Immunocompromised Children with Severe Adenoviral Respiratory Infection
Purpose. To investigate the impact of severe respiratory adenoviral infection on morbidity and case fatality in immunocompromised children. Methods. Combined retrospective-prospective cohort study of patients admitted to the intensive care unit (ICU) in four children’s hospitals with severe adenovir...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2016-01-01
|
| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2016/9458230 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832563235193094144 |
|---|---|
| author | Joanna C. Tylka Michael C. McCrory Shira J. Gertz Jason W. Custer Michael C. Spaeder |
| author_facet | Joanna C. Tylka Michael C. McCrory Shira J. Gertz Jason W. Custer Michael C. Spaeder |
| author_sort | Joanna C. Tylka |
| collection | DOAJ |
| description | Purpose. To investigate the impact of severe respiratory adenoviral infection on morbidity and case fatality in immunocompromised children. Methods. Combined retrospective-prospective cohort study of patients admitted to the intensive care unit (ICU) in four children’s hospitals with severe adenoviral respiratory infection and an immunocompromised state between August 2009 and October 2013. We performed a secondary case control analysis, matching our cohort 1 : 1 by age and severity of illness score with immunocompetent patients also with severe respiratory adenoviral infection. Results. Nineteen immunocompromised patients were included in our analysis. Eleven patients (58%) did not survive to hospital discharge. Case fatality was associated with cause of immunocompromised state (p=0.015), multiple organ dysfunction syndrome (p=0.001), requirement of renal replacement therapy (p=0.01), ICU admission severity of illness score (p=0.011), and treatment with cidofovir (p=0.005). Immunocompromised patients were more likely than matched controls to have multiple organ dysfunction syndrome (p=0.01), require renal replacement therapy (p=0.02), and not survive to hospital discharge (p=0.004). One year after infection, 43% of immunocompromised survivors required chronic mechanical ventilator support. Conclusions. There is substantial case fatality as well as short- and long-term morbidity associated with severe adenoviral respiratory infection in immunocompromised children. |
| format | Article |
| id | doaj-art-a2750888a9e243198142d8bd74623093 |
| institution | Kabale University |
| issn | 2090-1305 2090-1313 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Critical Care Research and Practice |
| spelling | doaj-art-a2750888a9e243198142d8bd746230932025-02-03T01:20:41ZengWileyCritical Care Research and Practice2090-13052090-13132016-01-01201610.1155/2016/94582309458230Immunocompromised Children with Severe Adenoviral Respiratory InfectionJoanna C. Tylka0Michael C. McCrory1Shira J. Gertz2Jason W. Custer3Michael C. Spaeder4Department of Pediatrics, Section of Pediatric Critical Care, Rush University Medical Center, Chicago, Il 60612, USADepartment of Anesthesiology, Section of Pediatric Critical Care, Wake Forest School of Medicine, Winston-Salem, NC 27157, USADepartment of Pediatrics, Hackensack University Medical Center, Hackensack, NJ 07601, USADivision of Pediatric Critical Care Medicine, University of Maryland Medical Center, Baltimore, MD 20201, USADivision of Pediatric Critical Care, University of Virginia Children’s Hospital, Charlottesville, VA 22908, USAPurpose. To investigate the impact of severe respiratory adenoviral infection on morbidity and case fatality in immunocompromised children. Methods. Combined retrospective-prospective cohort study of patients admitted to the intensive care unit (ICU) in four children’s hospitals with severe adenoviral respiratory infection and an immunocompromised state between August 2009 and October 2013. We performed a secondary case control analysis, matching our cohort 1 : 1 by age and severity of illness score with immunocompetent patients also with severe respiratory adenoviral infection. Results. Nineteen immunocompromised patients were included in our analysis. Eleven patients (58%) did not survive to hospital discharge. Case fatality was associated with cause of immunocompromised state (p=0.015), multiple organ dysfunction syndrome (p=0.001), requirement of renal replacement therapy (p=0.01), ICU admission severity of illness score (p=0.011), and treatment with cidofovir (p=0.005). Immunocompromised patients were more likely than matched controls to have multiple organ dysfunction syndrome (p=0.01), require renal replacement therapy (p=0.02), and not survive to hospital discharge (p=0.004). One year after infection, 43% of immunocompromised survivors required chronic mechanical ventilator support. Conclusions. There is substantial case fatality as well as short- and long-term morbidity associated with severe adenoviral respiratory infection in immunocompromised children.http://dx.doi.org/10.1155/2016/9458230 |
| spellingShingle | Joanna C. Tylka Michael C. McCrory Shira J. Gertz Jason W. Custer Michael C. Spaeder Immunocompromised Children with Severe Adenoviral Respiratory Infection Critical Care Research and Practice |
| title | Immunocompromised Children with Severe Adenoviral Respiratory Infection |
| title_full | Immunocompromised Children with Severe Adenoviral Respiratory Infection |
| title_fullStr | Immunocompromised Children with Severe Adenoviral Respiratory Infection |
| title_full_unstemmed | Immunocompromised Children with Severe Adenoviral Respiratory Infection |
| title_short | Immunocompromised Children with Severe Adenoviral Respiratory Infection |
| title_sort | immunocompromised children with severe adenoviral respiratory infection |
| url | http://dx.doi.org/10.1155/2016/9458230 |
| work_keys_str_mv | AT joannactylka immunocompromisedchildrenwithsevereadenoviralrespiratoryinfection AT michaelcmccrory immunocompromisedchildrenwithsevereadenoviralrespiratoryinfection AT shirajgertz immunocompromisedchildrenwithsevereadenoviralrespiratoryinfection AT jasonwcuster immunocompromisedchildrenwithsevereadenoviralrespiratoryinfection AT michaelcspaeder immunocompromisedchildrenwithsevereadenoviralrespiratoryinfection |