2016 年至 2018 年美国急性呼吸道疾病儿童中，腺病毒单独检测与腺病毒与其他呼吸道病毒共同检测的临床表现和严重程度。

Clinical Presentation and Severity of Adenovirus Detection Alone vs Adenovirus Co-detection With Other Respiratory Viruses in US Children With Acute Respiratory Illness from 2016 to 2018.

机构信息

Department of Pediatrics, Division of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Vanderbilt University, Nashville, Tennessee, USA.

Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

出版信息

J Pediatric Infect Dis Soc. 2022 Oct 25;11(10):430-439. doi: 10.1093/jpids/piac066.

DOI:10.1093/jpids/piac066

PMID:35849119

Abstract

BACKGROUND

Human adenovirus (HAdV) is commonly associated with acute respiratory illnesses (ARI) in children and is also frequently co-detected with other viral pathogens. We compared clinical presentation and outcomes in young children with HAdV detected alone vs co-detected with other respiratory viruses.

METHODS

We used data from a multicenter, prospective, viral surveillance study of children seen in the emergency department and inpatient pediatric settings at seven US sites. Children less than 18 years old with fever and/or respiratory symptoms were enrolled between 12/1/16 and 10/31/18 and tested by molecular methods for HAdV, human rhinovirus/enterovirus (HRV/EV), respiratory syncytial virus (RSV), parainfluenza (PIV, types 1-4), influenza (flu, types A-C), and human metapneumovirus (HMPV). Our primary measure of illness severity was hospitalization; among hospitalized children, secondary severity outcomes included oxygen support and length of stay (LOS).

RESULTS

Of the 18,603 children enrolled, HAdV was detected in 1,136 (6.1%), among whom 646 (56.9%) had co-detection with at least one other respiratory virus. HRV/EV (n = 293, 45.3%) and RSV (n = 123, 19.0%) were the most frequent co-detections. Children with HRV/EV (aOR = 1.61; 95% CI = [1.11-2.34]), RSV (aOR = 4.48; 95% CI = [2.81-7.14]), HMPV (aOR = 3.39; 95% CI = [1.69-6.77]), or ≥ 2 co-detections (aOR = 1.95; 95% CI = [1.14-3.36]) had higher odds of hospitalization compared to children with HAdV alone. Among hospitalized children, HAdV co-detection with RSV or HMPV was each associated with higher odds of oxygen support, while co-detection with PIV or influenza viruses was each associated with higher mean LOS.

CONCLUSIONS

HAdV co-detection with other respiratory viruses was associated with greater disease severity among children with ARI compared to HAdV detection alone.

摘要

背景

人类腺病毒（HAdV）通常与儿童急性呼吸道疾病（ARI）有关，并且经常与其他病毒病原体同时检测到。我们比较了单独检测到 HAdV 与同时检测到其他呼吸道病毒的幼儿的临床表现和结局。

方法

我们使用了来自美国七个地点的急诊室和住院儿科环境中进行的一项多中心、前瞻性、病毒监测研究的数据。16 年 12 月 1 日至 18 年 10 月 31 日期间，年龄小于 18 岁、发热和/或呼吸道症状的儿童入组，并通过分子方法检测 HAdV、人类鼻病毒/肠道病毒（HRV/EV）、呼吸道合胞病毒（RSV）、副流感（PIV，1-4 型）、流感（flu，A-C 型）和人偏肺病毒（HMPV）。我们疾病严重程度的主要衡量标准是住院治疗；在住院患儿中，次要严重程度结局包括氧支持和住院时间（LOS）。

结果

在 18603 名入组的儿童中，检测到 1136 例（6.1%）HAdV，其中 646 例（56.9%）至少与另一种呼吸道病毒同时检测到。HRV/EV（n=293，45.3%）和 RSV（n=123，19.0%）是最常见的共同检测。与单独检测到 HAdV 的儿童相比，HRV/EV（aOR=1.61；95%CI=[1.11-2.34]）、RSV（aOR=4.48；95%CI=[2.81-7.14]）、HMPV（aOR=3.39；95%CI=[1.69-6.77]）或≥2 种共同检测（aOR=1.95；95%CI=[1.14-3.36]）的儿童住院的可能性更高。在住院患儿中，与 HAdV 单独检测相比，HAdV 与 RSV 或 HMPV 共同检测与更高的吸氧支持几率相关，而与 PIV 或流感病毒共同检测与更高的平均 LOS 相关。