Adenovirus infection in critically ill children: Clinicoepidemiological insights from a tertiary care center in Eastern India

Background: Adenovirus infection is a significant cause of pediatric respiratory illness and may lead to severe disease requiring pediatric intensive care unit (PICU) admission. Affected children commonly present with fever, cough, and respiratory distress, with occasional gastrointestinal symptoms or conjunctivitis. The illness predominantly affects younger children and shows seasonal variation, often peaking in colder months. Understanding the clinicoepidemiological profile of severe adenoviral infection is essential for early diagnosis, timely management, and improved outcomes in tertiary care settings. Aims and Objectives: To describe the clinical profile, laboratory abnormalities, and outcomes of adenovirus infection in children admitted to a PICU. Materials and Methods: A retrospective observational study was conducted among 62 children aged 1–5 years with reverse transcription polymerase chain reaction confirmed adenovirus infection admitted to the PICU of Malda Medical College and Hospital, Malda. Demographic, clinical, laboratory, and outcome data were analyzed. Results: Infants and children aged ≤5 years constituted equal proportions (50% each), with a male predominance (58.1%). Fever and respiratory symptoms were present in all cases. Laboratory abnormalities were frequent, with transaminitis in 71%, elevated C-reactive protein in 53.2%, anemia in 33.9%, thrombocytopenia in 27.4%, and dyselectrolytemia in 32.3%. Overall mortality was 29%. Non-survivors had significantly higher alanine aminotransferase and aspartate aminotransferase levels, and liver dysfunction was more frequent among non-survivors (44.4% vs. 15.9%). Conclusion: Adenovirus infection in critically ill children presents as a severe multisystem disease with significant mortality. Early recognition and careful monitoring of organ dysfunction are essential.