Clinical Features and Radiological Findings of Adenovirus Pneumonia Associated with Progression to Acute Respiratory Distress Syndrome: A Single Center Study in 19 Adult Patients

Cha, Min Jae; Chung, Myung Jin; Lee, Kyung Soo; Kim, Tae Jung; Kim, Tae Sung; Chong, Semin; Han, Jungho

Our study also demonstrated that the disease extent seen on chest CT, which was defined by total CT score and the presence of pleural effusion significantly differed between the ARDS and non-ARDS groups (Fig. 1 ). In addition, the patients in the ARDS group showed progressive deterioration on sequential radiographs, rather than fluctuations or improvement. This result is consistent with previous reports regarding prognoses of other viral pneumonias such as H1N1, severe acute respiratory syndrome, and Middle East respiratory syndrome (16, 17, 23) . Close imaging follow- One can argue that the rate of respiratory failure in adenovirus pneumonia might have been overestimated in our study, considering the way that adenovirus pneumonia was confirmed. The effort for confirmatory diagnosis was usually made when the results of laboratory evaluations, including the staining and culture of blood, urine, and sputum, were negative, and the response to empirical antibiotic therapy was unsatisfactory. Thus, the diagnosis might have been delayed, missing the important opportunity for timely treatment. In addition, our institution is a tertiary referral hospital in Seoul; thus, the rates of ARDS and mortality could be further exaggerated. We admit that the rates of ARDS and mortality of adenovirus pneumonia in our study might not be applicable to those of adenovirus pneumonia in the general community. Nevertheless, we think that our results are meaningful with respect to emphasizing the severity of adenovirus pneumonia.