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Epidemiology, clinical presentation and respiratory sequelae of adenovirus pneumonia in children in Kuala Lumpur, Malaysia

Objectives To describe the severity, human adenovirus (HAdV) type and respiratory morbidity following adenovirus pneumonia in children. Methodology Retrospective review of children under 12 years of age, admitted with HAdV pneumonia, between January 2011 and July 2013, in a single centre in Malaysia...

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Main Authors:	Lim, Li Min, Woo, Yen Yen, De Bruyne, Jessie Anne, Nathan, Anna Marie, Kee, Sze Ying, Chan, Yoke Fun, Chiam, Chun Wei, Eg, Kah Peng, Thavagnanam, Surendran, Sam, I-Ching
Format:	Article
Published:	Public Library of Science 2018
Subjects:	R Medicine
Online Access:	http://eprints.um.edu.my/21441/ https://doi.org/10.1371/journal.pone.0205795
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spelling	my.um.eprints.214412019-05-31T03:41:16Z http://eprints.um.edu.my/21441/ Epidemiology, clinical presentation and respiratory sequelae of adenovirus pneumonia in children in Kuala Lumpur, Malaysia Lim, Li Min Woo, Yen Yen De Bruyne, Jessie Anne Nathan, Anna Marie Kee, Sze Ying Chan, Yoke Fun Chiam, Chun Wei Eg, Kah Peng Thavagnanam, Surendran Sam, I-Ching R Medicine Objectives To describe the severity, human adenovirus (HAdV) type and respiratory morbidity following adenovirus pneumonia in children. Methodology Retrospective review of children under 12 years of age, admitted with HAdV pneumonia, between January 2011 and July 2013, in a single centre in Malaysia. HAdV isolated from nasopharyngeal secretions were typed by sequencing hypervariable regions 1–6 of the hexon gene. Patients were reviewed for respiratory complications. Results HAdV was detected in 131 children of whom 92 fulfilled inclusion criteria. Median (range) age was 1.1 (0.1–8.0) years with 80% under 2 years. Twenty percent had severe disease with a case-fatality rate of 5.4%. Duration of admission (p = 0.02) was independently associated with severe illness. Twenty-two percent developed respiratory complications, the commonest being bronchiolitis obliterans (15.2%) and recurrent wheeze (5.4%). The predominant type shifted from HAdV1 and HAdV3 in 2011 to HAdV7 in 2013. The commonest types identified were types 7 (54.4%), 1(17.7%) and 3 (12.6%). Four out of the five patients who died were positive for HAdV7. Infection with type 7 (OR 8.90, 95% CI 1.32, 59.89), family history of asthma (OR 14.80, 95% CI 2.12–103.21) and need for invasive or non-invasive ventilation (OR 151.84, 95% CI 9.93–2.32E) were independent predictors of respiratory complications. Conclusions One in five children admitted with HAdV pneumonia had severe disease and 22% developed respiratory complications. Type 7 was commonly isolated in children with severe disease. Family history of asthma need for invasive or non-invasive ventilation and HAdV 7 were independent predictors of respiratory complications. Public Library of Science 2018 Article PeerReviewed Lim, Li Min and Woo, Yen Yen and De Bruyne, Jessie Anne and Nathan, Anna Marie and Kee, Sze Ying and Chan, Yoke Fun and Chiam, Chun Wei and Eg, Kah Peng and Thavagnanam, Surendran and Sam, I-Ching (2018) Epidemiology, clinical presentation and respiratory sequelae of adenovirus pneumonia in children in Kuala Lumpur, Malaysia. PLoS ONE, 13 (10). e0205795. ISSN 1932-6203 https://doi.org/10.1371/journal.pone.0205795 doi:10.1371/journal.pone.0205795
institution	Universiti Malaya
building	UM Library
collection	Institutional Repository
continent	Asia
country	Malaysia
content_provider	Universiti Malaya
content_source	UM Research Repository
url_provider	http://eprints.um.edu.my/
topic	R Medicine
spellingShingle	R Medicine Lim, Li Min Woo, Yen Yen De Bruyne, Jessie Anne Nathan, Anna Marie Kee, Sze Ying Chan, Yoke Fun Chiam, Chun Wei Eg, Kah Peng Thavagnanam, Surendran Sam, I-Ching Epidemiology, clinical presentation and respiratory sequelae of adenovirus pneumonia in children in Kuala Lumpur, Malaysia
description	Objectives To describe the severity, human adenovirus (HAdV) type and respiratory morbidity following adenovirus pneumonia in children. Methodology Retrospective review of children under 12 years of age, admitted with HAdV pneumonia, between January 2011 and July 2013, in a single centre in Malaysia. HAdV isolated from nasopharyngeal secretions were typed by sequencing hypervariable regions 1–6 of the hexon gene. Patients were reviewed for respiratory complications. Results HAdV was detected in 131 children of whom 92 fulfilled inclusion criteria. Median (range) age was 1.1 (0.1–8.0) years with 80% under 2 years. Twenty percent had severe disease with a case-fatality rate of 5.4%. Duration of admission (p = 0.02) was independently associated with severe illness. Twenty-two percent developed respiratory complications, the commonest being bronchiolitis obliterans (15.2%) and recurrent wheeze (5.4%). The predominant type shifted from HAdV1 and HAdV3 in 2011 to HAdV7 in 2013. The commonest types identified were types 7 (54.4%), 1(17.7%) and 3 (12.6%). Four out of the five patients who died were positive for HAdV7. Infection with type 7 (OR 8.90, 95% CI 1.32, 59.89), family history of asthma (OR 14.80, 95% CI 2.12–103.21) and need for invasive or non-invasive ventilation (OR 151.84, 95% CI 9.93–2.32E) were independent predictors of respiratory complications. Conclusions One in five children admitted with HAdV pneumonia had severe disease and 22% developed respiratory complications. Type 7 was commonly isolated in children with severe disease. Family history of asthma need for invasive or non-invasive ventilation and HAdV 7 were independent predictors of respiratory complications.
format	Article
author	Lim, Li Min Woo, Yen Yen De Bruyne, Jessie Anne Nathan, Anna Marie Kee, Sze Ying Chan, Yoke Fun Chiam, Chun Wei Eg, Kah Peng Thavagnanam, Surendran Sam, I-Ching
author_facet	Lim, Li Min Woo, Yen Yen De Bruyne, Jessie Anne Nathan, Anna Marie Kee, Sze Ying Chan, Yoke Fun Chiam, Chun Wei Eg, Kah Peng Thavagnanam, Surendran Sam, I-Ching
author_sort	Lim, Li Min
title	Epidemiology, clinical presentation and respiratory sequelae of adenovirus pneumonia in children in Kuala Lumpur, Malaysia
title_short	Epidemiology, clinical presentation and respiratory sequelae of adenovirus pneumonia in children in Kuala Lumpur, Malaysia
title_full	Epidemiology, clinical presentation and respiratory sequelae of adenovirus pneumonia in children in Kuala Lumpur, Malaysia
title_fullStr	Epidemiology, clinical presentation and respiratory sequelae of adenovirus pneumonia in children in Kuala Lumpur, Malaysia
title_full_unstemmed	Epidemiology, clinical presentation and respiratory sequelae of adenovirus pneumonia in children in Kuala Lumpur, Malaysia
title_sort	epidemiology, clinical presentation and respiratory sequelae of adenovirus pneumonia in children in kuala lumpur, malaysia
publisher	Public Library of Science
publishDate	2018
url	http://eprints.um.edu.my/21441/ https://doi.org/10.1371/journal.pone.0205795
_version_	1643691565159284736
score	13.211869

Epidemiology, clinical presentation and respiratory sequelae of adenovirus pneumonia in children in Kuala Lumpur, Malaysia

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