State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangdong-Hong Kong-Macao Joint Laboratory of Respiratory Infectious Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, Guangzhou Medical University, Guangzhou, 510040, China.
Scientific Research Center, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, 510062, China.
Virol Sin. 2022 Jun;37(3):331-340. doi: 10.1016/j.virs.2022.01.010. Epub 2022 Jan 17.
During 2018-2019, a severe human adenovirus (HAdV) infection outbreak occurred in southern China. Here, we screened 18 respiratory pathogens in 1704 children (≤ 14 years old) hospitalized with acute respiratory illness in Guangzhou, China, in 2019. In total, 151 patients had positive HAdV test results; 34.4% (52/151) of them exhibited severe illness. HAdV infection occurred throughout the year, with a peak in summer. The median patient age was 3.0 (interquartile range: 1.1-5.0) years. Patients with severe HAdV infection exhibited increases in 12 clinical indexes (P ≤ 0.019) and decreases in four indexes (P ≤ 0.007), compared with patients exhibiting non-severe infection. No significant differences were found in age or sex distribution according to HAdV infection severity (P > 0.05); however, the distributions of comorbid disease and HAdV co-infection differed according to HAdV infection severity (P < 0.05). The main epidemic types were HAdV-3 (47.0%, 71/151) and HAdV-7 (46.4%, 70/151). However, the severe illness rate was significantly higher in patients with HAdV-7 (51.4%) than in patients with HAdV-3 (19.7%) and other types of HAdV (20%) (P < 0.001). Sequencing analysis of genomes/capsid genes of 13 HAdV-7 isolates revealed high similarity to previous Chinese isolates. A representative HAdV-7 isolate exhibited a similar proliferation curve to the curve described for the epidemic HAdV-3 strain Guangzhou01 (accession no. DQ099432) (P > 0.05); the HAdV-7 isolate exhibited stronger virulence and infectivity, compared with HAdV-3 (P < 0.001). Overall, comorbid disease, HAdV co-infection, and high virulence and infectivity of HAdV-7 were critical risk factors for severe HAdV infection; these data can facilitate treatment, control, and prevention of HAdV infection.
2018-2019 年，中国南方发生了严重的人腺病毒（HAdV）感染疫情。本研究在中国广州，对 2019 年 1704 例急性呼吸道疾病住院患儿（≤14 岁）进行了 18 种呼吸道病原体检测。共 151 例患儿 HAdV 检测阳性，其中 34.4%（52/151）为重症。HAdV 全年均可感染，夏季为发病高峰。中位患儿年龄为 3.0（四分位间距：1.1-5.0）岁。与非重症感染患儿相比，重症感染患儿 12 项临床指标升高（P≤0.019），4 项指标降低（P≤0.007）。重症与非重症感染患儿在年龄或性别分布上无显著差异（P>0.05），但合并症和 HAdV 混合感染的分布存在差异（P<0.05）。主要流行型别为 HAdV-3（47.0%，71/151）和 HAdV-7（46.4%，70/151），但 HAdV-7 所致重症率（51.4%）显著高于 HAdV-3（19.7%）和其他 HAdV 型别（20%）（P<0.001）。13 株 HAdV-7 基因组/衣壳基因测序分析显示与既往中国分离株高度相似。代表性 HAdV-7 分离株的增殖曲线与流行的 HAdV-3 株 Guangzhou01（登录号：DQ099432）相似（P>0.05），但 HAdV-7 分离株的毒力和感染力强于 HAdV-3（P<0.001）。综上，合并症、HAdV 混合感染及 HAdV-7 的高毒力和感染力是 HAdV 重症感染的关键危险因素，可为 HAdV 感染的治疗、防控提供参考。
