Authors: Ghadi Zebian , Aurelie Guigon , Christos Gkizas , Sebastien Preau , Arthur Durand

Abstract

Background: Despite traditionally affecting individuals with compromised immune systems, severe human adenoviruses (HAdV) infections have been observed in young adults without immunodeficiency over recent decades.
Case Presentation: This case study documents two young patients infected with HAdV who experienced multi-organ failure, manifesting as respiratory distress, vasoplegia, myocardial injury, and kidney impairment. The resolution of organ failure correlated with the clearance of viral load, suggesting a potential prognostic indicator for infection outcomes. While the first case demonstrated a positive outcome with the resolution of viremia, regrettably, the second case succumbed to myocardial infarction followed by cardiac arrest. The use of cardiac monitoring may aid in the identification of significant myocardial complications associated with HAdV. Although various treatments, including the antiviral CIDOFOVIR, have been reported for immunocompromised individuals, it was not administered to our patients due to the favorable trajectory of the first case.
Tragically, the second case passed away before any potential antiviral intervention could be initiated.
Conclusion: HAdV infections can cause severe acute respiratory distress syndrome with multi-organ failure including severe cardiac complications in young non-immunocompromised adults.

Keywords: Case report, adenovirus, acute respiratory distress syndrome, intensive care unit, extracorporeal membrane oxygenation, pneumonia, viral pneumonia.