Analysis of severe human adenovirus infection outbreak in Guangdong Province, southern China in 2019

Wenkuan Liu; Shuyan Qiu; Li Zhang; Hongkai Wu; Xingui Tian; Xiao Li; Duo Xu; Jing Dai; Shujun Gu; Qian Liu; Dehui Chen; Rong Zhou

doi:10.1016/j.virs.2022.01.010

June 2022

Wenkuan Liu, Shuyan Qiu, Li Zhang, Hongkai Wu, Xingui Tian, Xiao Li, Duo Xu, Jing Dai, Shujun Gu, Qian Liu, Dehui Chen and Rong Zhou. Analysis of severe human adenovirus infection outbreak in Guangdong Province, southern China in 2019[J]. Virologica Sinica, 2022, 37(3): 331-340. doi: 10.1016/j.virs.2022.01.010

Citation: Wenkuan Liu, Shuyan Qiu, Li Zhang, Hongkai Wu, Xingui Tian, Xiao Li, Duo Xu, Jing Dai, Shujun Gu, Qian Liu, Dehui Chen, Rong Zhou. Analysis of severe human adenovirus infection outbreak in Guangdong Province, southern China in 2019 .VIROLOGICA SINICA, 2022, 37(3) : 331-340. http://dx.doi.org/10.1016/j.virs.2022.01.010

2019年中国南方广东省严重人腺病毒感染爆发分析

刘文宽 ^a ,
邱淑燕 ^a ,
张丽 ^a ,
吴宏楷 ^a ,
田新贵 ^a ,
李潇 ^a ,
许多 ^a ,
戴晶 ^a ,
辜淑君 ^a ,
刘倩 ^b,, ,
陈德晖 ^a,, ,
周荣 ^a,c,,

1 呼吸疾病国家重点实验室, 国家呼吸系统疾病临床医学研究中心, 粤港澳呼吸系统传染病联合实验室, 广州医科大学附属第一医院, 广州呼吸健康研究院, 广州医科大学, 广州 510040, 中国;
2 中心实验室, 广东药科大学附属第一医院, 广州 510062, 中国;
3 生物岛实验室, 广州实验室, 广州 510320, 中国

通讯作者： 刘倩, qianliu_ln@163.com; 陈德晖, cdh84@126.com; 周荣, zhourong@gird.cn
收稿日期： 2021-07-07
录用日期： 2021-12-06

摘要

2018-2019年，中国南方地区爆发严重的人腺病毒（HAdV）感染。在这里，我们对2019年在中国广州因急性呼吸道疾病住院的1，704名儿童（≤ 14岁）进行了18种呼吸道病原体筛查。共有151名患者的HAdV检测结果呈阳性；其中34.4%（52/151）患有严重疾病。HAdV感染全年均有发生，以夏季为高峰。患者的中位年龄为3.0（四分位距：1.1-5.0）岁。与非严重感染患者相比，重度HAdV感染患者12项临床指标增加（P≤0.019），4项指标下降（P≤0.007）。不同HAdV感染严重程度患者的年龄或性别分布无显着差异（P > 0.05）；然而，复合疾病和HAdV-共感染的分布在不同HAdV感染严重程度患者中有显著差异（P < 0.05）。主要流行类型为HAdV-3（47.0%，71/151）和HAdV-7（46.4%，70/151）。然而，HAdV-7患者（51.4%）的重症率显著高于HAdV-3患者（19.7%）和其他类型HAdV患者（20%）（P < 0.001）。对13株HAdV-7分离株的基因组/衣壳基因的测序分析显示，与以前的中国分离株高度相似。具有代表性的HAdV-7分离株表现出与流行的HAdV-3毒株Guangzhhou01（登录号DQ099432）相似的增殖曲线（P > 0.05）；与HAdV-3相比，HAdV-7分离株表现出更强的毒力和传染性（P < 0.001）。总体而言，复合疾病、HAdV-共感染以及HAdV-7的高毒力和传染性是严重HAdV感染的关键危险因素；这些数据有助于治疗、控制和预防HAdV感染。
- 人腺病毒(HAdV)
- , 人腺病毒7型(HAdV-7)
- , 重症
- , 流行病学
- , 急性呼吸道疾病
- , 毒力和传染性
- , 危险因素

Analysis of severe human adenovirus infection outbreak in Guangdong Province, southern China in 2019

Wenkuan Liu ^a ,
Shuyan Qiu ^a ,
Li Zhang ^a ,
Hongkai Wu ^a ,
Xingui Tian ^a ,
Xiao Li ^a ,
Duo Xu ^a ,
Jing Dai ^a ,
Shujun Gu ^a ,
Qian Liu ^b,, ,
Dehui Chen ^a,, ,
Rong Zhou ^a,c,,

a State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangdong-Hong Kong-Macao Joint Laboratory of Respiratory Infectious Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, Guangzhou Medical University, Guangzhou, 510040, China;
b Scientific Research Center, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, 510062, China;
c Bioland Laboratory, Guangzhou Laboratory, Guangzhou, 510320, China

Corresponding author: Qian Liu, qianliu_ln@163.com Dehui Chen, cdh84@126.com Rong Zhou, zhourong@gird.cn
Received Date: 07 July 2021
Accepted Date: 06 December 2021

Abstract

During 2018-2019, a severe human adenovirus (HAdV) infection outbreak occurred in southern China. Here, we screened 18 respiratory pathogens in 1704 children (≤ 14 years old) hospitalized with acute respiratory illness in Guangzhou, China, in 2019. In total, 151 patients had positive HAdV test results; 34.4% (52/151) of them exhibited severe illness. HAdV infection occurred throughout the year, with a peak in summer. The median patient age was 3.0 (interquartile range:1.1-5.0) years. Patients with severe HAdV infection exhibited increases in 12 clinical indexes (P ≤ 0.019) and decreases in four indexes (P ≤ 0.007), compared with patients exhibiting nonsevere infection. No significant differences were found in age or sex distribution according to HAdV infection severity (P > 0.05); however, the distributions of comorbid disease and HAdV co-infection differed according to HAdV infection severity (P < 0.05). The main epidemic types were HAdV-3 (47.0%, 71/151) and HAdV-7 (46.4%, 70/151). However, the severe illness rate was significantly higher in patients with HAdV-7 (51.4%) than in patients with HAdV-3 (19.7%) and other types of HAdV (20%) (P < 0.001). Sequencing analysis of genomes/capsid genes of 13 HAdV-7 isolates revealed high similarity to previous Chinese isolates. A representative HAdV-7 isolate exhibited a similar proliferation curve to the curve described for the epidemic HAdV-3 strain Guangzhou01 (accession no. DQ099432) (P > 0.05); the HAdV-7 isolate exhibited stronger virulence and infectivity, compared with HAdV-3 (P < 0.001). Overall, comorbid disease, HAdV co-infection, and high virulence and infectivity of HAdV-7 were critical risk factors for severe HAdV infection; these data can facilitate treatment, control, and prevention of HAdV infection.
- Human adenovirus (HAdV)
- , Human adenovirus type 7 (HAdV-7)
- , Severe illness
- , Epidemiology
- , Acute respiratory illness
- , Virulence and infectivity
- , Risk factor

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