Epidemiology , clinical characteristics, and prognostic factors of atopic children hospitalised for adenovirus infection

Background Atopy may be associated with the severity of disease and poor prognosis after adenovirus (Adv) infection in children. Our aim was to observe the clinical characteristics and pulmonary radiological changes in atopic children with Adv pneumonia in China. Methods Children hospitalised for Adv pneumonia from June 2018 to Dec 2019 were analysed. All children were divided into three groups: atopic with Adv, non-atopic with Adv, and atopic without Adv infection. Each group was further divided into mild or severe infection groups according to disease severity. Standard treatment was initiated after admission and regular follow-up evaluations were conducted at 1 month after discharge. Baseline and clinical characteristics, and pulmonary radiological changes of atopic and non-atopic children were collected. Risk factors associated with small airway diseases in Adv pneumonia patients were analyzed. Results Compared with non-atopic children with Adv infection, the cases of eosinophilic granulocyte count were significantly higher in atopic children than non-atopic children (P < 0.05). Among children with mild and severe infection, the number of patients with wheezing and small airway disease as observed by high-resolution computed tomography (HRCT) was significantly higher in atopic children than non-atopic children (P < 0.05). Furthermore, coughing was more severe in atopic children than non-atopic children (P < 0.05). A family history of asthma (OR 2.1 [95% CI 1.8–3.0]), personal history of asthma (OR 2.7 [95% CI 2.1–3.1]), atopy (OR 2.1 [95% CI 1.8–3.2]), severe infection (OR 1.9 [95% CI 1.0–2.7]), and Adv infection (OR 1.4, [95% CI 0.9–2.0]) were independent factors associated with the development of small airway disease, both after admission and a month after discharge. Conclusions Atopic children with Adv infection experience more severe coughing during hospitalisation and are prone to wheezing and small airway disease on the HRCT. Family and personal history of asthma, atopy, severe infection, and Adv infection were independent factors associated with the development of small airway disease on the chest HRCT scan.