Role of Intravenous immunoglobulin in Non-Immunocompromised children With Severe Adenovirus Pneumonia: A Retrospective Observational Study release_gi62jiu5rbgjxokl6mxjqgfn6y

Abstract

<jats:title>Abstract</jats:title> <jats:bold>Background: </jats:bold>Adenovirus pneumonia is a pulmonary infectious disease commonly occurring in children, and severe cases can lead to death and sequelae. Here, we aimed to observe the therapeutic timing and dosage of intravenous immunoglobulin(IVIg) in non-immunocompromised children with severe adenovirus pneumonia.<jats:bold>Methods:</jats:bold> This retrospective observational study investigated severe adenovirus pneumonia treated with IVIg in non-immunocompromised pediatric patients at a tertiary hospital in 2019. Participants were classified as early presenters (5-10 days of illness course) and later presenters (11-15 days) according to the timing of IVIg treatment. Patients' clinical data were then analyzed in terms of different dosages of IVIg administration. <jats:bold>Results:</jats:bold> Among 202 patients enrolled, 128 were early presenters and 74 were later presenters during the study period. The later presenters had longer fever duration, more incidences of fungal coinfections, more demands for mechanical ventilation, and higher incidence of bronchiectasis than early presenters (<jats:italic>P</jats:italic>&lt;0.05). For early presenters, no statistically significant differences in demands for advanced life support, outcomes and sequelae were observed between the two different dosage groups (<jats:italic>P</jats:italic>&gt;0.05). For later presenters, shorter fever duration and lower usage of extracorporeal membrane oxygenation (ECMO) were observed in the high-dosage group than that in the low-dosage group (<jats:italic>P</jats:italic>&lt;0.05). The incidence of post-infectious bronchiolitis obliterans (PIBO) and bronchiectasis was not significantly different between the two groups (<jats:italic>P</jats:italic>&gt;0.05). The incidence of adverse events was 6.62% during IVIg infusion, showing no significant difference between the two groups (<jats:italic>P</jats:italic>&gt;0.05).<jats:bold>Conclusions:</jats:bold> Early medical care and treatment with IVIg are very important to improve the prognosis of non-immunocompromised children with severe adenovirus pneumonia. For later presenters, children with severe conditions may benefit from a high IVIg dosage.
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