{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:28:56Z","timestamp":1787020136835,"version":"build-2736575974"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,2,25]],"date-time":"2021-02-25T00:00:00Z","timestamp":1614211200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,2,25]],"date-time":"2021-02-25T00:00:00Z","timestamp":1614211200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Previous studies have demonstrated an association between adenovirus viremia and disease severity in immunocompromised children. However, few studies have focused on this association in immunocompetent children. This study explored the association between adenovirus viremia and adenovirus pneumonia severity in immunocompetent children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective, observational study of immunocompetent children with adenovirus pneumonia admitted to Shenzhen Children\u2019s Hospital in Shenzhen, China. Pneumonia was classified as severe or mild based on the Chinese guideline for the classification of pneumonia severity. Serum samples from all the children included in the study were tested for adenovirus DNA with a quantitative polymerase chain reaction. Clinical manifestations, laboratory examinations, and disease severity were compared between children with severe and mild pneumonia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 111 immunocompetent children with adenovirus pneumonia (60 severe, 51 mild) were included. The median age was 40\u2009months, and 64 patients were male. Five patients were admitted to the intensive care unit, and two underwent endotracheal intubation. All patients were discharged after recovery or improvement. Univariate analysis and binary logistic regression analysis showed that leukocytosis (OR\u2009=\u20091.1; 95% CI: 1.0 to 1.2;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.033), co-infection with\n                      <jats:italic>Mycoplasma pneumoniae<\/jats:italic>\n                      (OR\u2009=\u20095.0; 95% CI: 2.1 to 12.3;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009\u00a00.001), and high blood viral load (OR\u2009=\u20091.5; 95% CI: 1.2 to 2.0;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001) may be risk factors for severe adenovirus pneumonia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Leukocytosis, co-infection with\n                      <jats:italic>Mycoplasma pneumoniae<\/jats:italic>\n                      , and high blood viral load may be risk factors for severe adenovirus pneumonia in immunocompetent children. Blood viral load may predict pneumonia severity.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-021-05903-4","type":"journal-article","created":{"date-parts":[[2021,2,25]],"date-time":"2021-02-25T08:03:29Z","timestamp":1614240209000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Adenovirus viremia may predict adenovirus pneumonia severity in immunocompetent children"],"prefix":"10.1186","volume":"21","author":[{"given":"Ruimu","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongmei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shufeng","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0040-1491","authenticated-orcid":false,"given":"Jikui","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,2,25]]},"reference":[{"key":"5903_CR1","doi-asserted-by":"publisher","first-page":"1194","DOI":"10.1086\/514978","volume":"27","author":"FM Munoz","year":"1998","unstructured":"Munoz FM, Piedra PA, Demmler GJ. Disseminated adenovirus disease in immunocompromised and immunocompetent children. Clin Infect Dis. 1998;27:1194\u2013200.","journal-title":"Clin Infect Dis"},{"key":"5903_CR2","doi-asserted-by":"publisher","first-page":"864","DOI":"10.1086\/339073","volume":"34","author":"AC Lankester","year":"2002","unstructured":"Lankester AC, van Tol MJ, Claas EC, Vossen JM, Kroes AC. Quantification of adenovirus DNA in plasma for management of infection in stem cell graft recipients. Clin Infect Dis. 2002;34:864\u20137.","journal-title":"Clin Infect Dis"},{"key":"5903_CR3","doi-asserted-by":"publisher","first-page":"1114","DOI":"10.1182\/blood-2002-07-2152","volume":"102","author":"T Lion","year":"2003","unstructured":"Lion T, Baumgartinger R, Watzinger F, et al. Molecular monitoring of adenovirus in peripheral blood after allogeneic bone marrow transplantation permits early diagnosis of disseminated disease. Blood. 2003;102:1114\u201320.","journal-title":"Blood."},{"key":"5903_CR4","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1016\/S0140-6736(01)05580-5","volume":"358","author":"M Echavarria","year":"2001","unstructured":"Echavarria M, Forman M, van Tol MJ, Vossen JM, Charache P, Kroes AC. Prediction of severe disseminated adenovirus infection by serum PCR. Lancet. 2001;358:384\u20135.","journal-title":"Lancet."},{"key":"5903_CR5","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1086\/380450","volume":"38","author":"M Leruez-Ville","year":"2004","unstructured":"Leruez-Ville M, Minard V, Lacaille F, et al. Real-time blood plasma polymerase chain reaction for management of disseminated adenovirus infection. Clin Infect Dis. 2004;38:45\u201352.","journal-title":"Clin Infect Dis"},{"key":"5903_CR6","first-page":"161","volume":"12","author":"National Health Commission of China","year":"2019","unstructured":"National Health Commission of China. Guideline for diagnosis and treatment of adenovirus pneumonia in children (2019 version). Chin J Clin Infect Dis. 2019;12:161\u20136.","journal-title":"Chin J Clin Infect Dis"},{"key":"5903_CR7","first-page":"6","volume":"12","author":"National Health Commission of China","year":"2019","unstructured":"National Health Commission of China. Guideline for diagnosis and treatment of community-acquired pneumonia in Children (2019 version). Chin J Clin Infect Dis. 2019;12:6\u201313.","journal-title":"Chin J Clin Infect Dis"},{"key":"5903_CR8","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1186\/s12985-018-1037-0","volume":"15","author":"L Xie","year":"2018","unstructured":"Xie L, Zhang B, Zhou J, et al. Human adenovirus load in respiratory tract secretions are predictors for disease severity in children with human adenovirus pneumonia. Virol J. 2018;15:123.","journal-title":"Virol J"},{"key":"5903_CR9","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1016\/j.jcv.2018.12.005","volume":"111","author":"NH Schjelderup","year":"2019","unstructured":"Schjelderup NH, Nordbo SA, Krokstad S, Dollner H, Christensen A. Human adenovirus in nasopharyngeal and blood samples from children with and without respiratory tract infections. J Clin Virol. 2019;111:19\u201323.","journal-title":"J Clin Virol"},{"issue":"Suppl 1","key":"5903_CR10","doi-asserted-by":"publisher","first-page":"S358","DOI":"10.1093\/ofid\/ofx163.868","volume":"4","author":"E Song","year":"2017","unstructured":"Song E, Wang H, Leber A, Jaggi P. Human adenovirus (HAdV) Viremia in Immunocompetent children with HAdV infection in respiratory specimens: does Viremia predict severity of illness? Open Forum Infect Dis. 2017;4(Suppl 1):S358.","journal-title":"Open Forum Infect Dis"},{"key":"5903_CR11","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1097\/01.inf.0000148882.97399.79","volume":"24","author":"H Shike","year":"2005","unstructured":"Shike H, Shimizu C, Kanegaye J, Foley JL, Burns JC. Quantitation of adenovirus genome during acute infection in normal children. Pediatr Infect Dis J. 2005;24:29\u201333.","journal-title":"Pediatr Infect Dis J"},{"key":"5903_CR12","volume":"11","author":"L Gu","year":"2016","unstructured":"Gu L, Qu J, Sun B, Yu X, Li H, Cao B. Sustained Viremia and high viral load in respiratory tract secretions are predictors for death in Immunocompetent adults with adenovirus pneumonia. PLoS One. 2016;11:e160777.","journal-title":"PLoS One"},{"key":"5903_CR13","first-page":"37","volume":"36","author":"Y Chuang","year":"2003","unstructured":"Chuang Y, Chiu CH, Wong KS, et al. Severe adenovirus infection in children. J Microbiol Immunol Infect. 2003;36:37\u201340.","journal-title":"J Microbiol Immunol Infect"},{"key":"5903_CR14","first-page":"159","volume":"19","author":"H Miao","year":"2017","unstructured":"Miao H, Rong L, Zhou F. Risk factors for poor prognosis in children with severe adenovirus pneumonia. Chin J Contemp Pediatr. 2017;19:159\u201362.","journal-title":"Chin J Contemp Pediatr"},{"key":"5903_CR15","first-page":"62","volume":"32","author":"L Mingyue","year":"2018","unstructured":"Mingyue L, Linying G, Dong Q, et al. Clinical analysis of children in hospital with adenovirus pneumonia in Beijing from 2015 to 2016. Chin J Exp Clin Virol. 2018;32:62\u20135.","journal-title":"Chin J Exp Clin Virol"},{"key":"5903_CR16","doi-asserted-by":"publisher","first-page":"1182","DOI":"10.1093\/clinids\/21.5.1182","volume":"21","author":"N Cimolai","year":"1995","unstructured":"Cimolai N, Wensley D, Seear M, Thomas ET. Mycoplasma pneumoniae as a cofactor in severe respiratory infections. Clin Infect Dis. 1995;21:1182\u20135.","journal-title":"Clin Infect Dis"},{"key":"5903_CR17","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1186\/s12879-020-05152-x","volume":"20","author":"J Gao","year":"2020","unstructured":"Gao J, Xu L, Xu B, Xie Z, Shen K. Human adenovirus Coinfection aggravates the severity of mycoplasma pneumoniae pneumonia in children. BMC Infect Dis. 2020;20:420.","journal-title":"BMC Infect Dis"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-021-05903-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12879-021-05903-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-021-05903-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,25]],"date-time":"2021-02-25T08:27:31Z","timestamp":1614241651000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-021-05903-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,25]]},"references-count":17,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["5903"],"URL":"https:\/\/doi.org\/10.1186\/s12879-021-05903-4","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-66081\/v2","asserted-by":"object"},{"id-type":"doi","id":"10.21203\/rs.3.rs-66081\/v1","asserted-by":"object"}]},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,25]]},"assertion":[{"value":"26 August 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 February 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 February 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was performed in strict accordance with the human subject protection guidance of Ministry of Science and Technology of China, and the study protocol was approved by the Ethical Review Committee of Shenzhen Children\u2019s Hospital with judgment\u2019s reference number 201907903. Written consent was obtained from the guardians of all participants before data collection.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors have no potential conflicts of interest.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"213"}}