Molecular Epidemiology and Clinical Features Analysis of Respiratory Adenovirus Infections Reveals Correlations between Genotype, Inflammatory Biomarkers, and Disease Severity.

Zhiwu Yu,Yongcai Tang,Zhaohu Yuan,Hongli Xi,Yike Liao,Hui Dai,Ling Min,Jun Liao,Li Huang,Salvatore Battaglia

doi:10.1155/2020/4357910

Abstract

Background Human adenoviruses (HAdVs) are commonly causing respiratory disease. We molecularly genotyped HAdV circulating in Chinese hospitalized children with respiratory infections and summarized the clinical profiles and common inflammatory biomarkers, so as to better determine their associations with disease severity. Method Children with respiratory single HAdV infection cases that occurred from December 2017 to March 2019 were enrolled for a cross-sectional study. Clinical/laboratory features based on the genotypes of respiratory HAdV infection were reviewed for comparative analysis. Results A total of 84 patients were enrolled, and HAdV types were identified from 82 patients. Species B (HAdV-7, 44%; HAdV-3, 43%, and HAdV-14, 5%) was the most common, followed by C (HAdV-2, 4% and HAdV-1, 1%) and E (HAdV-4, 1%). Severe HAdV infection and HAdV-7 infection groups were associated with significantly longer duration of fever and hospitalized days, higher morbidity of tachypnea/dyspnea, more pleural effusion, more respiratory rales, more frequently required mechanical ventilation, and significantly higher fatality rate. The elevated procalcitonin (PCT) and C-reactive protein (CRP) levels were significantly associated with severe HAdV infection. Conclusions HAdV-7 and HAdV-3 were the most common types among children with respiratory adenovirus infection; vaccines against these two genotypes are in urgent need. PCT and CRP are significantly associated with the severity of HAdV infection.

Highlights

Adenoviridae, genus Adenovirus, human adenoviruses (HAdVs) are highly contagious pathogens with marked differences in tissue tropism and clinical syndromes based on different species’ infection involvement [1]
Human adenoviruses (HAdVs)-positive cases account for febrile respiratory infection in hospitalized children in Southern China predominantly appeared in the summer; the genotypes of HAdV-7 and HAdV-3 were actively circulating all year round (Figure 2(c))
We found that a higher C-reactive protein (CRP) level was significantly associated with the severe HAdV infection group, which looks like CRP levels in H1N1 influenza patients who develop a severe disease outcome [29]

Summary

Introduction

Adenoviridae, genus Adenovirus, human adenoviruses (HAdVs) are highly contagious pathogens with marked differences in tissue tropism and clinical syndromes based on different species’ infection involvement [1]. Human adenoviruses (HAdVs) were the leading causative pathogen, usually responsible for 5%-7% of respiratory infections in infants and children [3]; the disease they cause are present with ranged from mild and self-limiting to severe pneumonia, even occasionally led to death [4]. Differences in the disease severity to the various genotypes of HAdV, the association between clinical/laboratory profiles, and the circulation patterns of HAdV have not been well studied. Links between the molecular epidemiology of HAdV and the inflammatory biomarkers, such as total white blood cell counts (WBC), serum C-reactive protein (CRP), and procalcitonin (PCT), may provide clues to clarifying the mechanisms underlying the disease severity of HAdV infections in children. We molecularly genotyped HAdV circulating in Chinese hospitalized children with respiratory infections and summarized the clinical profiles and common inflammatory biomarkers, so as to better determine their associations with disease severity. PCT and CRP are significantly associated with the severity of HAdV infection

Methods

Results

Conclusion