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.

中文翻译：

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2016 年至 2018 年美国急性呼吸道疾病儿童中单独检测腺病毒与腺病毒与其他呼吸道病毒联合检测的临床表现和严重程度。


背景人类腺病毒（HAdV）通常与儿童急性呼吸道疾病（ARI）相关，并且也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的 HAdV 与与其他呼吸道病毒同时检测到的幼儿的临床表现和结果。方法 我们使用了一项多中心、前瞻性病毒监测研究的数据，该研究的对象是在美国七个地点的急诊科和住院儿科环境中观察到的儿童。于2016年12月1日至2018年10月31日期间入组有发烧和/或呼吸道症状的18岁以下儿童，并通过分子方法检测HAdV、人鼻病毒/肠道病毒（HRV/EV）、呼吸道合胞病毒（RSV） ）、副流感病毒（PIV，1-4 型）、流感（流感，AC 型）和人类偏肺病毒 (HMPV)。我们衡量疾病严重程度的主要指标是住院治疗；在住院儿童中，次要严重程度结果包括氧气支持和住院时间（LOS）。结果 在纳入的 18,603 名儿童中，1,136 名儿童（6.1%）检出 HAdV，其中 646 名儿童（56.9%）同时检测出至少一种其他呼吸道病毒。 HRV/EV (n = 293, 45.3%) 和 RSV (n = 123, 19.0%) 是最常见的联合检测。患有 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] 的儿童-6.77]）或 ≥ 2 次同时检测（aOR = 1.95；95% CI = [1.14-3.36]）与单独感染 HAdV 的儿童相比，住院几率更高。在住院儿童中，HAdV 与 RSV 或 HMPV 共同检测均与较高的氧气支持几率相关，而与 PIV 或流感病毒共同检测均与较高的平均 LOS 相关。 结论 与单独检测 HAdV 相比，HAdV 与其他呼吸道病毒联合检测与 ARI 儿童的疾病严重程度相关。