Genome and proteomic analysis of risk factors for fatal outcome in children with severe community‐acquired pneumonia caused by human adenovirus 7

Wei, Jianhua; Zang, Na; Zhang, Jing; He, Yu; Huang, Haixia; Liu, Xiangyu; Xu, Ximing; Ren, Luo; Deng, Yu; Wu, Jianguo; Seto, Donald; Zhong, Wen; Zhang, Qiwei; Liu, Enmei

doi:10.1002/jmv.29182

Cited by 5 publications

(3 citation statements)

References 36 publications

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“…The subgroups most associated with respiratory tract disease are B (serotypes 3 and 7), C (serotypes 1, 2, and 5) and E (serotype 4). The most severe LRTIs are because of adenovirus types B7, and to a lesser extent, B3, which can cause necrotizing pneumonia [ 27 ]. Recently, HAdV-B55 has also been associated with outbreaks of pneumonia in both immunocompetent and immunocompromised children [ 28 ].…”

Section: Pathophysiology and Immune Responsesmentioning

confidence: 99%

“…Intravenous immunoglobulin has been used to treat acute myocarditis, pneumonia (in immunocompromised patients), and disseminated disease due to adenovirus [ 27 , 39 ]. Glucocorticoids have also been used in patients with adenovirus-associated pneumonia; early administration may improve treatment success and reduce inpatient mortality [ 27 , 48 ].…”

Section: Treatment Optionsmentioning

confidence: 99%

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Respiratory adenovirus infections in children: a focus on Africa

van der Zalm,

Sam-Agudu,

Verhagen

2024

Current Opinion in Pediatrics

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Purpose of review Lower respiratory tract infections (LRTIs) are an important cause of child morbidity and mortality globally, especially in children under the age of 5 years in Africa. Respiratory viruses, including human adenoviruses (HAdVs), are common causes of LRTIs in children. This review aims to shed light on the epidemiology, clinical manifestations, sequelae, and treatment options specific to adenovirus respiratory infections in African children. Recent findings Recent evidence has challenged the perception that adenovirus is a negligible cause of LRTIs. Studies show HAdV emerging as the third most common viral pathogen in fatal pneumonias among under-5 children in low-income and middle-income African countries, contributing to 5.5% of all pneumonia deaths and ranking second in hospital-associated viral pneumonia deaths. Predominant HAdV serotypes associated with disease differ by country and region, and have changed over time. Risk factors for increased disease severity and long-term respiratory sequelae in previously healthy African children with HAdV LRTIs are not well established. Summary Although respiratory viruses, including HAdV, are recognized contributors to LRTIs, the prevalence and impact of adenovirus infections have been under-recognized and understated. Available data suggests that African children, particularly those under 5 years old, are at risk of severe sequelae from respiratory HAdV infections. Long-term sequelae, including bronchiectasis and postinfectious bronchiolitis obliterans, further underscore the significant impact of HAdV infections. However, the scarcity of comprehensive data hampers our understanding of the extent on the impact of HAdV infections child lung health in Africa. We recommend scaled-up HAdV surveillance, ensuring its consistent inclusion in population-level LRTI assessments, and expanded and equitable access to diagnostics for early recognition of African children at risk of developing chronic sequelae and death. Enhanced understanding of adenovirus epidemiology and clinical outcomes and the availability of therapeutic options are essential for informed public health strategies and clinical care.

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Section: Pathophysiology and Immune Responsesmentioning

confidence: 99%

Section: Treatment Optionsmentioning

confidence: 99%

Respiratory adenovirus infections in children: a focus on Africa

van der Zalm,

Sam-Agudu,

Verhagen

2024

Current Opinion in Pediatrics

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“…Human mastadenoviruses, frequently denominated adenoviruses (HAdVs), may cause respiratory tract and gastrointestinal symptoms, while ophthalmologic, genitourinary, and neurologic involvement is far less frequent. HAdV disease is usually self-limiting, although fatal outcome may occur in immunocompromised hosts and occasionally in healthy children and adults [1][2][3][4]. HAdVs have a worldwide distribution and cause 5 to 10 percent of all febrile illnesses in infants and young children throughout the year without seasonality [5].…”

Section: Introductionmentioning

confidence: 99%

A High Copy Number from a Pharyngeal Swab Is Not Associated with Different Presenting Features in 100 Children with Acute Adenovirus Infection from a Cluster in Italy

Mariani,

Cavallo,

La Bella

et al. 2023

Children

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Human mastadenoviruses, frequently denominated adenoviruses (HAdVs), may cause respiratory tract, gastrointestinal or, less frequently, other involvements. Epidemics of HAdV infections occur globally, in communities, and in closed or crowded settings. In our institution, a cluster of infants and children admitted for HAdV infection was recently observed. The aim of this study was to describe the pattern of their presenting features and investigate the possible correlation between the HAdV copy number and the clinical picture. Two main patterns of clinical presentation were observed: 68 patients had mainly respiratory symptoms (pharyngitis n = 67, cough n = 44; tonsillar exudate n = 17; other respiratory signs n = 4) while 26 patients showed prevalent gastrointestinal involvement (diarrhea n = 26, vomiting n = 8). Patients with respiratory symptoms had a significantly higher count of WBC, PMN, and platelets, while CRP level approached statistical significance (p = 0.07) for higher values in the patients with diarrhea. In order to explore the impact of selected presenting features, the possible association between the level of CRP and the presence of pharyngeal exudate, cough, vomiting, diarrhea, duration of fever, number of neutrophils, and administration of antibiotics was analyzed. Patients falling in the tertile with more elevated CRP values had tonsillar exudate and diarrhea significantly more often, while those in the lower tertile had a 4.4-day duration fever vs. ≥5.0 days in the remaining patients. Antibiotic therapy was administered more frequently to patients with higher values of CRP (p = 0.006). The duration of hospitalization was not associated with the CRP level. The median time from the receipt of a positive HAdV PCR test result to patient discharge was 1 day in 73% of cases. The number of copies of HAdV detected via PCR ranged between 47 million and 15/μL. Falling in the highest tertile of copy number was significantly associated with pharyngitis. The 24 patients with evidence of viral coinfection had no difference in the demographics or presenting features, with the only exception being a significantly higher leukocyte count. The rapid turn-around of the results of the molecular testing of the HAdV genome on a pharyngeal swab allowed us to rapidly diagnose HAdV infection, allowing us to stop antibiotic therapy and immediately discharge the patients, with reduced discomfort for the families and more appropriate use of hospital beds. A high copy number of HAdV from a pharyngeal swab should not be taken as an indicator of worse prognosis, thus allowing for the preferential use of qualitative rather than quantitative assay.

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