Adenovirus types associated with severe respiratory diseases: A retrospective 4‐year study in Kuwait

Abstract

Human adenovirus (HAdV) infection can result in a severe respiratory disease. The aim of this study was to identify HAdV types detected in patients hospitalized for severe respiratory illness. The study population consisted of 743 patients with severe respiratory disease admitted to four major hospitals in Kuwait between January 2013 and December 2016. Respiratory specimens were retrospectively screened for 20 respiratory viruses by real-time PCR. The HAdV hexon gene was amplified and directly sequenced, and HAdV types were identified by performing Bayesian phylogenetic analysis. HAdV DNA was detected in 27 (3.6%) patients, with peaks in November and March. Most patients were infants and young children suffering from pneumonia or acute bronchiolitis. The detected HAdV types were C1, C2, C5, B3, and B7. Clusters of HAdV C1, C2, and C5 were observed with high posterior probability. All patients infected with HAdV C5 and 50% of patients infected with HAdV C2 or B7 were admitted to the intensive care unit (ICU). Co-infection with other viruses was detected in 44.4% of patients. The most common co-infecting virus was rhinovirus (HRV). HAdV/HRV co-infection was detected in two children who presumably developed disseminated HAdV infection and died. This is the first report describing the circulation of HAdV types associated with severe outcomes in Kuwait. These findings highlight the need for a national surveillance system to monitor changes in predominant HAdV types and increased numbers of severe respiratory infections.

Human adenovirus load in respiratory tract secretions are predictors for disease severity in children with human adenovirus pneumonia

“…In China, pneumonia is the main cause of child hospitalization which brings about increased burden for outpatient clinic [2,3]. Respiratory virus infections are increasingly recognized as playing a major role in the burden of severe acute respiratory illness in many countries due to expanded global surveillance and improved molecular diagnostic testing [4][5][6][7]. It is reported that among children with pneumonia, 4-10% are caused by human adenovirus (HAdV).…”

“…In recent years, more and more people have recognized the role of adenovirus in severe respiratory infection: resulting in increased hospitalization and mortality [10,11]. The severity of lower respiratory tract infection caused by HAdV is related to HAdV types, age of onset, immune status, and environment [7,12,13]. Notwithstanding children and patients with immunodeficiencies are at increased risk for severe HAdV disease, most children with HAdV requiring hospitalization are previously healthy.…”

“…In healthy children, most adenovirus respiratory infections are mild and indistinguishable from other viral causes. However, specific serotypes, such as serotypes human adenovirus type 3 (HAdV-3), human adenovirus type 7 (HAdV-7), and human adenovirus type 14 (HAdV-14) have been implicated with fatal outcomes [7,14,15]. HAdV-3 and HAdV-7 are the most common types in China, and HAdV-7 is more likely to cause severe pneumonia and significant mortality especially in infants and young children (6-24 months) [10].…”

Human adenoviruses associated with respiratory illness in neonates, infants, and children in the Sousse area of Tunisia

“…Moreover, a study done in Kuwait found that 75% of patients with HAdV severe respiratory infection had Ct-values less than 30 cycles. 42 In this study, no correlation could be established 15.4, respectively). In this study, the mean Ct-values for non-typed samples were 34.4 against 24.6 for successfully typed samples.…”

Severe Pneumonia with and without Adenovirus Infection in Children Under the Age of 5 in Guangzhou, 2009-2019: A Retrospective Cohort Study

“…ADVs have seven species (A to G) with more than 90 serotypes, and some serotypes are associated with speci c clinical manifestations. Therefore, many previous researches focus on the serotypes of ADV and their clinical manifestations (10). NATRS summaries reporting of laboratory detections of ADV types to determine patterns of circulation for individual human adenovirus types, assist with the recognition and documentation of outbreaks associated with circulating types, and to inform diagnostic and surveillance activities by clinician and public health practitioners (11), and has reported that ADV-7 caused severe pneumonia might be reemerging in USA (4).…”