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Hospital Outcomes Among Children With Congenital Heart Disease and Adenovirus Pneumonia

Richard Crawford1, Chary Akmyradov2, Rashmitha Dachepally3,4

  • 1From the Department of Cardiology, University of Oklahoma, Oklahoma.

The Pediatric Infectious Disease Journal
|April 2, 2024
PubMed

Insights

Adenovirus pneumonia in children with congenital heart disease has a 12.1% mortality rate. Key risk factors include being a neonate, sepsis, acute kidney failure, and specific cardiac conditions like shunts.

Area of Science:

  • Pediatric Cardiology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Adenovirus pneumonia poses a significant threat to pediatric patients, particularly those with congenital heart disease (CHD).
  • Understanding mortality risk factors and hospitalization outcomes is crucial for improving care in this vulnerable population.

Purpose of the Study:

  • To evaluate the mortality risk factors and hospitalization outcomes of adenovirus pneumonia in pediatric patients diagnosed with congenital heart disease.

Main Methods:

  • A retrospective multicenter cohort study analyzed data from the Pediatric Health Information System database (January 2004 - September 2018).
  • Congenital heart disease patients with adenovirus pneumonia were categorized into groups based on lesion type (shunts, obstructive, cyanotic, mixing).
  • Multivariate logistic regression and Mann-Whitney U tests identified mortality risk factors and compared hospital length of stay.

Main Results:

  • The overall mortality rate was 12.1%, with the highest rate (15.1%) observed in patients with shunts.
  • Independent mortality risk factors included early age (0-30 days), sepsis/shock, acute kidney failure, shunts, and cardiac catheterization.
  • Extracorporeal membrane oxygenation (ECMO) use was also significantly associated with increased mortality.

Conclusions:

  • Adenoviral pneumonia in children with CHD carries a substantial mortality risk (12.1%).
  • Identified risk factors such as neonatal status, sepsis, acute kidney failure, shunts, cardiac catheterization, and ECMO necessitate targeted interventions.
  • Nonsurvivors experienced a significantly longer hospital stay (median 47 days) compared to survivors (median 15 days).
Abstract

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