Our aim was to observe the clinical characteristics and pulmonary radiological changes in children with atopy and HAdV pneumonia in China.MethodsChildren hospitalised with HAdV pneumonia from June 2018 to December 2019 were analysed. All children were divided into atopic with HAdV, non-atopic with HAdV, and atopic without HAdV infection group. Each group was further divided into the mild and severe pneumonia groups according to disease severity. Standard treatment was initiated after admission, and regular follow-up evaluations were conducted at 1 month after discharge. Baseline and clinical characteristics and pulmonary radiological changes in children with and without atopy were evaluated. Risk factors associated with small airway lesions in patients with HAdV pneumonia were analysed.ResultsThe eosinophil count in the atopic group was significantly higher than that in the non-atopic group (P < 0.05). Severe coughing, wheezing, and small airway lesions on chest high-resolution computed tomography (HRCT) upon admission, after discharge and 1 month after discharge were significantly higher in the atopic group (with or without HAdV infection) than in the non-atopic group (P < 0.05). There were significant differences in the number of patients with wheezing and small airway lesions during hospitalisation and after discharge among the three groups (P < 0.05). The risks of small airway lesions in children with a family or personal history of asthma, severe infection, atopy, and HAdV infection were 2.1-, 2.7-, 1.9-, 2.1-, and 1.4-times higher than those in children without these characteristics, respectively.ConclusionsChildren with atopy and HAdV pneumonia may experience severe coughing in mild cases and wheezing in mild and severe cases. Children with atopy are more susceptible to the development of small airway lesions, recurrent wheezing after discharge and slower recovery of small airway lesions as observed on pulmonary imaging than non-atopic children after HAdV infection. A family or personal history of asthma, atopy, severe infection, and HAdV infection are independent risk factors associated with the development of small airway lesion as observed on chest HRCT.
Highlights
Atopy may be associated with disease severity and a poor prognosis of human adenovirus (HAdV) pneumonia in children
Because we wanted to study whether adenovirus infection could affect the severity of pneumonia and whether it could affect the prognosis of pneumonia, and want to analyze the reason for the poor prognosis of pneumonia is severity of pneumonia or atopy, 80 children with atopic and without HAdV infection were select as control group
Baseline and laboratory characteristics of children with HAdV infection and atopy and HAdV infection without atopy Of the 200 children, 62 boys and 60 girls were included in the atopic group, and 45 boys and 33 girls were included in the non-atopic group
Summary
Atopy may be associated with disease severity and a poor prognosis of human adenovirus (HAdV) pneumonia in children. Human adenovirus (HAdV) infection is a major cause of community-acquired pneumonia in infants and young children [1, 2]. Children with severe HAdV pneumonia often require hospitalisation due to more severe clinical symptom and extra-pulmonary complications. Despite continuous advancements in medical technology and increasing administration of standardised HAdV treatment, some children still have a poor prognosis; HAdV infection continues to require further attention. Previous regional studies in Singapore have shown that an HAdV type 7 infection, a severe infection requiring invasive or non-invasive ventilation, and a family or personal history of asthma were risk factors for respiratory complications [14]
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