Clinical characteristics and epidemiological analysis of respiratory adenovirus infection in hospitalized children

OBJECTIVE: To investigate the clinical characteristics and epidemiology of human adenovirus (HAdV) infection in the respiratory tract of children,, and to provide evidence for the diagnosis, treatment, prevention and control of HAdV infection in this area. METHODS: Retrospective analysis was conducted on data from 91 children with HAdV infection admitted to the Department of Infection at Xiamen Children's Hospital between June 1, 2023, and May 31, 2024. The study analyzed the clinical characteristics, epidemiology, laboratory examination results, and co-infections among these children. RESULTS: Among a total of 772 cases of respiratory tract infections examined, HAdV infection was detected in 91 cases with a detection rate of 11.8%. The prevalence peaked during summer and winter months with February (24%) and August (22.5%) having the highest detection rates respectively. HAdV was found across all age groups with a median age of five years and two months; however, children aged ≥ 5 years had the highest detection rate at 27.5% (49/178). Acute upper respiratory tract infection accounted for most common clinical manifestations (48 cases or 52.7%), followed by bronchial pneumonia (26 cases or28 .6%)and acute bronchitis(17casesor18 .7%). Recurrent high fever was identified as the most common clinical symptom observed. Adenovirus serotyping was performed on twenty-six out of ninety-one cases revealing that all were adenovirus type three infections. Co-infection with other pathogens occurred in thirty-four cases (37 .4%), particularly prevalent among younger children (< 5 years old). Peripheral blood white blood cell count(WBC), C-reactive protein(CRP), NE%,and procalcitonin(PCT) levels were significantly higher in patients with single HAdV infections compared to those with mixed infections (P < 0 .05). CONCLUSIONS: HAdV is a common pathogen causing respiratory tract infection in children. It can occur in children of all ages. However, this study suggests that the population susceptible to HAdV may change significantly. Older children may become the key population for HAdV infection, while younger children are more prone to mixed infections. Some HAdV patients show significantly elevated inflammatory markers, which is believed to be related to the adenovirus-induced inflammatory response.