Clinical features of adenovirus pneumonia in immunocompetent adults: A meta-analysis
Received date: 2023-08-09
Online published: 2024-06-27
Objective To analyze the clinical features of adenovirus pneumonia in immunocompetent adults. Methods The literature about adult patients with adenovirus pneumonia were screened in China National Knowledge Infrastructure (CNKI), Wanfang, VIP, Great Medical Medicine, PubMed, Cochrane Library, Springer Link, Wiley, JSTOR and other databases from the establishment of the database to July 15, 2022. State 16 software was used to conduct a meta-analysis of the clinical features. Results Forty-three literatures representing 2381 adults were included. Among adult patients with adenovirus pneumonia, 96.8% of the patients were male, Human adenovirus type 55 (HAdV-55) and Human adenovirus type 7 (HAdv-7) were the most common types, with lower mortality (0.3%, 95%CI: 0.0-1.5). The common clinical symptoms of adult patients with adenovirus pneumonia were fever (99.1%, 95%CI: 97.5-100.0), following by cough, fatigue, phlegm, and sore throat. The common signs included pharyngeal congestion (74.7%, 95%CI: 57.9-88.7), following by increased heart rate, tonsil enlargement, pharyngeal lymphoid follicle hyperplasia, abnormal respiratory sounds, and increased respiratory rate. The most common complications were pharyngitis (66.6%, 95%CI: 47.9-85.3), following by hypoxemia, acute respiratory distress syndrome (ARDS), respiratory failure, shock, abnormal liver function, hypoproteinemia and electrolyte disturbance. The laboratory test results verified that most patients had normal white blood cell count (68.4%, 95%CI: 60.4-75.9), reduced lymphocyte count (65.5%,95%CI: 44.8-86.1), normal platelet count (79.1%, 95%CI: 74.8-83.3), increased C-reactive protein (82.1%, 95%CI: 67.9-93.2), oxygenation index less than 300 (60.5%, 95%CI: 28.4-88.6), increased erythrocyte sedimentation rate (ESR) (44.3%, 95%CI: 33.2-55.3), and the part patients had increased procalcitonin (PCT) (37.3%, 95%CI: 12.8-65.3). Conclusion Adenovirus pneumonia can also affect immunocompetent adults, and it is more common in middle-aged and young men in the military, mainly with HAdV-55 and HAdV-7 infection. The common clinical manifestations are fever, cough, fatigue, sputum, and pharyngeal pain. The common signs include pharyngeal congestion, rapid heart rate, tonsil enlargement, pharyngeal lymphatic follicular hyperplasia, abnormal respiratory sound, and often complicated with pharyngitis. Most patients had normal white blood cell count, decreased lymphocyte count, normal platelets, elevated C-reactive protein, oxygenation index less than 300, with relatively low mortality.
Key words： adenovirus pneumonia; clinical features; adult; Meta analysis
Yun Xiaoxiao , Li Shufen , Sun Fang . Clinical features of adenovirus pneumonia in immunocompetent adults: A meta-analysis[J]. Clinical Focus, 2024 , 39(4) : 293 -303 . DOI: 10.3969/j.issn.1004-583X.2024.04.001
| [1] | Lenaerts L, Naesens L. Antiviral therapy for adenovirus infections[J]. Antivir Res, 2006, 71(2-3):172-180. |
| [2] | Robinson CM, Singh G, Lee JY, et al. Molecular evolution of human adenoviruses[J]. Sci Rep, 2013, 3:1812. |
| [3] | 全军传染病专业委员会, 新突发传染病中西医临床救治课题组. 腺病毒感染诊疗指南[J]. 解放军医学杂志, 2013, 38(7):529-534. |
| [4] | 人腺病毒呼吸道感染预防控制技术指南编写审定专家组. 人腺病毒呼吸道感染预防控制技术指南[J]. 中华预防医学杂志, 2019, 53(11):1088-1093. |
| [5] | Zhao B, Yang TF, Zheng R. Adenovirus pneumonia should not be overlooked in immunocompetent youths and adults[J]. Epidemio Infec, 2021, 149(e199):1-8. |
| [6] | Sacks D, Baxter B, Campbell BCV, et al. Multisociety consensus quality improvement revised consensus statement for endovascular therapy of acute ischemic stroke[J]. Int J Stroke, 2018, 13(6):612-632. |
| [7] | Gu L, Liu Z, Li X, et al. Severe community-acquired pneumonia caused by adenovirus type 11 in immunocompetent adults in Beijing[J]. J Clin Virol, 2012, 54(4):295-301. |
| [8] | Irizar Aramburu MI, Arrondo Beguiristain MA, Insausti Carretero MJ, et al. Epidemiology of community-acquired pneumonia[J]. Aten Prim, 2013, 45(10):503-513. |
| [9] | 葛均波, 徐永健, 王辰. 内科学[M]. 北京: 人民卫生出版社, 2018:41-52. |
| [10] | 杨继春, 杨智荣, 于树青, 等. 美国卫生保健和质量机构干预性研究偏倚风险评价工具的解读[J]. 中华流行病学杂志, 2019, 40(1):106-111. |
| [11] | Hu J, Dong Y, C'hen X, et al. Prevalence of suicide attempts among Chinese adolescents: A meta-analysis of cross-sectional studies[J]. Compr Psychiat, 2015, 61:78-89. |
| [12] | 周波, 陈欣, 时景璞, 等. 率的Meta分析及软件实现[J]. 中国循证医学杂志, 2014, 14(8):1009-1016. |
| [13] | Nyaga VN, Arbyn M, Aerts M. Metaprop:a Stata command to perform meta-analysis of binomial data[J]. Arch of Public Health, 2014, 72:39. |
| [14] | Lau TG. [尔云间]单组率的meta分析:metan还是metaprop[EB/OL]. https://www.zhihu.com/zvideo/1472309557104340992 |
| [15] | 董洁, 童小清, 徐永银. 6例成人重症腺病毒肺炎的护理[J]. 东南国防医药, 2016, 18(2):203-205. |
| [16] | 李刚锋, 王文, 井勇, 等. 14例军营内腺病毒肺炎的CT特征分析[J]. 中国CT和MRI杂志, 2018, 16(11):59-61, 68. |
| [17] | 任晓荣, 曹玉贵, 高丽华, 等. 97例成人7型腺病毒肺炎的临床分析[J]. 实用医药杂志, 2019, 36(9):808-810. |
| [18] | 涂波, 谢杨新, 张昕, 等. 121例成人55型腺病毒肺炎胸部CT影像分析[J]. 传染病信息, 2014, 27(1):49-51. |
| [19] | 温阿明, 杨学东, 王培军, 等. 成人7型腺病毒肺炎的HRCT表现与动态变化[J]. 东南国防医药, 2015, 17(2):154-156. |
| [20] | 陈韦, 卓安山, 曹玉书, 等. 成人重症腺病毒肺炎临床研究[J]. 转化医学杂志, 2018, 7(3):172-175. |
| [21] | 廖刚, 彭文鸿, 朱振宇, 等. 聚集性人B组7型腺病毒性肺炎218例临床特征分析[J]. 中华肺部疾病杂志电子版, 2015, 8(6):725-729. |
| [22] | 孙军平, 郎杉, 张明月, 等. 军营中腺病毒 7 型呼吸系统感染的临床特点分析[J]. 传染病信息, 2019, 32(3):226-229. |
| [23] | 李小芳, 席雯, 王媛媛, 等. 群发7型腺病毒肺炎42例临床特点及基因组学分析[J]. 中华结核和呼吸杂志, 2019, 42(3):206-212. |
| [24] | 徐磊, 刘斌, 张玉华, 等. 武警新兵腺病毒肺炎在不同海拔地区的临床特征[J]. 武警后勤学院学报(医学版), 2021, 30(1):21-27. |
| [25] | 江宗群, 段军, 李锐锋, 等. 腺病毒肺炎52例临床诊治分析[J]. 环球中医药, 2015, 8(S2):74. |
| [26] | 尹辉明, 邱飞, 谌绍林, 等. 成人重症腺病毒肺炎的临床特点与诊疗分析[J]. 中国呼吸与危重监护杂志, 2021, 20(6):424-426. |
| [27] | 唐琼, 方瑶, 刘奕, 等. 糖皮质激素在55型腺病毒性肺炎辅助治疗中的疗效分析[J]. 华南国防医学杂志, 2020, 34(11):783-785, 790. |
| [28] | 侯蓓蕾, 夏国际, 欧阳晓春, 等. 新型冠状病毒肺炎临床特点及鉴别诊断分析[J]. 赣南医学院学报, 2021, 41(5):464-467, 471. |
| [29] | 赵薇薇. 腺病毒肺炎 100 例临床分析关键要点[J]. 临床医学, 2020, 177. |
| [30] | 赵瑞臣, 高文文. 高原92例成人B组55型腺病毒感染治疗浅析[J]. 华南国防医学杂志, 2016, 30(7):470-471. |
| [31] | 宋乐, 江晓静, 赵甫涛, 等. 军队腺病毒感染217例临床分析[J]. 华南国防医学杂志, 2016, 30(3):184-186. |
| [32] | 赵春洪, 张志强, 翟永志, 等. 青壮年腺病毒 B 组 55 型重症肺炎临床特征分析[J]. 解放军医学院学报, 2014, 35(7):663-666, 695. |
| [33] | 屈磊, 方瑶, 李翔, 等. 一起群体性55型腺病毒性肺炎临床分析[J]. 华南国防医学杂志, 2019, 33(11):764-766, 774. |
| [34] | 梁建琴, 许国宇, 王芳, 等. 一起人腺病毒 55 型感染聚集暴发病例的临床特征分析[J]. 解放军预防医学杂志, 2020, 38(8):37-40. |
| [35] | 王涛, 杜虹, 张野, 等. 人腺病毒55型致成人肺炎的临床特征及外周血淋巴细胞亚群分析[J]. 中国感染控制杂志, 2021, 20(3):191-197. |
| [36] | Brosch L, Tchandja J, Marconi V, et al. Adenovirus serotype 14 pneumonia at a basic military training site in the united states, spring 2007- a case series[J]. Mil Med, 2009, 174(12):1295-1299. |
| [37] | Yoon H, Jhun BW, Kim H, et al. Characteristics of adenovirus pneumonia in korean military personnel, 2012-2016[J]. J Korean Med Sci, 2017, 32(2):287-295. |
| [38] | Yoo H, Oh J, Park C. Characteristics of fever and response to antipyretic therapy in military personnel with adenovirus-positive community-acquired pneumonia[J]. Mil Med Res, 2020, 7(1):6. |
| [39] | Yu HX, Zhao MM, Pu ZH, et al. Clinical data analysis of 19 cases of community-acquired adenovirus pneumonia in immunocompetent adults[J]. Int J Clin Exp Med, 2015, 8(10):19051-19057. |
| [40] | Park JY, Kim BJ, Lee EJ, et al. Clinical features and courses of adenovirus pneumonia in healthy young adults during an outbreak among Korean military personnel[J]. PloS One, 2017, 12(1):e0170592. |
| [41] | Cha MJ, Chung MJ, Lee KS, et al. Clinical features and radiological findings of adenovirus pneumonia associated with progression to acute respiratory distress syndrome: A single center study in 19 adult patients[J]. Korean J Radiol, 2016, 17(6):940-949. |
| [42] | Moon SM, Choe J, Na SJ, et al. Comparative study on the effect of cidofovir treatment for severe adenovirus pneumonia[J]. J Intensive Care Med, 2020, 36(12):1436-1442. |
| [43] | Lim JU, Choi JY, Jeong HJ, et al. Comparison of clinical characteristics and inflammatory cytokines between hypoxemic and non-hypoxemic human adenovirus 55 pneumonia[J]. J Thorac Dis, 2020, 12(8):4044-4056. |
| [44] | Jiang J, Wan R, Pan P, et al. Comparison of clinical, laboratory and radiological characteristics between COVID-19 and adenovirus pneumonia: A retrospective study[J]. Infect Drug Resist, 2020, 13:3401-3408. |
| [45] | Ko JH, Lim JU, Choi JY, et al. Early cidofovir administration might be associated with a lower probability of respiratory failure in treating human adenovirus pneumonia: A retrospective cohort study[J]. Clin Microbiol Infect, 2019, 26(5):646.e9-.e14. |
| [46] | Klinger JR, Sanchez MP, Curtin LA, et al. Multiple cases of life-threatening adenovirus pneumonia in a mental health care center[J]. Am J Respir Crit Care Med, 1998, 157:645-649. |
| [47] | Hwang SM, Park DE, Yang YI, et al. Outbreak of febrile respiratory illness caused by adenovirus at a South Korean military training facility- clinical and radiological characteristics of adenovirus pneumonia[J]. Jpn J Infect Dis, 2013, 66(5):359-365. |
| [48] | Kim SJ, Kim K, Park SB, et al. Outcomes of early administration of cidofovir in non-immunocompromised patients with severe adenovirus pneumonia[J]. PLoS one, 2015, 10(4):e0122642. |
| [49] | Sun J, Xiao Y, Zhang M, et al. Serum Inflammatory Markers in Patients with Adenovirus Respiratory Infection[J]. Med Sci Monit, 2018, 24:3848-3855. |
| [50] | Tan D, Fu Y, Xu J, et al. Severe adenovirus community-acquired pneumonia in immunocompetent adults: chest radiographic and CT findings[J]. J Thorac Dis, 2016, 8(5):848-854. |
| [51] | Clark TW, Fleet DH, Wiselka MJ. Severe community-acquired adenovirus pneumonia in an immunocompetent 44-year-old woman: a case report and review of the literature[J]. J Med Case Rep, 2011, 5:259. |
| [52] | Cao B, Huang GH, Pu ZH, et al. Emergence of community-acquired adenovirus type 55 as a cause of community-onset pneumonia[J]. Chest, 2014, 145(1):79-86. |
| [53] | Gu L, Qu J, Sun B, et al. Sustained viremia and high viral load in respiratory tract secretions are predictors for death in immunocompetent adults with adenovirus pneumonia[J]. PLoS One, 2016, 11(8):e0160777. |
| [54] | Vento TJ, Prakash V, Murray CK, et al. Pneumonia in military trainees: A comparison study based on adenovirus serotype 14 infection[J]. J Infect Dis, 2011, 203(10):1388-1395. |
| [55] | Zhang P, Liu M, Zhang L, et al. Clinical and CT findings of adenovirus pneumonia in immunocompetent adults[J]. Clin Respir J, 2021, 15(12):1343-1351. |
| [56] | 陈伟, 王盛书, 张文义, 等. 我国呼吸道腺病毒疾病流行病学现况分析[J]. 军事医学, 2017, 41(10):814-821. |
| [57] | 章保新, 简明, 袁桔华, 等. 基于文献的中国军队腺病毒感染流行特征分析[J]. 中国感染控制杂志, 2021, 20(3):198-204. |
| [58] | 徐磊, 李国强. 免疫功能正常成人重症腺病毒肺炎临床特征[J]. 河南医学研究, 2020, 29(27):5012-5015. |
| [59] | 黄莺琴, 冯钧静, 黄智瑜, 等. 呼吸道腺病毒感染患者外周血清中降钙素原、C反应蛋白水平与病情严重程度相关性研究[J]. 中外医学研究, 2021, 19(8):140-142. |
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