Clinical Profile, Intensive Care Needs, and Outcome of Children with Adenoviral Pneumonia: A Retrospective Study from a Tertiary Care Hospital in North India

<div xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="section"> <a class="named-anchor" id="d874711e210"> <!-- named anchor --> </a> <h5 class="section-title" id="d874711e211">Background and aims</h5> <p dir="auto" id="d874711e213">Adenoviral pneumonia is a significant cause of morbidity and mortality among children. There is limited data about the clinical profile, intensive care needs, and outcomes of children with adenoviral pneumonia from resource-limited settings. </p> </div><div xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="section"> <a class="named-anchor" id="d874711e215"> <!-- named anchor --> </a> <h5 class="section-title" id="d874711e216">Patients and methods</h5> <p dir="auto" id="d874711e218">This retrospective study was conducted in the pediatric emergency room (PER) and pediatric intensive care unit (PICU) of a tertiary care hospital in North India over a period of a period of 2 years (July 2022 to June 2024). The data collection included demographic and clinical features, laboratory investigations, complications, treatment, intensive care needs, and outcomes. </p> </div><div xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="section"> <a class="named-anchor" id="d874711e220"> <!-- named anchor --> </a> <h5 class="section-title" id="d874711e221">Results</h5> <p dir="auto" id="d874711e223">Eighty-five children were enrolled, majority were <1 year of age and males (71.7% each). All presented with fever and respiratory symptoms. The common complications were acute respiratory distress syndrome (ARDS) (47%), multiple organ dysfunction syndrome (MODS) (26%), shock (25%), and encephalopathy (25%). PICU admission was needed in 46% of children. The intensive care needs included invasive mechanical ventilation (48%), CPAP (39%), HFNC (9%), vasoactive drugs (25%), IVIG (8%), RRT (6%), and cidofovir (5%). The duration of ER, PICU, and hospital stay was 48 (24–96) hours, 7 (4–14) days, and 9 (5–18) days, respectively. The mortality rate was 22%. On multivariate analysis, the independent predictors of mortality were low admission pH, myocardial dysfunction, acute kidney (AKI), ARDS, shock, encephalopathy, MODS, and healthcare-associated infection (HCAI). </p> </div><div xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="section"> <a class="named-anchor" id="d874711e225"> <!-- named anchor --> </a> <h5 class="section-title" id="d874711e226">Conclusion</h5> <p dir="auto" id="d874711e228">Infants constituted the largest group of patients requiring admission for adenoviral infection to pediatric emergency in a tertiary care center. Common complications were ARDS, shock, MODS, and encephalopathy. Nearly half required PICU admission for organ support. The mortality rate was 22%; and low admission pH, myocardial dysfunction, AKI, ARDS, shock, encephalopathy, MODS, and HCAI were independent predictors of mortality. </p> </div><div xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="section"> <a class="named-anchor" id="d874711e230"> <!-- named anchor --> </a> <h5 class="section-title" id="d874711e231">How to cite this article</h5> <p dir="auto" id="d874711e233">Vyasam S, Jayaram J, Sarkar S, Angurana SK, Raj S, Bora I, <i>et al</i>. Clinical Profile, Intensive Care Needs, and Outcome of Children with Adenoviral Pneumonia: A Retrospective Study from a Tertiary Care Hospital in North India. Indian J Crit Care Med 2025;29(7):586–591. </p> </div>