Risk Factors for Developing Adenovirus-Associated Post-Infectious Bronchiolitis Obliterans

Area of Science:

• Pediatric Respiratory Medicine
• Infectious Diseases
• Epidemiology

Background:

• Risk factors for progression from adenovirus (AdV)-associated bronchiolitis (AdV-B) to post-infectious bronchiolitis obliterans (PIBO) are not well-established.
• Understanding these risk factors is essential for developing targeted interventions.

Purpose of the Study:

• To investigate the risk factors associated with the progression of AdV-B to PIBO in a multicenter cohort.
• To identify specific clinical and demographic characteristics that predict PIBO development.

Main Methods:

• A multicenter hospital-based analysis of children admitted with AdV-B between 2016-2022.
• A case-control study comparing AdV-PIBO patients (2005-2023) with AdV-B controls without progression.
• Multivariate logistic regression analysis was employed to identify independent risk factors.

Main Results:

• The incidence of AdV-B and AdV-PIBO admissions increased from 2016-2022.
• Jewish ethnicity (92% vs. 66%), oxygen supplementation (84% vs. 45%), noninvasive ventilation (20% vs. 4%), consolidations (44% vs. 19%), and lymphopenia (92% vs. 46%) were significantly more common in AdV-PIBO cases.
• A combination of Jewish ethnicity, lymphopenia, consolidations, and prolonged admission demonstrated high predictive values for AdV-PIBO.

Conclusions:

• The study identifies Jewish ethnicity, lymphopenia, and consolidations as significant risk factors for AdV-B progression to PIBO.
• These findings highlight the need for targeted preventive and management strategies for AdV-B.
• The association with Jewish ethnicity suggests a potential genetic predisposition to PIBO.