title: Sustained Viremia and High Viral Load in Respiratory Tract Secretions Are Predictors for Death in Immunocompetent Adults with Adenovirus Pneumonia.
abstract: The predictors for fatal adenovirus (AdV) pneumonia among immunocompetent adults are unclear. Laboratory-confirmed, hospitalized AdV pneumonia adults were prospectively enrolled in Beijing Chao-Yang hospital from March to June 2013. Clinical data and serial whole blood and respiratory tract secretions from such patients were collected. Quantitative real-time polymerase chain reaction was performed to quantify the viral load. A total of 14 AdV pneumonia cases were consecutively enrolled, and four of them were fatal. Ten cases were caused by AdV-55, three by AdV-7 and one by AdV-3. There were no differences in age, gender or underlying diseases between the patients in the fatal cases and surviving cases. At admission (on day 5-7 after illness onset), the patients in fatal cases presented higher initial viral loads in respiratory tract secretions (8.578 ± 2.115 vs 6.263 ± 1.225 Log10 copies/ml, p = 0.023). All patients in fatal cases presented with viremia on day 12-14 (100% vs 66.7%, p = 0.017). A higher initial viral load in the respiratory tract and sustained viremia (more than 2 weeks) may be predictors for fatal clinical outcomes.
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing, China.
authors.forename: Li
authors.initials: L
authors.lastname: Gu
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing, China.
authors.forename: Jiuxin
authors.initials: J
authors.lastname: Qu
authors.affiliation: Department of Pulmonary and Critical Care. Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Sun
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing, China.
authors.forename: Xiaomin
authors.initials: X
authors.lastname: Yu
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing, China.|Department of Respiratory and Critical Care Medicine, Clinical Microbiology and Infectious Disease Lab, China- Japan Friendship Hospital, Beijing, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Cao
mesh_terms: D000258:Adenovirus Infections, Human / Q000276:immunology / Q000821:virology*; D000260:Adenoviruses, Human / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007121:Immunocompetence; D008297:Male; D011024:Pneumonia, Viral / Q000276:immunology / Q000821:virology*; D011379:Prognosis; D012137:Respiratory System / Q000378:metabolism / Q000821:virology; D012307:Risk Factors; D019562:Viral Load; D014766:Viremia / Q000276:immunology / Q000821:virology; D055815:Young Adult