Abstract:Objective To explore the risk factors of severe adenovirus pneumonia（SAP） in children and provide reference basis for early identification of SAP in clinic. Methods A total of 1046 children with adenovirus pneumonia（AP） admitted to Jiangxi Provincal Childrens Hospital from Januery 2010 to Pecember 2019 were selected for a retrospective analysis. There were 705 cases of SAP（SAP group） and 341 cases of non-SAP（NSAP group）. The clinical data,including gender, age, onset season, history of premature or low birth weight infants and underlying diseases, clinical manifestations and laboratory examinations were collected in two groups to find out the risk factors for SAP by the univariate analysis ond multivariate analysis. Results Univariate analysis showed that the incidences of fever time ≥1 week（73.9% vs 66.3%）, alanine aminotransferase（ALT） level of ＞100u/L（21.4% vs 9.1%） and co-infection bacterial（10.8% vs 3.5%） in SAP group were significantly higher than those in NSAP group（P＜0.05）. Multivariate logistic regression analysis showed that elevated level of ALT（＞100u/L） and co-infection with bacterias were the independent risk factors of SAP（P＜0.01）. Conclusion Early and active intervention should be carried out for AP in children accompanied with high level of ALT（＞100u/L） and with bacterial.