Journal
JOURNAL OF THE PEDIATRIC INFECTIOUS DISEASES SOCIETY
Volume 11, Issue 10, Pages 430-439Publisher
OXFORD UNIV PRESS
DOI: 10.1093/jpids/piac066
Keywords
acute respiratory illness; adenovirus; co-detection; respiratory viruses
Categories
Funding
- US Centers for Disease Control and Prevention [CDCRFA-IP16-004, UL1 TR000445]
- National Center for Advancing Translational Sciences
- National Institutes of Health
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Co-detection of human adenovirus (HAdV) with other common respiratory viruses in children with acute respiratory illness is associated with more severe illness (e.g., hospitalization and oxygen support) compared with detection of HAdV alone.
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. Co-detection of human adenovirus (HAdV) with other common respiratory viruses in children with acute respiratory illness is associated with more severe illness (e.g., hospitalization and oxygen support) compared with detection of HAdV alone.
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