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

There are limitations to our study. First, our study was retrospective in nature and thus had a selection bias. Patients with adenovirus pneumonia who had severe respiratory symptoms or abnormal radiologic findings might have been selectively included. Second, we did not perform a serotype analysis of adenovirus. To date, more than 52 serotypes of adenovirus have been recognized and are known to show different biological properties (29) . Further work needs to be performed investigating the virulent strains of adenovirus, particularly with regard to radiologic appearance, disease extent, and severity. Third, the time to CT acquisition from symptom onset was heterogeneous, ranging from two to 15 days. CT scans from the ARDS group might have progressed from an initially mild disease to showing a relatively large extent of involvement. Fourth, we simplified the chest radiographic abnormality as focal, multifocal, and diffuse opacity without assessing other findings such as interstitial opacities. However, we were more focused on the disease extent and sequential radiographic changes rather than detailed radiographic findings. Fifth, our study only included patients confirmed to have adenovirus pneumonia and did not include a comparison group. Sixth, the diagnosis of adenovirus pneumonia was made using various methods. Lastly, the number of cases in the present study is small, and a large-scale prospective study is needed. In addition, comparison of clinico-radiological features between immunocompromised and immunocompetent patients with adenovirus pneumonia would also have clinical implications toward understanding the clinical course of the disease.