Adenovirus (ADV) is a prevalent infective virus in children, accounting for around 5–10% of all cases of acute respiratory illnesses and 4–15% of pneumonia cases in children younger than five years old. Without treatment, severe ADV pneumonia could result in fatality rates of over 50% in cases of emerging strains or disseminated disease. This study aims to uncover the relationship of clinical indicators with primary ADV infection severity, regarding duration of hospitalization and liver injury. In this retrospective study, we collected and analyzed the medical records of 1151 in-patients who met the inclusion and exclusion criteria. According to duration of hospitalization, all patients were divided into three groups. Then the difference and correlation of clinical indicators with ADV infection were analyzed, and the relationship among liver injury, immune cells and cytokines was evaluated. The study revealed that patients with a duration of hospitalization exceeding 14 days had the highest percentage of abnormalities across most indicators. This was in contrast to the patients with a hospitalization duration of either less than or equal to 7 days or between 7 and 14 days. Furthermore, correlation analysis indicated that a longer duration of body temperature of ≥ 39°C, bilateral lung lobes infiltration detected by X ray, abnormal levels of AST, PaO2, and SPO2, and a lower age were all predictive of longer hospital stays. Furthermore, an elevated AST level and reduced liver synthesis capacity were related with a longer hospital stay and higher ADV copy number. Additionally, AST/ALT was correlated positively with IFN-γ level and IFN-γ level was only correlated positively with CD4+ T cells. The study provided a set of predicting indicators for longer duration of hospitalization, which responded for primary severe ADV infection, and elucidated the possible reason for prolonged duration of hospitalization attributing to liver injury via higher ADV copy number, IFN-γ and CD4+ T cells, which suggested the importance of IFN-γ level and liver function monitoring for the patients with primary severe ADV infection.

中文翻译：

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肝损伤和住院时间延长是腺病毒感染患者严重程度的指标

腺病毒 (ADV) 是儿童中常见的感染性病毒，约占所有急性呼吸道疾病病例的 5-10%，占 5 岁以下儿童肺炎病例的 4-15%。如果不进行治疗，严重的 ADV 肺炎在新出现病毒株或传播疾病的情况下可能会导致超过 50% 的死亡率。本研究旨在揭示临床指标与原发性 ADV 感染严重程度（住院时间和肝损伤）之间的关系。在这项回顾性研究中，我们收集并分析了 1151 名符合纳入和排除标准的住院患者的病历。根据住院时间，所有患者分为三组。分析临床指标与ADV感染的差异及相关性，评价肝损伤与免疫细胞、细胞因子之间的关系。研究显示，住院时间超过 14 天的患者在大多数指标中出现异常的比例最高。这与住院时间小于或等于 7 天或 7 至 14 天的患者形成鲜明对比。此外，相关分析表明，体温≥39℃持续时间较长、X线检测到双侧肺叶浸润、AST、PaO2和SPO2水平异常以及年龄较低都是住院时间较长的预测因素。此外，AST水平升高和肝脏合成能力降低与较长的住院时间和较高的ADV拷贝数有关。此外，AST/ALT与IFN-γ水平呈正相关，而IFN-γ水平仅与CD4+T细胞呈正相关。该研究提供了一套针对原发性严重ADV感染的较长住院时间的预测指标，并阐明了通过较高的ADV拷贝数、IFN-γ和CD4+ T细胞导致肝损伤导致住院时间延长的可能原因。提示IFN-γ水平和肝功能监测对于原发重症ADV感染患者的重要性。