Lower respiratory infections by adenovirus in children. Clinical features and risk factors for bronchiolitis obliterans and mortality

P Murtagh, V Giubergia, D Viale, G Bauer… - Pediatric …, 2009 - Wiley Online Library
P Murtagh, V Giubergia, D Viale, G Bauer, HG Pena
Pediatric pulmonology, 2009Wiley Online Library
Adenovirus (Ad) respiratory infections have a profound impact in Argentina. Severe chronic
disease and a high mortality rate are observed in children after acute lower respiratory
infections (ALRI) by Ad. Methods A retrospective observational study was performed to
describe clinical characteristics and to analyze risk factors for bronchiolitis obliterans (BO)
and death in 415 children hospitalized with ALRI caused by Ad from March 1988 to May
2005. Results Mean age of patients was 10.7 months (±9.2) Overall 80% of patients were …
Abstract
Adenovirus (Ad) respiratory infections have a profound impact in Argentina. Severe chronic disease and a high mortality rate are observed in children after acute lower respiratory infections (ALRI) by Ad.
Methods
A retrospective observational study was performed to describe clinical characteristics and to analyze risk factors for bronchiolitis obliterans (BO) and death in 415 children hospitalized with ALRI caused by Ad from March 1988 to May 2005.
Results
Mean age of patients was 10.7 months (±9.2) Overall 80% of patients were healthy before ALRI. Forty‐nine percent recovered, sequelae were observed in 36% and 15% died. Independent risk factors for BO were: >30 days of hospitalization (odds ratio (OR) 27.2, 95% confidence interval (CI) 14.6–50.9), multifocal pneumonia (OR 26.6, 95% CI 5.3–132) and hypercapnia (OR 5.6, 95% CI 3.5–9). Independent risk factors for death in acute stage of disease were: mechanical assistance (OR 121, 95% CI 18.2–814), multifocal pneumonia (OR 102, 95% CI 9.5–31.1), hypercapnia (OR 42.6, 95% CI 10.2–177.1), coagulation disorders (OR 17, 95% CI 8.25–35), neurological symptoms (OR 12.7, 95% CI 3.5–6.6) and co‐infection with measles (OR 9.6, 95% CI 2.1–44.2).
Conclusions
High incidence of sequelae and mortality in previously healthy children after Ad infection was observed in a population of children from Argentina. Pediatr Pulmonol. 2009; 44:450–456. © 2009 Wiley‐Liss, Inc.
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