{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T01:45:56Z","timestamp":1788918356067,"version":"build-2803163510"},"reference-count":39,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T00:00:00Z","timestamp":1761868800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100014996","name":"Health Commission of Zhejiang Province","doi-asserted-by":"publisher","award":["WKJ-ZJ-2534"],"award-info":[{"award-number":["WKJ-ZJ-2534"]}],"id":[{"id":"10.13039\/501100014996","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Key Joint Construction Project of Zhejiang Province and the National Administration of Traditional Chinese Medicine","award":["GZY-ZJ-KJ-24085"],"award-info":[{"award-number":["GZY-ZJ-KJ-24085"]}]},{"DOI":"10.13039\/501100017594","name":"Medical Science and Technology Project of Zhejiang Province","doi-asserted-by":"publisher","award":["2022KY1011"],"award-info":[{"award-number":["2022KY1011"]}],"id":[{"id":"10.13039\/501100017594","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Quzhou Science and Technology Program","award":["2020112"],"award-info":[{"award-number":["2020112"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Identifying effective indicators and developing predictive models for the early detection of severe adenoviral pneumonia (SAP) is critical to safeguarding patients\u2019 lives. This study examined differences between 428 patients with SAP and those with non-severe adenoviral pneumonia (NSAP) from March 2022 to January 2023, focusing on variables such as age, sex, type of coinfection, and a range of clinical laboratory indicators. SAP was significantly more common in children aged 3\u20136 years (20\/54 of all SAP cases, p = 0.0258) and among those with polymicrobial coinfections (p &lt; 1.20 \u00d7 10\u221211). Patients with SAP exhibited significantly higher prealbumin (PA) level, while C-reactive protein (CRP) level was significantly lower. Composite indicator, such as CRP -to- prealbumin ratio (CPAR), was also significantly elevated (p &lt; 0.05). The random forest model achieved an area under the receiver operating characteristic (ROC) curve (AUC) of 0.699, with an accuracy of 84.5% and a precision of 91.5%. Analysis of the data revealed key predictive parameters for early-stage SAP. Indicators such as CPAR, PA, and CRP are valuable for assessing SAP risk. Moreover, commonly available clinical indicators can effectively construct a random forest-based predictive model for SAP.<\/jats:p>","DOI":"10.3390\/pathogens14111110","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T13:15:14Z","timestamp":1762175714000},"page":"1110","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical Characteristics of Adenovirus Pneumonia in Children"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1087-6885","authenticated-orcid":false,"given":"Huifen","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Pharmacy, The Children\u2019s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310053, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The Children\u2019s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310053, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinrui","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The Children\u2019s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310053, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingying","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The Children\u2019s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310053, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yajun","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The Children\u2019s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310053, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, The Affiliated Huaian No. 1 People\u2019s Hospital of Nanjing Medical University, Huaian 223001, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The Children\u2019s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310053, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1055\/s-0041-1733802","article-title":"Adenovirus: Epidemiology, Global Spread of Novel Types, and Approach to Treatment","volume":"42","author":"Lynch","year":"2021","journal-title":"Semin. Respir. Crit. Care Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1007\/s12519-022-00669-4","article-title":"Viral-mediated gene therapy in pediatric neurological disorders","volume":"20","author":"Peng","year":"2024","journal-title":"World J. Pediatr."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Hu, C., Zeng, Y., Zhong, Z., Yang, L., Li, H., Zhang, H.M., Xia, H., and Jiang, M.Y. (2023). Clinical characteristics and severity prediction score of Adenovirus pneumonia in immunocompetent adult. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0281590"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Xu, N., Chen, P., and Wang, Y. (2020). Evaluation of Risk Factors for Exacerbations in Children with Adenoviral Pneumonia. Biomed. Res. Int., 31.","DOI":"10.1155\/2020\/4878635"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1097\/QCO.0000000000000919","article-title":"Human adenovirus lung disease: Outbreaks, models of immune-response-driven acute lung injury and pandemic potential","volume":"36","author":"Radke","year":"2023","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e36162","DOI":"10.1097\/MD.0000000000036162","article-title":"Clinical characteristics, early blood biochemical indicators, and prognostic status of children with bronchopneumonia","volume":"102","author":"Ling","year":"2023","journal-title":"Medicine"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1186\/s12890-020-01207-6","article-title":"Procalcitonin and C-reactive protein perform better than the neutrophil\/lymphocyte count ratio in evaluating hospital acquired pneumonia","volume":"20","author":"Zheng","year":"2020","journal-title":"BMC Pulm. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"811","DOI":"10.7754\/Clin.Lab.2019.190929","article-title":"Serum Prealbumin Improves the Sensitivity of Pneumonia Severity Index in Predicting 30-day Mortality of CAP Patients","volume":"66","author":"Zhang","year":"2020","journal-title":"Clin. Lab."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1080\/09537104.2016.1219032","article-title":"Prognostic significance of platelet count changes during hospitalization for community-acquired pneumonia","volume":"28","author":"Gorelik","year":"2017","journal-title":"Platelets"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1016\/j.micinf.2005.12.017","article-title":"Dual function of the long pentraxin PTX3 in resistance against pulmonary infection with Klebsiella pneumoniae in transgenic mice","volume":"8","author":"Soares","year":"2006","journal-title":"Microbes Infect."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Zhang, Z., Dou, H., Tu, P., Shi, D., Wei, R., Wan, R., Jia, C., Ning, L., Wang, D., and Li, J. (2022). Serum cytokine profiling reveals different immune response patterns during general and severe Mycoplasma pneumoniae pneumonia. Front. Immunol., 13.","DOI":"10.3389\/fimmu.2022.1088725"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1186\/s12985-022-01949-1","article-title":"Profiles and predictive value of cytokines in children with human metapneumovirus pneumonia","volume":"19","author":"Xiang","year":"2022","journal-title":"Virol. J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e390","DOI":"10.7717\/peerj-cs.390","article-title":"BCD-WERT: A novel approach for breast cancer detection using whale optimization based efficient features and extremely randomized tree algorithm","volume":"7","author":"Abbas","year":"2021","journal-title":"PeerJ Comput. Sci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1567","DOI":"10.1007\/s00125-024-06179-4","article-title":"Heterogeneity of glycaemic phenotypes in type 1 diabetes","volume":"67","author":"Fagherazzi","year":"2024","journal-title":"Diabetologia"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.semcancer.2019.12.011","article-title":"Machine and deep learning approaches for cancer drug repurposing","volume":"68","author":"Issa","year":"2021","journal-title":"Semin. Cancer Biol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2316267","DOI":"10.1080\/0886022X.2024.2316267","article-title":"Machine learning-based prediction of in-hospital mortality for critically ill patients with sepsis-associated acute kidney injury","volume":"46","author":"Gao","year":"2024","journal-title":"Ren. Fail."},{"key":"ref_17","first-page":"856","article-title":"Artificial Intelligence for Mental Health Care: Clinical Applications, Barriers, Facilitators, and Artificial Wisdom","volume":"6","author":"Lee","year":"2021","journal-title":"Biol. Psychiatry Cogn. Neurosci. Neuroimaging"},{"key":"ref_18","unstructured":"National Health Commission of the People\u2019s Republic of China, and State Administration of Traditional Chinese Medicine (2019). Guideline for diagnosis and treatment of adenovirus pneumonia in children (2019 version). Chin. J. Clin. Infect. Dis., 12, 161\u2013166."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Li, X., Zhong, X., Wang, Y., Zeng, X., Luo, T., and Liu, Q. (2021). Clinical determinants of the severity of COVID-19: A systematic review and meta-analysis. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0250602"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1708","DOI":"10.1056\/NEJMoa2002032","article-title":"China Medical Treatment Expert Group for Covid-19. Clinical Characteristics of Coronavirus Disease 2019 in China","volume":"382","author":"Guan","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_21","first-page":"160","article-title":"Latest developments in early diagnosis and specific treatment of severe influenza infection","volume":"4","author":"Estella","year":"2023","journal-title":"J. Intensive Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1089\/gtmb.2023.0037","article-title":"Clinical Characteristics and Genotyping of Pediatric Adenovirus Pneumonia Disease and Coinfection in Southeast China","volume":"27","author":"Pan","year":"2023","journal-title":"Genet. Test. Mol. Biomark."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/j.virs.2022.01.010","article-title":"Analysis of severe human adenovirus infection outbreak in Guangdong Province, southern China in 2019","volume":"37","author":"Liu","year":"2022","journal-title":"Virol. Sin."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1186\/s12879-021-05903-4","article-title":"Adenovirus viremia may predict adenovirus pneumonia severity in immunocompetent children","volume":"21","author":"Zhang","year":"2021","journal-title":"BMC Infect. Dis."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1007\/s12199-010-0158-x","article-title":"Clinical factors associated with severity in hospitalized children infected with avian influenza (H5N1)","volume":"16","author":"Furuya","year":"2011","journal-title":"Environ. Health Prev. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/j.medcli.2020.05.012","article-title":"Evaluation of organ function in patients with severe COVID-19 infections","volume":"155","author":"Zhu","year":"2020","journal-title":"Med. Clin."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"3561","DOI":"10.2147\/IDR.S408126","article-title":"An Analysis of Predictive Factors for Severe Neonatal Infection and the Construction of a Prediction Model","volume":"16","author":"Wang","year":"2023","journal-title":"Infect. Drug Resist."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e2021053418","DOI":"10.1542\/peds.2021-053418","article-title":"Risk Factors for Severe COVID-19 in Children","volume":"149","author":"Woodruff","year":"2022","journal-title":"Pediatrics"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/j.ijid.2021.05.057","article-title":"SAA and CRP are potential indicators in distinction and severity assessment for children with influenza","volume":"108","author":"Zou","year":"2021","journal-title":"Int. J. Infect. Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e30010","DOI":"10.1097\/MD.0000000000030010","article-title":"A retrospective observational study of biomarker levels and severity assessment in pediatric community-acquired pneumonia","volume":"101","author":"Bashir","year":"2022","journal-title":"Medicine"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"101","DOI":"10.2174\/1871520615666150824153523","article-title":"The Immune System in Cancer Prevention, Development and Therapy","volume":"16","author":"Candeias","year":"2016","journal-title":"Anticancer Agents Med. Chem."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1111\/j.1399-3038.2006.00419.x","article-title":"Suppression of IFN-gamma production in atopic group at the acute phase of RSV infection","volume":"17","author":"Kaneko","year":"2006","journal-title":"Pediatr. Allergy Immunol."},{"key":"ref_33","first-page":"1014","article-title":"Value of heparin-binding protein in the diagnosis of severe adenovirus pneumonia in children","volume":"24","author":"Liu","year":"2022","journal-title":"Chin. J. Contemp. Pediatr."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1007\/s00134-019-05898-2","article-title":"Clinical management of sepsis can be improved by artificial intelligence: Yes","volume":"46","author":"Komorowski","year":"2020","journal-title":"Intensive Care Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1038\/s41591-018-0300-7","article-title":"High-performance medicine: The convergence of human and artificial intelligence","volume":"25","author":"Topol","year":"2019","journal-title":"Nat. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.ijid.2017.06.020","article-title":"Respiratory viruses detected in Mexican children younger than 5 years old with community-acquired pneumonia: A national multicenter study","volume":"62","author":"Noyola","year":"2017","journal-title":"Int. J. Infect. Dis."},{"key":"ref_37","first-page":"9595184","article-title":"Predictive Value of Adenoviral Load for Bronchial Mucus Plugs Formation in Children with Adenovirus Pneumonia","volume":"8","author":"Peng","year":"2022","journal-title":"Can. Respir. J."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e29182","DOI":"10.1002\/jmv.29182","article-title":"Genome and proteomic analysis of risk factors for fatal outcome in children with severe community-acquired pneumonia caused by human adenovirus 7","volume":"95","author":"Wei","year":"2023","journal-title":"J. Med. Virol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/s12887-023-03840-6","article-title":"Analysis of the typing of adenovirus and its clinical characteristics in children with acute respiratory tract infection","volume":"23","author":"Wang","year":"2023","journal-title":"BMC Pediatr."}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/14\/11\/1110\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T14:07:23Z","timestamp":1762178843000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/14\/11\/1110"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,31]]},"references-count":39,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["pathogens14111110"],"URL":"https:\/\/doi.org\/10.3390\/pathogens14111110","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,31]]}}}