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Published on: November 10, 2023
Epidemiology of Respiratory Adenovirus Infections Among Hospitalized Children in Hainan Province, China, 2021-2024
Xiangyue Zeng1, Shengjie Shi1, Mengchun Chen1
1Department of Clinical Laboratory, Center for laboratory Medicine, Hainan Women and Children's Medical Center, Haikou 570206, China.
Insights
Human adenovirus (HAdV) infections surged in hospitalized children in Hainan, China, post-COVID-19. Genotype shifts and increased co-infections highlight the need for ongoing surveillance in pediatric respiratory infections.
Area of Science:
- Virology
- Epidemiology
- Pediatrics
Background:
- Human adenoviruses (HAdVs) are key causes of pediatric acute respiratory tract infections (ARTIs).
- Understanding HAdV epidemiology is crucial, especially during and after the COVID-19 pandemic.
Purpose of the Study:
- To characterize HAdV epidemiological patterns in hospitalized children in Hainan, China (2021-2024).
- To identify shifts in genotypes, seasonality, age distribution, and co-infection prevalence.
Main Methods:
- Retrospective analysis of hospitalized pediatric ARTI cases (n=31,843) from 2021-2024.
- Detection of HAdVs and genotyping.
- Analysis of temporal trends, seasonality, age groups, and co-infections, including next-generation sequencing (tNGS) data.
Main Results:
- HAdV prevalence was 7.74% (2464/31,843), with a sharp increase in 2024 (11.58%).
- Dominant genotypes shifted from HAdV-C to HAdV-B; a summer peak and year-round circulation were observed in 2024.
- Children aged 1-7 years were most affected; co-infections became predominant (>85% by 2023-2024), especially with tNGS diagnostics.
Conclusions:
- A post-pandemic resurgence of HAdV activity is evident in pediatric populations.
- Altered immunity, social interactions, and improved diagnostics contribute to increased HAdV detection and co-infections.
- Continuous surveillance is vital for managing pediatric respiratory infections and guiding interventions.
Abstract:
Human adenoviruses (HAdVs) are significant viral pathogens associated with a wide spectrum of diseases, particularly acute respiratory tract infections (ARTIs) in children. This study aimed to characterize the epidemiological features of HAdV infections among hospitalized pediatric patients in Hainan Province, China, from January 2021 to December 2024, encompassing the COVID-19 pandemic and post-policy transition period. Among 31,843 hospitalized children with ARTIs, HAdVs were detected in 2464 cases (7.74%). Annual positivity rates were 4.87% in 2021, 7.21% in 2022, and 4.39% in 2023, and sharply increased to 11.58% in 2024. No significant sex-based difference in infection rates was observed. Distinctly seasonal and temporal patterns were noted, with a pronounced summer peak in 2024 and increased circulation throughout the year. A notable shift in dominant genotypes was observed, with HAdV-C initially prevailing, followed by a surge in HAdV-B between late 2023 and mid-2024. Children aged 1-7 years exhibited the highest positivity rates, indicating age-related susceptibility. Furthermore, co-infections were common and became increasingly predominant after the implementation of tNGS diagnostics, accounting for over 85% of HAdV-positive cases by 2023-2024. These findings suggest a post-pandemic resurgence of HAdV activity, shaped by altered population immunity, resumed social contact, and improved diagnostic sensitivity. Continuous molecular and epidemiological surveillance is essential to guide targeted interventions and inform pediatric respiratory infection management strategies.
