Probst Varvara, Stopczynski Tess, Amarin Justin Z, Gailani Adam, Rahman Herdi K, Stewart Laura S, Selvarangan Rangaraj, Schuster Jennifer E, Michaels Marian G, Williams John V, Boom Julie A, Sahni Leila C, Avadhanula Vasanthi, Staat Mary Allen, Schlaudecker Elizabeth P, Quigley Christina, Harrison Christopher J, Moffatt Mary E, Weinberg Geoffrey A, Szilagyi Peter G, Englund Janet A, Klein Eileen J, Curns Aaron T, Moline Heidi L, Toepfer Ariana P, Gerber Susan I, Chappell James D, Spieker Andrew J, Halasa Natasha B
Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232, United States.
Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN 37203, United States.
J Pediatric Infect Dis Soc. 2025 Jun 16;14(6). doi: 10.1093/jpids/piaf051.
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.
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.
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).
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.
人腺病毒（HAdV）是小儿急性呼吸道疾病（ARI）的常见病因。HAdV-B、-C和-E型与ARI有关，尽管在美国其相对检测频率以及在有症状呼吸道感染中的各自作用仍不清楚。
我们于2016年1月12日至2019年11月30日在美国7家儿童医院开展了一项多中心前瞻性病毒监测研究，这些医院组成了新疫苗监测网络。纳入急诊科<18岁或因发热和/或呼吸道症状住院的儿童，并对呼吸道标本进行HAdV和其他病毒病原体检测。随后使用针对六邻体基因序列的单重实时PCR检测法对HAdV阳性标本进行分型。比较了HAdV-B型和HAdV-C型之间的人口统计学、临床特征和结局（以住院和使用补充氧气作为严重程度指标）。
在29381例ARI患儿中，1843例（6.3%）检测到HAdV，1402份标本（76.0%）成功分型。HAdV-C型是最常检测到的类型（73.0%），其次是HAdV-B型（22.3%）。HAdV-C型患儿比HAdV-B型患儿年龄更小，且更有可能感染另一种呼吸道病原体。在未检测到其他呼吸道病原体的患儿中，HAdV-C型患儿住院几率低于HAdV-B型患儿（校正比值比：0.44，95%置信区间，0.27-0.73，P = 0.001）。
在我们对急诊科就诊或因ARI住院的患儿的研究中，HAdV-C型患儿的住院几率低于HAdV-B型患儿。这些发现值得进一步评估，以确定哪些HAdV类型会导致疾病严重程度。
