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Risk factors for bronchiolitis obliterans complicating adenovirus pneumonia in children: a meta-analysis

Mei-Mei Yao1, Tian-Ji Gao1, Min Zhao1

  • 1Department of Rheumatology and Immunology, Baoding Hospital, Beijing Children's Hospital Affiliated to Capital Medical University, Baoding, China.

Frontiers in Pediatrics
|August 16, 2024
PubMed

Insights

This meta-analysis identified key risk factors for post-infectious bronchiolitis obliterans (PIBO) in children with adenovirus pneumonia (ADVP). Hypoxaemia, persistent wheezing, mechanical ventilation, prolonged hospital stay, and fever duration are significant predictors of PIBO.

Area of Science:

  • Pediatric Pulmonology
  • Infectious Diseases
  • Epidemiology

Background:

  • Adenovirus pneumonia (ADVP) is a common respiratory infection in children.
  • Post-infectious bronchiolitis obliterans (PIBO) is a serious complication of viral pneumonia, particularly ADVP.
  • Identifying risk factors for PIBO is crucial for early intervention and improved outcomes.

Purpose of the Study:

  • To conduct a meta-analysis to identify and preliminarily explore the risk factors for PIBO complicating ADVP in children.
  • To provide a foundation for a clinical prediction model for PIBO in pediatric ADVP patients.

Main Methods:

  • Systematic literature search of multiple English and Chinese databases up to January 1, 2023.
  • Meta-analysis of data from 10 included articles, considering 8 reported risk factors.
  • Statistical analysis performed using Stata 15.1 software.

Main Results:

  • Five significant risk factors for PIBO complicating ADVP were identified: hypoxaemia (OR=9.37), persistent wheezing (OR=4.65), mechanical ventilation (OR=3.87), length of hospital stay (LoHS) (OR=1.25), and fever duration (OR=1.08).
  • All identified risk factors showed statistically significant associations with PIBO (p < 0.001 for most).

Conclusions:

  • Hypoxaemia, persistent wheezing, mechanical ventilation, extended LoHS, and prolonged fever duration are significant risk factors for PIBO in pediatric ADVP.
  • These findings highlight the need for heightened clinical vigilance and management strategies for children with ADVP.
  • The identified factors can inform the development of a clinical prediction model to aid in preventing PIBO in this vulnerable population.
Abstract

Keywords:
adenovirus pneumoniabronchiolitis obliteranschildrenpost-infectious bronchiolitis obliterans (PIBO)risk factor

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