Clinical profile and risk factors of severe adenoviral infections among hospitalised children in South India: a...

Area of Science:

• Pediatric Infectious Diseases
• Clinical Virology
• Epidemiology

Background:

• Adenoviral infections represent a major cause of childhood morbidity with diverse clinical presentations.
• Early identification of at-risk children is crucial for prompt medical intervention.

Purpose of the Study:

• To characterize the clinical profile of hospitalized children with adenoviral infections in South India.
• To identify risk factors associated with severe adenoviral infection in this pediatric cohort.

Main Methods:

• A cross-sectional study included 138 children (<13 years) with PCR-confirmed adenoviral infection (Jan-Dec 2023).
• Severe infection was defined by specific clinical criteria (e.g., severe pneumonia, shock).
• Multivariate logistic regression identified predictors of severity, with lab parameters dichotomized using ROC curves.

Main Results:

• Of 88 children without predominant co-infections, 31.8% experienced severe adenoviral infection.
• Independent predictors of severity included breathlessness, elevated procalcitonin (≥0.59 ng/mL), elevated SGOT (≥39 U/L), and low hemoglobin (≤11.0 g/dL).
• Severe cases required more respiratory support and longer hospital stays; overall mortality was 2.2%.

Conclusions:

• Approximately one-third of hospitalized children with adenoviral infections developed severe disease.
• Readily available clinical (breathlessness) and laboratory markers (procalcitonin, SGOT, hemoglobin) predict severity.
• These markers can guide closer monitoring and timely escalation of care for high-risk children.