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Liver injury and prolonged hospitalization as indicators of severity in patients with adenovirus infections.

Authors
  • Tang, Shi1
  • Qin, Ru2
  • Zhang, Dayong1
  • He, Xiaoyan1
  • Yu, Chaowen1
  • Chen, Dapeng2
  • Li, Xiaoqiang2
  • Liu, Shan3
  • 1 Newborn Screening Center/Center for Clinical Molecular Laboratory Medicine, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing Medical University affiliated Children's Hospital, 136 Zhongshan Er Road, Yuzhong District, 400014, Chongqing, China. , (China)
  • 2 Clinical Laboratory of Chongqing, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Medical University affiliated Children's Hospital, 400014, Chongqing, China. , (China)
  • 3 Newborn Screening Center/Center for Clinical Molecular Laboratory Medicine, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing Medical University affiliated Children's Hospital, 136 Zhongshan Er Road, Yuzhong District, 400014, Chongqing, China. [email protected]. , (China)
Type
Published Article
Journal
BMC Infectious Diseases
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Apr 22, 2024
Volume
24
Issue
1
Pages
430–430
Identifiers
DOI: 10.1186/s12879-024-09324-x
PMID: 38649842
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Adenovirus (ADV) is a prevalent infective virus in children, accounting for around 5-10% of all cases of acute respiratory illnesses and 4-15% of pneumonia cases in children younger than five years old. Without treatment, severe ADV pneumonia could result in fatality rates of over 50% in cases of emerging strains or disseminated disease. This study aims to uncover the relationship of clinical indicators with primary ADV infection severity, regarding duration of hospitalization and liver injury. In this retrospective study, we collected and analyzed the medical records of 1151 in-patients who met the inclusion and exclusion criteria. According to duration of hospitalization, all patients were divided into three groups. Then the difference and correlation of clinical indicators with ADV infection were analyzed, and the relationship among liver injury, immune cells and cytokines was evaluated. The study revealed that patients with a duration of hospitalization exceeding 14 days had the highest percentage of abnormalities across most indicators. This was in contrast to the patients with a hospitalization duration of either less than or equal to 7 days or between 7 and 14 days. Furthermore, correlation analysis indicated that a longer duration of body temperature of ≥ 39°C, bilateral lung lobes infiltration detected by X ray, abnormal levels of AST, PaO2, and SPO2, and a lower age were all predictive of longer hospital stays. Furthermore, an elevated AST level and reduced liver synthesis capacity were related with a longer hospital stay and higher ADV copy number. Additionally, AST/ALT was correlated positively with IFN-γ level and IFN-γ level was only correlated positively with CD4+ T cells. The study provided a set of predicting indicators for longer duration of hospitalization, which responded for primary severe ADV infection, and elucidated the possible reason for prolonged duration of hospitalization attributing to liver injury via higher ADV copy number, IFN-γ and CD4+ T cells, which suggested the importance of IFN-γ level and liver function monitoring for the patients with primary severe ADV infection. © 2024. The Author(s).

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