Risk Factors for Developing Adenovirus-Associated Post-Infectious Bronchiolitis Obliterans.

Autor: Gordon O; Pediatric Infectious Unit, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.; The Goldyne Savad Institute of Gene Therapy, Hadassah Medical Center, Jerusalem, Israel., Mohamad H; Pediatric Pulmonology Unit, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel., Guzner N; Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel., Cohen Y; Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel., Ben-Meir E; Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel., Samman N; Pediatric Department, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel., Sergienko R; Department of Health Policy and Management, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel., Wolf DG; Infectious Diseases, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.; The Lautenberg Center for Immunology and Cancer Research, Institute of Medical Research Israel-Canada, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel., Picard E; Pediatric Pulmonology Unit, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel., Kerem E; Pediatric Pulmonology Unit, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel., Shamriz O; The Lautenberg Center for Immunology and Cancer Research, Institute of Medical Research Israel-Canada, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.; Allergy and Clinical Immunology Unit, Department of Medicine, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Jazyk: angličtina
Zdroj: Pediatric pulmonology [Pediatr Pulmonol] 2024 Nov 21, pp. e27411. Date of Electronic Publication: 2024 Nov 21.
DOI: 10.1002/ppul.27411
Abstrakt: Background: Risk factors for progression of adenovirus (AdV)-associated bronchiolitis (AdV-B) to post-infectious bronchiolitis obliterans (PIBO) are poorly defined. We aimed to investigate this in a multicenter cohort.
Methods: A multicenter hospital-based analysis included children admitted with AdV-B in Jerusalem during 2016-2022. A case-control analysis included AdV-PIBO patients in Jerusalem during 2005-2023. Cases were compared to randomly assigned controls admitted with AdV-B without progression to AdV-PIBO. Multivariate analysis with logistic regression was used.
Results: The annual incidence of AdV-B admissions and AdV-PIBO increased during 2016-2022, during which 1522 children were admitted with AdV-B and 8 developed AdV-PIBO (0.5%). Of 30 AdV-PIBO cases identified during 2005-2023, available data were compared for 25 of them (72% boys; mean age ± standard deviation 1.2 ± 0.8 years) and 139 controls (66% boys; mean age 1.0 ± 0.6 years, p = 0.5 for age). Jewish ethnicity was more common in the AdV-PIBO versus control group (92% vs. 66%, p = 0.009), as were oxygen supplementation (84% vs. 45%, p < 0.001), noninvasive ventilation (20% vs. 4%, p = 0.004), consolidations on chest X-ray (44% vs. 19%, p = 0.011), and lymphopenia (92% vs. 46%, p < 0.001). Combining Jewish ethnicity, lymphopenia, consolidations, and prolonged admission as independent risk factors yielded positive and negative predictive values of 68.8% and 90.5%, respectively.
Conclusion: These findings emphasize the urgent need for targeted preventive and management strategies. The identification of Jewish ethnicity as a risk factor may imply a genetic contribution to Adv-PIBO risk.
(© 2024 Wiley Periodicals LLC.)
Databáze: MEDLINE
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