OBJECTIVE  To investigate the biochemical and immunological characteristics of adenovirus-positive children, analyze correlated changes among laboratory indicators, and evaluate their value in assessing disease severity and guiding clinical treatment.

METHODS  Clinical data from 333 children admitted to Yicheng People's Hospital from Mar. 1, 2023, to Feb. 29, 2024, were collected. All patients underwent etiological testing of blood and respiratory secretions within 24 hours of admission. The following laboratory indicators were analyzed: white blood cell count （WBC）, alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, uric acid （UA）, creatinine （Cr）, lactate dehydrogenase （LDH）, creatine kinase （CK）, and immunoglobulin G （IgG）, IgM, and IgA levels. After Z-score standardization of all continuous variables, Pearson correlation analysis was performed to evaluate the linear relationships among the markers, and principal component analysis （PCA） was conducted to identify potential characteristic factors.

RESULTS  Positive correlations were observed between CK and each of ALT, AST and LDH （r=0.770, 0.781 and 0.624, respectively, all P＜0.001）, constituting a "liver function and tissue injury cluster".

CONCLUSIONS  Laboratory changes in adenovirus infection in children are primarily driven by a "tissue injury–immune–metabolic" triaxial mechanism. Children with adenovirus infection exhibit characteristic concurrent metabolic injury and humoral immune activation. The immune–metabolic principal components derived from PCA may serve as potential auxiliary indicators for early identification of high-risk children and offer reference value for clinical management, including immunomodulation and intravenous immunoglobulin therapy.