Clinical Impact of Mixed Respiratory Viral Infection in Children with Adenoviral Infection

Lee, Hyun Jun; Seo, Young Eun; Han, Seung Beom; Jeong, Dae Chul; Kang, Jin Han

The present study had several limitations, its retrospective nature being the first. We did not identify infecting ADV serotypes in our study, and the severity of ADV infection, as well as frequency of respiratory viral infection, varied according to the causative serotype [8] [9] [10] [11] . To evaluate the impact of specific ADV serotypes on clinical severity and frequency of coinfections, a multicenter study, involving several geographically-separated hospitals would need to be conducted for a sufficiently long period to capture multiple ADV outbreaks with different causative serotypes. Attending daycare centers may further increase the risk of exposure to a variety of respiratory viruses, and influence the frequency and severity of respiratory viral infections; however, this was not evaluated in the present study. We also could not determine the independent effect of each respiratory virus concurrently identified with ADV infection because of the small group size for each respiratory virus. Finally, the impact of coinfection on the long-term sequelae of ADV infection (e.g., bronchiectasis and bronchiolitis obliterans) could not be assessed [29, 30] .