ArticleFrontiers in cellular and infection microbiology2026
Risk factors for hospitalization in pediatric patients with human adenovirus infection and changes in epidemiological and clinical characteristics before and after the COVID-19 pandemic in China: a multicenter retrospective study.
Article in Frontiers in cellular and infection microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Human adenovirus (HAdV) is an important cause of respiratory and systemic infection in children. Since the COVID-19 pandemic, changes in population immunity, transmission patterns, and circulation of respiratory pathogens may have altered the epidemiological and clinical profile of pediatric HAdV infection. However, data comparing pediatric HAdV infection before and after the COVID-19 pandemic remain limited. Methods: We analyzed pediatric patients with HAdV infection admitted to four tertiary hospitals in Jiangsu Province, China, before and after the COVID-19 pandemic. Epidemiological features, including seasonal distribution and age patterns, were compared between the two periods. Clinical manifestations, co-infections, inflammatory biomarkers, and imaging findings were evaluated to characterize differences in disease presentation between pre- and post-COVID periods. Also, risk factors associated with pediatric hospitalization in the post-COVID period were explored. Results: Marked changes were observed in the epidemiological and clinical profile of pediatric HAdV infection after the COVID-19 pandemic. In the post-COVID period, hospitalized children were younger than outpatients and were more likely to present with respiratory, gastrointestinal, and neurological symptoms. They had higher rates of viral or bacterial co-infections, particularly influenza co-infection, along with moderately increased inflammatory biomarkers and greater pulmonary involvement. In addition, seasonal patterns and age distribution shifted measurably after the COVID-19 pandemic. Despite these changes, the overall clinical severity of pediatric HAdV infection did not show substantial worsening. Conclusion: Pediatric HAdV infection after the COVID-19 pandemic was characterized by a distinct epidemiological and clinical pattern, including altered seasonality, younger age concentration, increased influenza co-infection, and moderately heightened inflammatory responses. However, these changes were not accompanied by a substantial deterioration in overall clinical severity. Continued surveillance is warranted to monitor the evolving post-pandemic profile of pediatric HAdV infection.
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