Université Clermont Auvergne, LMGE CNRS 6023, UFR de Médecine et des Professions Paramédicales, 63001 Clermont-Ferrand, France.
CHU Clermont-Ferrand, Centre National de Référence Des Entérovirus et Parechovirus, Laboratoire de Virologie, 63003 Clermont-Ferrand, France.
Viruses. 2021 Aug 13;13(8):1607. doi: 10.3390/v13081607.
Enterovirus D68 (EV-D68) has emerged as an agent of epidemic respiratory illness and acute flaccid myelitis in the paediatric population but data are lacking in adult patients. We performed a 4.5-year single-centre retrospective study of all patients who tested positive for EV-D68 and analysed full-length EV-D68 genomes of the predominant clades B3 and D1. Between 1 June 2014, and 31 December 2018, 73 of the 11,365 patients investigated for respiratory pathogens tested positive for EV-D68, of whom 20 (27%) were adults (median age 53.7 years [IQR 34.0-65.7]) and 53 (73%) were children (median age 1.9 years [IQR 0.2-4.0]). The proportion of adults increased from 12% in 2014 to 48% in 2018 ( = 0.01). All adults had an underlying comorbidity factor, including chronic lung disease in 12 (60%), diabetes mellitus in six (30%), and chronic heart disease in five (25%). Clade D1 infected a higher proportion of adults than clades B3 and B2 ( = 0.001). Clade D1 was more divergent than clade B3: 5 of 19 amino acid changes in the capsid proteins were located in putative antigenic sites. Adult patients with underlying conditions are more likely to present with severe complications associated with EV-D68, notably the emergent clade D1.
肠道病毒 D68（EV-D68）已成为儿科人群中流行的呼吸道疾病和急性弛缓性脊髓炎的病原体，但在成年患者中数据缺乏。我们对所有 EV-D68 检测呈阳性的患者进行了为期 4.5 年的单中心回顾性研究，并分析了主要分支 B3 和 D1 的 EV-D68 全长基因组。在 2014 年 6 月 1 日至 2018 年 12 月 31 日期间，在调查呼吸道病原体的 11365 名患者中，有 73 名患者的 EV-D68 检测呈阳性，其中 20 名（27%）为成年人（中位数年龄 53.7 岁[IQR 34.0-65.7]），53 名（73%）为儿童（中位数年龄 1.9 岁[IQR 0.2-4.0]）。成年人的比例从 2014 年的 12%增加到 2018 年的 48%（ = 0.01）。所有成年人都有潜在的合并症因素，包括 12 名（60%）慢性肺部疾病、6 名（30%）糖尿病和 5 名（25%）慢性心脏病。分支 D1 感染成年人的比例高于分支 B3 和 B2（ = 0.001）。分支 D1 比分支 B3 更具变异性：衣壳蛋白中的 5 个氨基酸变化位于假定的抗原位点。有潜在疾病的成年患者更有可能出现与 EV-D68 相关的严重并发症，特别是新兴的分支 D1。
