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Adenovirus Species in U.S. Children With Acute Respiratory Illness, 2016-2019
Varvara Probst1, Tess Stopczynski2, Justin Z Amarin1
1Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232, United States.
Insights
Human adenovirus (HAdV) species C caused fewer hospitalizations in children with acute respiratory illness (ARI) than HAdV species B. Further research is needed to understand HAdV types and illness severity.
Area of Science:
- Pediatric infectious diseases
- Virology
- Public health surveillance
Background:
- Human adenovirus (HAdV) is a frequent cause of pediatric acute respiratory illness (ARI).
- While HAdV-B, -C, and -E species are linked to ARI, their detection frequencies and roles in symptomatic infections in the U.S. are not well-defined.
Purpose of the Study:
- To determine the relative detection frequencies of HAdV species B and C in children with ARI in the U.S.
- To compare the clinical characteristics and hospitalization rates between children infected with HAdV-B and HAdV-C.
Main Methods:
- A prospective viral surveillance study was conducted across 7 U.S. children's hospitals from 2016 to 2019.
- Respiratory specimens from children under 18 with ARI symptoms were tested for HAdV, and positive samples were typed using real-time PCR.
- Clinical data and outcomes, including hospitalization and oxygen use, were compared between HAdV-B and HAdV-C infections.
Main Results:
- Of 29,381 children with ARI, 6.3% tested positive for HAdV, with HAdV-C (73.0%) being more common than HAdV-B (22.3%).
- Children with HAdV-C were younger and more likely to have co-infections with other respiratory pathogens.
- After adjusting for other pathogens, HAdV-C was associated with significantly lower odds of hospitalization compared to HAdV-B (aOR: 0.44).
Conclusions:
- HAdV-C infections in children presenting with ARI were associated with lower hospitalization rates compared to HAdV-B infections.
- These findings highlight the need for further investigation into specific HAdV types and their contribution to respiratory illness severity in pediatric populations.
Background:
Human adenovirus (HAdV) is a common cause of pediatric acute respiratory illness (ARI). HAdV-B, -C, and -E species have been associated with ARI, though relative detection frequencies in United States (U.S.) and respective roles in symptomatic respiratory infections remain unclear.
Methods:
We conducted a multicenter, prospective viral surveillance study at 7 U.S. children's hospitals comprising the New Vaccine Surveillance Network from January 12, 2016 to November 30, 2019. Children <18 years old in the emergency department or hospitalized with fever and/or respiratory symptoms were enrolled, and respiratory specimens were tested for HAdV and other viral pathogens. HAdV-positive specimens were subsequently typed using single-plex real-time PCR assays targeting sequences in the hexon gene. Demographics, clinical characteristics, and outcomes (hospitalization and supplemental oxygen use as severity indicators) were compared between HAdV-B and HAdV-C species.
Results:
Of the 29 381 children with ARI, 1843 (6.3%) had HAdV detected, with 1402 specimens (76.0%) successfully typed. HAdV-C was the most frequently detected species (73.0%), followed by HAdV-B (22.3%). Children with HAdV-C were younger than those with HAdV-B and more likely to have another respiratory pathogen. Among children without other detected respiratory pathogens, those with HAdV-C had lower odds of hospitalization compared with children with HAdV-B (aOR: 0.44, 95% CI, 0.27-0.73, P =.001).
Conclusions:
In our study among children seen in the emergency department or hospitalized with ARI, those with HAdV-C had lower odds of hospitalization compared with HAdV-B. These findings warrant further assessment to identify which HAdV types contribute to illness severity.
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