The Risk Factors Involved in Airway Mucus Plug in Children with ADV Pneumonia

Overview

Journal BMC Pulm Med

Publisher Biomed Central

Specialty Pulmonary Medicine

Date 2023 Nov 18

PMID 37978491

Authors

Jing-Jing Huang

Lin Yuan

Zhi-Qiang Zhuo

Ming-Zhen Li

Xing-Dong Wu

Affiliations

Soon will be listed here.

Abstract

Background: The risk factors for mucus plug in children with adenovirus (ADV) pneumonia.

Methods And Materials: A retrospective analysis was conducted of children diagnosed ADV pneumonia and underwent fiberoptic bronchoscopy admitted to the Xiamen Children's Hospital from September 2018 to September 2021.The patients were divided into a mucus plug group (39 cases) and a non-mucus plug group (53 cases). The children's data including sex, age, clinical presentation, laboratory test parameters, imaging and bronchoscopic data were collected. The risk factors for the development of airway mucus plug were analysed by multifactorial logistic regression.

Results: There were no statistically significant differences in sex, age, fever, hospitalization days, mixed infection, white blood cells (WBC) count, percentage of neutrophils (NE%), C-reactive protein(CRP), and D-dimer (all P > 0.05); Thermal range, procalcitonin (PCT), lactate dehydrogenase (LDH), Pleural effusion and associated decreased breath sounds was significantly higher in mucus plug group than in non-mucus plug group, and the differences were statistically significant (all P < 0.05); multifactorial logistic regression analysis showed that the duration of fever, PCT, and LDH were independent risk factors for the formation of mucus plugs. The critical values of ROC curves were pyroprocedure ≥ 6.5 d, PCT ≥ 0.705 ng/ml and LDH ≥ 478.5 U/L.

Conclusion: Duration of fever, PCT and LDH levels were the independent risk factors for the formation of an airway mucus plug in children with ADV pneumonia.

References

Cha M, Chung M, Lee K, Kim T, Kim T, Chong S . Clinical Features and Radiological Findings of Adenovirus Pneumonia Associated with Progression to Acute Respiratory Distress Syndrome: A Single Center Study in 19 Adult Patients. Korean J Radiol. 2016; 17(6):940-949. PMC: 5102922. DOI: 10.3348/kjr.2016.17.6.940. View

Chen R, Lee C . Adenoviruses types, cell receptors and local innate cytokines in adenovirus infection. Int Rev Immunol. 2013; 33(1):45-53. DOI: 10.3109/08830185.2013.823420. View

Kawasaki Y, Hosoya M, Katayose M, Suzuki H . Correlation between serum interleukin 6 and C-reactive protein concentrations in patients with adenoviral respiratory infection. Pediatr Infect Dis J. 2002; 21(5):370-4. DOI: 10.1097/00006454-200205000-00004. View

Tan D, Zhu H, Fu Y, Tong F, Yao D, Walline J . Severe Community-Acquired Pneumonia Caused by Human Adenovirus in Immunocompetent Adults: A Multicenter Case Series. PLoS One. 2016; 11(3):e0151199. PMC: 4788423. DOI: 10.1371/journal.pone.0151199. View

An S, Zhang L, Li J . [Prognostic judgment of children with Mycoplasma pneumoniae pneumonia associated with airway mucous plug formation]. Zhongguo Dang Dai Er Ke Za Zhi. 2015; 17(5):487-91. View

Yuan L, Huang J, Zhu Q, Li M, Zhuo Z . Plastic bronchitis associated with adenovirus serotype 7 in children. BMC Pediatr. 2020; 20(1):268. PMC: 7268262. DOI: 10.1186/s12887-020-02119-4. View

Zhang Y, Zhou Y, Li S, Yang D, Wu X, Chen Z . The Clinical Characteristics and Predictors of Refractory Mycoplasma pneumoniae Pneumonia in Children. PLoS One. 2016; 11(5):e0156465. PMC: 4882022. DOI: 10.1371/journal.pone.0156465. View

Shen C, Wang S, Ho T, Liu C . Clinical features of community acquired adenovirus pneumonia during the 2011 community outbreak in Southern Taiwan: role of host immune response. BMC Infect Dis. 2017; 17(1):196. PMC: 5341368. DOI: 10.1186/s12879-017-2272-5. View

Lu Z, Zheng Y . Plastic bronchitis associated with adenovirus infection. Lancet Infect Dis. 2018; 18(4):474. DOI: 10.1016/S1473-3099(18)30095-1. View

10.

Toikka P, Irjala K, Juven T, Virkki R, Mertsola J, Leinonen M . Serum procalcitonin, C-reactive protein and interleukin-6 for distinguishing bacterial and viral pneumonia in children. Pediatr Infect Dis J. 2000; 19(7):598-602. DOI: 10.1097/00006454-200007000-00003. View

11.

Lynch 3rd J, Kajon A . Adenovirus: Epidemiology, Global Spread of Novel Serotypes, and Advances in Treatment and Prevention. Semin Respir Crit Care Med. 2016; 37(4):586-602. PMC: 7171713. DOI: 10.1055/s-0036-1584923. View

12.

Zhang Y, Chen Y, Chen Z, Zhou Y, Sheng Y, Xu D . Effects of bronchoalveolar lavage on refractory Mycoplasma pneumoniae pneumonia. Respir Care. 2014; 59(9):1433-9. DOI: 10.4187/respcare.03032. View

13.

Elenius V, Peltola V, Ruuskanen O, Yliharsila M, Waris M . Plasma procalcitonin levels in children with adenovirus infection. Arch Dis Child. 2011; 97(6):582-3. DOI: 10.1136/archdischild-2011-301308. View

14.

Lion T . Adenovirus infections in immunocompetent and immunocompromised patients. Clin Microbiol Rev. 2014; 27(3):441-62. PMC: 4135893. DOI: 10.1128/CMR.00116-13. View

15.

Tao R, Luo X, Xu W, Mao B, Dai R, Li C . Viral infection in community acquired pneumonia patients with fever: a prospective observational study. J Thorac Dis. 2018; 10(7):4387-4395. PMC: 6105945. DOI: 10.21037/jtd.2018.06.33. View

16.

Dunican E, Elicker B, Gierada D, Nagle S, Schiebler M, Newell J . Mucus plugs in patients with asthma linked to eosinophilia and airflow obstruction. J Clin Invest. 2018; 128(3):997-1009. PMC: 5824874. DOI: 10.1172/JCI95693. View