Abstract
Adenoviral pneumonia is a significant cause of morbidity and mortality among children. There is limited data about the clinical profile, intensive care needs, and outcomes of children with adenoviral pneumonia from resource-limited settings. This retrospective study was conducted in the pediatric emergency room (PER) and pediatric intensive care unit (PICU) of a tertiary care hospital in North India over a period of a period of 2 years (July 2022 to June 2024). The data collection included demographic and clinical features, laboratory investigations, complications, treatment, intensive care needs, and outcomes. Eighty-five children were enrolled, majority were <1 year of age and males (71.7% each). All presented with fever and respiratory symptoms. The common complications were acute respiratory distress syndrome (ARDS) (47%), multiple organ dysfunction syndrome (MODS) (26%), shock (25%), and encephalopathy (25%). PICU admission was needed in 46% of children. The intensive care needs included invasive mechanical ventilation (48%), CPAP (39%), HFNC (9%), vasoactive drugs (25%), IVIG (8%), RRT (6%), and cidofovir (5%). The duration of ER, PICU, and hospital stay was 48 (24–96) hours, 7 (4–14) days, and 9 (5–18) days, respectively. The mortality rate was 22%. On multivariate analysis, the independent predictors of mortality were low admission pH, myocardial dysfunction, acute kidney (AKI), ARDS, shock, encephalopathy, MODS, and healthcare-associated infection (HCAI). Infants constituted the largest group of patients requiring admission for adenoviral infection to pediatric emergency in a tertiary care center. Common complications were ARDS, shock, MODS, and encephalopathy. Nearly half required PICU admission for organ support. The mortality rate was 22%; and low admission pH, myocardial dysfunction, AKI, ARDS, shock, encephalopathy, MODS, and HCAI were independent predictors of mortality. Vyasam S, Jayaram J, Sarkar S, Angurana SK, Raj S, Bora I, et al. Clinical Profile, Intensive Care Needs, and Outcome of Children with Adenoviral Pneumonia: A Retrospective Study from a Tertiary Care Hospital in North India. Indian J Crit Care Med 2025;29(7):586–591.

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