Background: Severe adenovirus (AdV) pneumonia is a significant cause of morbidity and mortality in pediatric intensive care units (PICUs).This study aims to compare the clinical profile, laboratory parameters, radiological findings, and outcomes of children with severe AdV pneumonia with non-AdV viral pneumonia.Patients and methods: We conducted a retrospective review of case records of children diagnosed with viral pneumonia through PCR analysis of nasopharyngeal/throat swabs or bronchoalveolar lavage.Outcomes assessed included all-cause mortality, need for mechanical ventilation, duration of PICU and hospital stay, and incidence of bronchiolitis obliterans (BO) in each group.Univariate and multivariate logistic regression analyses were performed to identify risk factors for mortality and BO in the entire cohort.Results: Among 148 children with severe pneumonia, 63 (42.5%) had one or more viral isolates: AdV (31, 49.2%) and non-AdV viruses (32, 50.7%).The clinical profiles of the AdV and non-AdV viral pneumonia groups were comparable, except that all children in the AdV group were under 5 years of age 32 (100%) vs 26 (81.2%), (p = 0.02).Leukopenia was more common in the AdV group (16.1 vs 0%, p = 0.01).Short-term outcomes, including mortality, length of PICU and hospital stay, and duration of mechanical ventilation, were similar between the groups.However, BO incidence was significantly higher in AdV cases (22.5 vs 3.1%, p = 0.02).Multivariate analysis identified acute respiratory distress syndrome (ARDS) and acute kidney injury (AKI) as independent risk factors for mortality, while prolonged PICU and hospital stay were linked to BO development.Conclusion: While the overall clinical profile and short-term outcomes of severe AdV and non-AdV viral pneumonia are similar, children with AdV pneumonia are younger, more prone to leukopenia, and at a higher risk of developing BO.
Agarwal et al. (Wed,) studied this question.