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Serum C-reactive protein in children with adenovirus infection
Christina Appenzeller1, Roland A Ammann, Andrea Duppenthaler
1Department of Padiatrics, University of Bern, Inselspital, Switzerland.
Insights
Children with adenovirus infection show significantly higher serum C-reactive protein (CRP) levels compared to those with influenza. These elevated CRP levels in adenovirus infections suggest a strong inflammatory response, even without bacterial complications.
Area of Science:
- Pediatric infectious diseases
- Clinical immunology
- Biomarker research
Background:
- C-reactive protein (CRP) is a key inflammatory marker.
- Distinguishing viral infections like adenovirus and influenza is crucial in pediatric care.
- Understanding inflammatory responses in pediatric viral infections aids in diagnosis and management.
Purpose of the Study:
- To evaluate serum C-reactive protein (CRP) concentrations in children diagnosed with adenovirus infection.
- To compare CRP levels between children with adenovirus infection and those with influenza virus infection.
Main Methods:
- Retrospective, comparative study in a pediatric tertiary care center's Emergency Department.
- Analysis of CRP levels in 87 children with adenovirus infection and 130 with influenza.
- Patient groups were stratified by age and fever duration for comparative analysis.
Main Results:
- Children with adenovirus infection had a median CRP of 49 mg/L, significantly higher than the 9 mg/L in children with influenza (p = 0.001).
- Elevated CRP levels in adenovirus infection persisted across different age groups and fever durations.
- CRP concentrations in adenovirus infection were not correlated with illness severity, hospitalization, or mucosal involvement.
Conclusions:
- Pediatric adenovirus infection is linked to markedly elevated CRP levels, even without secondary bacterial infections.
- Adenovirus infection triggers an immediate inflammatory response comparable to invasive bacterial infections.
- CRP levels in adenovirus infection are independent of illness duration, suggesting a rapid host response.
Objectives:
(1) To evaluate serum C-reactive protein (CRP) concentrations in children with adenovirus infection, and (2) to compare CRP concentrations in adenovirus and influenza virus infection.
Patients And Methods:
Retrospective, comparative single-center study conducted in Emergency Department patients of a paediatric tertiary care center. Comparison of CRP in adenovirus infection and influenza was performed in patient groups stratified according to age and duration of fever.
Results:
In 87 children with adenovirus infection (median age, 1.5 years; interquartile range, 0.9-3.0), CRP levels of <2 mg/L, <10 mg/L, and <100 mg/L were found in 4 (4%), 12 (13%), and 66 (76%) patients, respectively. Median CRP in the children with adenovirus infection and in 130 children with influenza was 49 mg/L (21-96) and 9 mg/L (3-20), respectively (p = 0.001). A statistically significant difference remained when these 2 patient groups were stratified according to age (2 years) and duration of fever (3 days) (p <0.001). In adenovirus infection CRP concentrations were unrelated to age, duration of fever and severity of illness, as judged by the extent of mucosal involvement and by the frequency and duration of hospitalisation.
Conclusion:
Paediatric adenovirus infection is associated with substantially elevated CRP concentrations in the absence of secondary bacterial infection. CRP levels were independent of the duration of illness, indicating that adenoviruses trigger an immediate inflammatory host response resembling invasive bacterial infection.