Evidence map›Paper›PMID 31886457›Full record

ArticleClinical infection in practice2019

Adenovirus Type 7 causing severe lower respiratory tract infection in immunocompetent adults: a comparison of two contrasting cases from an intensive care unit in North West England.

Tom Wingfield, Luke Dearden, Pete Calvert, Orod Osanlou, Brian Johnston, Anu Chawla, Ian Hart, Catherine Thompson, Lance Turtle, Richard Wenstone

Open access · goldAbstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical infection in practice, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
0.5field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 2 countries.

Tom WingfieldLIV-TB Collaboration and Departments of Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK.
Luke DeardenIntensive Care Unit, Royal Liverpool University and Broadgreen Hospitals NHS Trust, Liverpool, UK.
Pete CalvertIntensive Care Unit, Royal Liverpool University and Broadgreen Hospitals NHS Trust, Liverpool, UK.
Orod OsanlouDepartment of Clinical Pharmacology, Royal Liverpool University and Broadgreen Hospitals NHS Trust, Liverpool, UK.
Brian JohnstonIntensive Care Unit, Royal Liverpool University and Broadgreen Hospitals NHS Trust, Liverpool, UK.
Anu ChawlaLiverpool Specialist Virology Centre, Royal Liverpool University and Broadgreen Hospitals NHS Trust, Liverpool, UK.
Ian HartLiverpool Specialist Virology Centre, Royal Liverpool University and Broadgreen Hospitals NHS Trust, Liverpool, UK.
Catherine ThompsonRespiratory Virus Unit, Virus Reference Department, National Infection Service, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK.
Lance TurtleDepartment of Clinical Infection, Microbiology and Immunology, Institute of Infection and Global Health, University of Liverpool, UK.
Richard WenstoneIntensive Care Unit, Royal Liverpool University and Broadgreen Hospitals NHS Trust, Liverpool, UK.
Royal Liverpool and Broadgreen University Hospital NHS Trust · GBBroadgreen Hospital · GBLiverpool School of Tropical Medicine · GBPublic Health England · GBUniversity of Liverpool · GB

Funding

Medical Research Council MR/K007467/1Wellcome Trust 205228/Z/16/Z
6 · The paper itself

Abstract

objectivesSevere lower respiratory tract infection caused by adenovirus is well described in immunocompromised hosts and can cause significant morbidity and mortality. We compare and contrast the clinical presentation, radiological, and virological features of two rare cases in immunocompetent adults admitted to an intensive care unit in a large, teaching hospital in North West England. We then provide a concise, comprehensive literature review.

methodsThe first case was a 35-year old female asthmatic who presented with respiratory distress and pneumonitis during peak influenza season, and recovered after a prolonged hospital stay. The second case was a 73-year old male who presented with diarrhoea, vomiting, and general malaise outside of influenza season, developed respiratory compromise, and died. Adenovirus type 7 was identified in bronchoalveolar lavages and plasma samples of both patients, each of whom received cidofovir. No other infectious aetiology was identified.

resultsClinical and radiological features of severe lower respiratory tract adenoviral infection are similar to other infectious causes of pneumonia and ARDS, including severe influenza. This can create diagnostic uncertainty, especially during influenza season. Positive adenovirus polymerase chain reaction results can support a diagnosis of severe lower respiratory tract adenovirus infection in patients with a clinically compatible syndrome and no other identified aetiology, with higher viral loads being associated with worse prognosis. Although treatment is predominantly supportive, early use of cidofovir may improve outcomes.

conclusionsThese rare cases highlight that severe lower respiratory tract adenoviral infection should be considered in the differential diagnoses of immunocompetent patients presenting with pneumonia and ARDS.

Indexed as

Acute respiratory distressAdenovirusCritical careIntensive carePneumoniaPneumonitisSevere lower respiratory tract infection

Identifiers

PMID31886457
PMCPMC6919333
OpenAlexW2979940529

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.