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Objectives: High and varying cutoff values of C-reactive protein (CRP) levels are observed in human adenoviral infection. Our objectives were to determine the ideal cutoff of CRP level in adenoviral infection and compare the clinical features, investigations, and outcomes in adenoviral and other viral infections. Material and Methods: This descriptive study includes 140 children satisfying inclusion criteria aged 1 month to 18 years admitted to our hospital. Seventy nasopharyngeal swabs positive for adenovirus and 70 positive for other viruses during the study period September 2022 to March 2023 were taken up for our analysis. Data for CRP levels, clinical features at admission, investigations, and outcomes were analyzed for both adenoviral and nonadenoviral groups (Groups 1 and 2). Our main outcome of the study was to analyze the data for both groups and determine the ideal cutoff for CRP in predicting adenoviral infection. Results: Our results yielded that mean CRP levels were higher in the adenoviral group than in other viral infections (non-adenoviral). Based on the receiver operative characteristic curve, the cutoff value of CRP for predicting adenoviral infections is 5.5 mg/L with a sensitivity of 84.71 and specificity of 54.17. Conjunctivitis and tonsillitis/pharyngitis are significantly more in the adenoviral group, and when they are used as diagnostic tests the ideal cutoff of CRP in diagnosis becomes more specific. Conclusion: We concluded that the ideal cutoff for CRP in predicting adenoviral infection is 5.5 mg/L. CRP, along with clinical features of tonsillitis/pharyngitis and conjunctivitis, make the diagnosis more specific.
Thiruchelvam et al. (Thu,) studied this question.