Clinical Manifestations and Risk Factors for Co-Infection in Children with Adenovirus Infections in Hangzhou, China

Abstract

Background: This study aimed to explore the clinical manifestations of adenovirus infections and the epidemiologic factors for subsequent co-infection in children from Hangzhou, China.Methods: In this retrospective study, the characteristics of children with adenovirus infections presenting at Hangzhou Children’s Hospital and Zhejiang Xiaoshan Hospital from January to December in 2019 were collected. The epidemiologic factors for co-infection were assessed by the multivariate logistic regression analyses. Results: A total of 5,989 children presented with adenovirus infections, of which 559 children were hospitalized for adenovirus respiratory infections. The severity of adenovirus respiratory infection was divided as follows: mild (bronchiolitis, 73.6%), moderate (bronchopneumonia, 17.6%), or severe (pneumonia, 8.8%). Of the 559 children who were hospitalized, 267 presented with co-infection, while the remaining 292 only had adenovirus infections. Multivariate logistic regression analyses indicated that a longer duration of hospitalization was associated with an increased risk of co-infection (Odds ratio [OR]: 1.048; 95% confidence interval [CI]: 1.011-1.087; P = 0.0107). However, increased procalcitonin was associated with a reduced risk of co-infection (OR: 0.677; 95% CI: 0.462-0.992; P = 0.0456). Conclusions: The study indicated that most children with adenovirus respiratory infections showed mild manifestations, and the risk of co-infection was significantly correlated with the duration of hospitalization and procalcitonin level.