Clinical Features and Radiological Findings of Adenovirus Pneumonia Associated with Progression to Acute Respiratory Distress Syndrome: A Single Center Study in 19 Adult Patients

Jae, Min; Chung, Myung Jin; Lee, Kyung Soo; Kim, Tae Jung; Chong, Semin; Han, Jungho

doi:10.3348/kjr.2016.17.6.940

Cited by 27 publications

(25 citation statements)

References 29 publications

(34 reference statements)

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“…Even if mortality results or clinical outcome of Adv infection could be affected by selection bias, it has been reported that Adv infection may be severe with a higher incidence of progression to respiratory and multiorgan failure compared to other viral etiologies with the exception of influenza. Thus, some clinical data have been reported regarding predictive factors of respiratory failure associated with Adv infection [18,19].…”

Section: Introductionmentioning

confidence: 99%

Characteristics of fever and response to antipyretic therapy in military personnel with adenovirus-positive community-acquired pneumonia

Yoo

Park

2020

Military Med Res

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Background: In 2014, an outbreak of adenoviral pneumonia occurred in the Korean military training center. However, there are limited data on the characteristics of the fever and its response to antipyretic therapy in immunocompetent adults with adenovirus-positive community-acquired pneumonia (CAP). Methods: The medical records of the patients who were admitted to the Armed Forces Chuncheon Hospital for the treatment of CAP between January 2014 and December 2016 were retrospectively analyzed. The patients were divided into three groups, namely, the adenovirus-positive (Adv) group, the adenovirus-negative (Non-Adv) group and the unknown pathogen group, according to the results of a polymerase chain reaction (PCR) test and sputum culture used to measure adenovirus and other bacteria or viruses in respiratory specimens. We evaluated and compared the demographics, clinicolaboratory findings and radiological findings upon admission between the two groups. Results: Out of the 251 military personnel with CAP during the study periods, 67 were classified into the Adv group, while 134 were classified into the Non-Adv group and 50 were classified into the unknown pathogen group. The patients in the Adv group had a longer duration of fever after admission (3.2 ± 1.6 vs. 1.9 ± 1.2 vs. 2.2 ± 1.5 days, P = 0.018) and symptom onset (5.8 ± 2.2 vs. 3.9 ± 2.5 vs. 3.7 ± 2.0 days, P = 0.006) than patients in the Non-Adv and unknown pathogen groups, respectively. The patients in the Adv group had a higher mean temperature at admission (37.8 ± 0.3 vs. 37.3 ± 0.3 vs. 37.3 ± 0.3, P = 0.005), and more patients were observed over 40 and 39 to 40(14.9% vs. 2.2% vs. 4.0%, 35.8% vs. 3.7% vs. 6.0%, P < 0.001) than those in the Non-Adv and unknown pathogen groups, respectively. The Adv group more commonly had no response or exhibited adverse events after antipyretic treatment compared to the Non-Adv group (17.9% vs. 1.5%, 35.0% vs. 4.3%, P < 0.001, P = 0.05, respectively). In addition, the time from admission to overall clinical stabilization was significantly longer in the patients in the Adv group than in those in the Non-Adv group (4.3 ± 2.8 vs. 2.9 ± 1.8 days, P = 0.034, respectively). Furthermore, no significant difference in the length of hospital stay was observed between the two groups, and no patient died in either group. Conclusion: In this study, Adv-positive CAP in immunocompetent military personnel patients had distinct fever characteristics and responses to antipyretic treatment.

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Section: Introductionmentioning

confidence: 99%

Characteristics of fever and response to antipyretic therapy in military personnel with adenovirus-positive community-acquired pneumonia

Yoo

Park

2020

Military Med Res

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“…Similar to other acute lung injuries, fibrosis is thought to be the result of resolution [14,15]. Fibrosis in the early stages, assuming all of the patients to be in an early stage of infection who underwent initial CT scans from the symptom onset with a mean interval of 5 ± 3 days, may be associated with good prognosis in early chest CT examinations.…”

Section: Discussionmentioning

confidence: 99%

Correlation between CT findings and outcomes in 46 Patients with Coronavirus Disease-19

Lei

et al. 2020

Preprint

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Purpose: The aim of this study was to retrospectively analyze chest Computed Tomography (CT) findings in COVID-19 pneumonia and identify features associated with poor prognosis.Methods: This retrospective review included 46 patients with RT-PCR confirmed COVID-19 infection. Basic clinical characteristics and detailed CT features were evaluated and compared between patients who recovered (n = 40) from coronavirus and those who expired (n = 6). Chest CT examinations for ground-glass opacity, crazy-paving pattern, consolidation, and fibrosis were scored by two reviewers. The total CT score comprised the sum of lung involvement (5 lobes, scores 1-5 for each lobe, range; 0, none; 25, maximum) was determined.Results: We analyzed clinical data from 46 patients (26 males and 20 females; age 9-82 years) with confirmed COVID-19 pneumonia were evaluated. The chest CTs showed 27 (58.7%) patients had ground-glass opacity, 19 (41.3%) had ground glass and consolidation, and 35 (76.1%) patients had crazy-paving pattern. None of the patients who expired had fibrosis, in contrast to six (15%) patients who recovered from coronavirus. Most patients had subpleural lesions (89.0%), bilateral (87.0%) and lower (93.0%) lung lobe involvement. Diffuse lesions were present in four (67%) patients who succumbed to coronavirus, but only one (2.5%) patient who recovered (p = 0.000). CT identified a greater area of lung lobe involvement in patients who died (p = 0.000). In the group of patients who expired, the total CT score was higher than that of the recovery group (17.2 ± 7.8 vs. 7.1 ± 4.3, p = 0.005). Patients in the death group had lower lymphocyte count and higher C-reactive protein than those in the recovery group (p = 0.011 and p = 0.041, respectively).Conclusion: The CT of patients with COVID-19 mainly showed ground-glass opacity and ground-glass opacity plus consolidation, with a peripheral lower lobe preference. Early fibrosis may correlate with well prognosis. Lymphopenia, elevated C-reactive protein, and high CT score in conjunction with diffuse distribution of lung lesions are indicative of disease severity and short- term mortality.

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“…In recent years, the incidence of immunocompetent adults has gradually increased and was reported to account for 1-7% of adult respiratory infections [4] . However, most cases are reported sporadically while the clinical and radiological reports of adult community-acquired adenovirus pneumonia was limited [5] .The purpose of the present study was to summary clinical and CT characteristics of community-acquired adenovirus pneumonia in immunocompetent adults.…”

Section: Introductionmentioning

confidence: 95%

Clinical and CT Findings of Adenovirus Pneumonia in Immunocompetent Adults, a Two-center Retrospectively Observation

Zhang

Liu

Zhang

et al. 2020

Preprint

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Background: Adenovirus pneumonia account for 5%–10% of respiratory tract infections in children. However, it is rarely observed in immunocompetent patients. We sought to describe clinical and CT characteristics of community-acquired Adenovirus pneumonia in immunocompetent adults.Methods: 20 patients with clinically diagnosed adenovirus pneumonia from two hospitals were retrospectively included from January 2018 to December 2019. Medical records and chest CT of all patients were reviewed and summarized.Results: A total of 20 patients who were consisted of 18 men and 2 women with a median age of 36 years-old (range, 18-48). The clinical findings of patients with adenovirus pneumonia is high fever (>39oC) with the normal white blood cell (WBC) count and decreased Lymphocyte and elevated C-reactive protein. 10 cases complicated with mycoplasma infection when admission. Staphylococcus epidermidis was found in blood culture of 2 patients. CT findings included consolidation in all patients, ground glass opacity (GGO) in 13 patients, and pleural effusion in 12 patients. 13 patients were mechanically ventilated and 2 patients died during hospitalization.Conclusions: The most frequent finding of adenovirus pneumonia on CT was consolidation in the early stage. In adult patients with high fever, normal WBC count and decreased Lymphocyte, consolidation with/without GGO in the early stage may be a clue for suspecting adenovirus pneumonia.

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Clinical Features and Radiological Findings of Adenovirus Pneumonia Associated with Progression to Acute Respiratory Distress Syndrome: A Single Center Study in 19 Adult Patients

Cited by 27 publications

References 29 publications

Characteristics of fever and response to antipyretic therapy in military personnel with adenovirus-positive community-acquired pneumonia

Characteristics of fever and response to antipyretic therapy in military personnel with adenovirus-positive community-acquired pneumonia

Correlation between CT findings and outcomes in 46 Patients with Coronavirus Disease-19

Clinical and CT Findings of Adenovirus Pneumonia in Immunocompetent Adults, a Two-center Retrospectively Observation

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