The Epidemiology, Molecular, and Clinical of Human Adenoviruses in Children Hospitalized With Acute Respiratory Infections

Abstract

IntroductionHuman adenovirus (HAdV) is a common pathogen in children with acute respiratory infections (ARIs). The aim was to describe the epidemiology, molecular, and clinical characteristics of HAdV among children hospitalized with ARIs in Wenzhou in southeastern China.MethodologyFrom January 2018 to December 2019, nasopharyngeal swab or sputum specimens were prospectively collected from hospitalized children with ARIs. HAdV was detected using direct immunofluorescence. We used a multiplex PCR assay combined with capillary electrophoresis targeting the hexon gene’s hypervariable region to identify HAdV types 1, 2, 3, 4, 5, 7, 14, 21, 37, 40, 41, and 55. We analyzed the epidemiological, molecular, and clinical data according to the HAdV type.ResultsHAdVs were detected in 1,059 (3.5%) of the total of 30,543 children tested. A total of 947 cases with monotype HAdV identified by the PCR assay were included in the analysis. HAdV-3 (415/947, 43.8%), HAdV-7 (318/947, 33.6%), HAdV-2 (108/947, 11.4%), and HAdV-1 (70/947, 7.4%) were the predominant types. Of the 550 (58.1%) cases detected from December 2018 to August 2019, HAdV-3, and HAdV-7 were the main types. The main diagnoses included 358 cases of pneumonia, 232 cases of tonsillitis, 198 cases of bronchitis, and 159 cases of upper respiratory tract infection (URTI). Among children with pneumonia the main types were HAdV-7 (51.1%), HAdV-3 (36.9%), and HAdV-1 (2.2%). Among children with bronchitis, the main types were HAdV-3 (48.0%), HAdV-7 (28.3%), and HAdV-2 (10.6%). Among children with URTIs, the main types were HAdV-3 (49.7%), HAdV-7 (22.6%), and HAdV-2 (13.2%). Among children with tonsillitis, the main types were HAdV-3 (47.4%), HAdV-2 (22.4%), and HAdV-7 (18.5%). In total, 101 (55.2%) patients required supplemental oxygen, 15 (8.2%) required critical care, and 1 child (0.5%) with HAdV-7 pneumonia died.ConclusionHAdV-3 -7, -2, and -1 were the predominant types identified in hospitalized children with ARIs in Wenzhou. From December 2018 to August 2019, there were outbreaks of HAdV-3 and -7. There were significant differences in HAdV types among children with pneumonia, tonsillitis, bronchitis, and URTI. HAdV-7 can cause more severe pneumonia in children than HAdV-3.

Molecular typing of human adenoviruses among hospitalized patients with respiratory tract infections in a tertiary Hospital in Guangzhou, China between 2017 and 2019

“…In this study, the overall positive rate of HAdV was 2.4%, which is consistent with the positive rate (2.0–6.1%) found in hospitalized patients with acute viral respiratory infection in recent reports in China, Israel, and Switzerland [ 3 , 17 – 20 ]. However, two previous studies conducted in the Northern part of China showed a higher HAdV prevalence (10.4–20.1%) than our study [ 21 , 22 ].…”

“…Bootstrap values were calculated on 1000 replicates, and values < 70% are not shown. The tree is drawn to scale, with branch lengths measured in the number of substitutions per site respiratory infection in recent reports in China, Israel, and Switzerland [3,[17][18][19][20]. However, two previous studies conducted in the Northern part of China showed a higher HAdV prevalence (10.4-20.1%) than our study [21,22].…”

Clinical features and epidemiological analysis of respiratory human adenovirus infection in hospitalized children: a cross-sectional study in Zhejiang

“…HAdV often causes respiratory adenovirus epidemics and outbreaks in different provinces of China [ 8 , 9 ]. Re-emergence of HAdV epidemic in central and southern China in late 2018 and 2019 [ 10 , 11 ]. HAdV genotypes causing localized outbreaks or epidemics of respiratory infections in specific regions may be different or new types may emerge, presenting a complex and variable molecular epidemiological profile [ 12 ].…”

Broad Impact of Exchange Protein Directly Activated by cAMP 2 (EPAC2) on Respiratory Viral Infections

“…As RSV, HMPV, Ebola, VSV, and MERS-CoV are all RNA viruses, we then decided to take a look at whether EPAC plays a role in respiratory DNA viral infection. Herein, AdV, which is a double-stranded DNA virus and also one of the predominant viral pathogens causing lower RTI in humans, was used for the study [16]. As shown in Figure 3A, the AdV titer was not affected by treatment with H89 and CE3F4, while there was a significant drop in viral replication in the MAY0132-treated A549 cells, compared with DMSO-treated infected cells.…”

“…Co-infection of HMPV and RSV has been demonstrated to be associated with a higher risk of ICU admission in children under five years [14] and increased disease severity in infants [15]. In addition to these RNA viruses, double-stranded DNA adenovirus (AdV) is also a common cause of RTI in children and adults [16,17]. Adenovirus infection can cause significant morbidity and mortality in young children and immunocompromised patients [18][19][20].…”