1
|
Davies EA, Dutton L, Guiver M. Evaluation of a custom designed hybridisation assay for whole genome sequencing of human adenoviruses direct from clinical samples. J Clin Virol 2024; 171:105640. [PMID: 38219683 DOI: 10.1016/j.jcv.2024.105640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 01/05/2024] [Accepted: 01/10/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND Human Adenoviruses are a common cause of disease and can cause significant morbidity and mortality in immunocompromised patients. Nosocomial transmission events can occur with whole genome sequencing playing a crucial role. This study evaluates the performance of a custom designed SureSelectXT target enrichment assay based on 14 adenovirus genomes for sequencing direct from clinical samples. METHODS Modifications were made to the SureSelectXT low input protocol to enhance performance for viral targets. Consensus sequences were generated using an in-house designed three stage bioinformatics pipeline. We assessed, percentage of on target reads, average depth of coverage and percentage genome coverage to determine assay performance across a range of sample matrices. RESULTS Whole genome sequences were successfully generated for 91.6 % of samples assessed. Adenovirus DNA concentration was a good indicator of enrichment success. Highly specific enrichment was observed with only 6 % of samples showing < 50 % on target reads. Respiratory and faecal samples performed well where bloods showed higher levels of non-specific enrichment likely confounded by low adenovirus DNA concentrations. Protocol performance did not appear impacted by Adenovirus type or species. CONCLUSION Overall performance of this modified SureSelectXT protocol appears in line with previously published works although there are some confounding factors requiring further investigation. The use of a small RNA bait set has the potential to reduce associated costs which can be prohibitive.
Collapse
Affiliation(s)
- Emma Ann Davies
- UKHSA Manchester Virology Laboratory, Manchester Medical Microbiology Partnership, Manchester Foundation Trust, Manchester, UK.
| | - Laura Dutton
- North West Genomic Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester Foundation Trust, Manchester, UK
| | - Malcolm Guiver
- UKHSA Manchester Virology Laboratory, Manchester Medical Microbiology Partnership, Manchester Foundation Trust, Manchester, UK
| |
Collapse
|
2
|
Nguyen STT, Tran TA, Vo GV. Severe Pneumonia Caused by Respiratory Syncytial Virus and Adenovirus in Children from 2 to 24 Months at Children's Hospital 1 in Ho Chi Minh City, Vietnam. Viruses 2024; 16:410. [PMID: 38543775 PMCID: PMC10975604 DOI: 10.3390/v16030410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/02/2024] [Accepted: 03/04/2024] [Indexed: 05/23/2024] Open
Abstract
In Vietnam, due to the lack of facilities to detect respiratory viruses from patients' specimens, there are only a few studies on the detection of viral pathogens causing pneumonia in children, especially respiratory syncytial virus (RSV) and adenovirus (Adv). Here, we performed a cross-sectional descriptive prospective study on 138 children patients from 2 to 24 months old diagnosed with severe pneumonia hospitalized at the Respiratory Department of Children's Hospital 1 from November 2021 to August 2022. The number of patients selected in this study was based on the formula n = ([Z(1 - α/2)]2 × P [1 - P])/d2, with α = 0.05, p = 0.5, and d = 9%, and the sampling technique was convenient sampling until the sample size was met. A rapid test was used to detect RSV and Adv from the nasopharyngeal swabs and was conducted immediately after the patient's hospitalization. Laboratory tests were performed, medical history interviews were conducted, and nasotracheal aspirates were collected for multiplex real-time PCR (MPL-rPCR) to detect viral and bacterial pathogens. The results of the rapid test and the MPL-rPCR in the detection of both pathogens were the same at 31.9% (44/138) for RSV and 8.7% (7/138) for Adv, respectively. Using MPL-rPCR, the detection rate was 21% (29/138) for bacterial pathogens, 68.8% (95/138) for bacterial-viral co-infections, and 6.5% (9/138) for viral pathogens. The results showed few distinctive traits between RSV-associated and Adv-associated groups, and the Adv group children were more prone to bacterial infection than those in the RSV group. In addition, the Adv group experienced a longer duration of treatment and a higher frequency of re-hospitalizations compared to the RSV group. A total of 100% of Adv infections were co-infected with bacteria, while 81.82% of RSV co-infected with bacterial pathogens (p = 0.000009). This study might be one of the few conducted in Vietnam aimed at identifying viral pathogens causing severe pneumonia in children.
Collapse
Affiliation(s)
- Suong Thi Thu Nguyen
- School of Medicine, Vietnam National University—Ho Chi Minh City (VNU-HCM), Ho Chi Minh City 710000, Vietnam
- Vietnam National University—Ho Chi Minh City (VNU-HCM), Ho Chi Minh City 700000, Vietnam
| | - Tuan Anh Tran
- School of Medicine, Vietnam National University—Ho Chi Minh City (VNU-HCM), Ho Chi Minh City 710000, Vietnam
- Children’s Hospital 1, Ho Chi Minh City 710000, Vietnam
| | - Giau Van Vo
- School of Medicine, Vietnam National University—Ho Chi Minh City (VNU-HCM), Ho Chi Minh City 710000, Vietnam
- Vietnam National University—Ho Chi Minh City (VNU-HCM), Ho Chi Minh City 700000, Vietnam
- Research Center for Genetics and Reproductive Health (CGRH), School of Medicine, Vietnam National University, Ho Chi Minh City (VNU-HCM), Ho Chi Minh City 70000, Vietnam
| |
Collapse
|
3
|
Wen S, Xu M, Jin W, Zeng L, Lin Z, Yu G, Lv F, Zhu L, Xu C, Zheng Y, Dong L, Lin L, Zhang H. Risk factors and prediction models for bronchiolitis obliterans after severe adenoviral pneumonia. Eur J Pediatr 2024; 183:1315-1323. [PMID: 38117354 DOI: 10.1007/s00431-023-05379-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 12/07/2023] [Accepted: 12/09/2023] [Indexed: 12/21/2023]
Abstract
Severe adenoviral pneumonia (SAP) can cause post-infectious bronchiolitis obliterans (PIBO) in children. We aimed to investigate the relevant risk factors for PIBO and develop a predictive nomogram for PIBO in children with SAP. This prospective study analysed the clinical data of hospitalised children with SAP and categorised them into the PIBO and non-PIBO groups. Least absolute shrinkage and selection operator (LASSO) regressions were applied to variables that exhibited significant intergroup differences. Logistic regression was adopted to analyse the risk factors for PIBO. Additionally, a nomogram was constructed, and its effectiveness was assessed using calibration curves, C-index, and decision curve analysis. A total of 148 hospitalised children with SAP were collected in this study. Among them, 112 achieved favourable recovery, whereas 36 developed PIBO. Multivariable regression after variable selection via LASSO revealed that aged < 1 year (OR, 2.38, 95% CI, 0.82-6.77), admission to PICU (OR, 24.40, 95% CI, 7.16-105.00), long duration of fever (OR, 1.16, 95% CI, 1.04-1.31), and bilateral lung infection (OR, 8.78, 95% CI, 1.32-195.00) were major risk factors for PIBO. The nomogram model included the four risk factors: The C-index of the model was 0.85 (95% CI, 0.71-0.99), and the area under the curve was 0.85 (95% CI, 0.78-0.92). The model showed good calibration with the Hosmer-Lemeshow test (χ2 = 8.52, P = 0.38) and was useful in clinical settings with decision curve analysis. CONCLUSION Age < 1 year, PICU admission, long fever duration, and bilateral lung infection are independent risk factors for PIBO in children with SAP. The nomogram model may aid clinicians in the early diagnosis and intervention of PIBO. WHAT IS KNOWN • Adenoviruses are the most common pathogens associated with PIBO. • Wheezing, tachypnoea, hypoxemia, and mechanical ventilation are the risk factors for PIBO. WHAT IS NEW • Age < 1 year, admission to PICU, long duration of fever days, and bilateral lung infection are independent risk factors for PIBO in children with SAP. • A prediction model presented as a nomogram may help clinicians in the early diagnosis and intervention of PIBO.
Collapse
Affiliation(s)
- Shunhang Wen
- Department of Children's Respiration Disease, the Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, 109 West Xueyuan Road, Lucheng District, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Ming Xu
- Department of Children's Respiration Disease, the Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, 109 West Xueyuan Road, Lucheng District, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Weigang Jin
- Department of Children's Respiration Disease, the Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, 109 West Xueyuan Road, Lucheng District, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Luyao Zeng
- Department of Children's Respiration Disease, the Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, 109 West Xueyuan Road, Lucheng District, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Zupan Lin
- Department of Pediatrics, Jinhua Maternal and Child Health Care Hospital, Jinhua, 321000, Zhejiang, People's Republic of China
| | - Gang Yu
- Department of Children's Respiration Disease, the Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, 109 West Xueyuan Road, Lucheng District, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Fangfang Lv
- Department of Children's Respiration Disease, the Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, 109 West Xueyuan Road, Lucheng District, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Lili Zhu
- Department of Children's Respiration Disease, the Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, 109 West Xueyuan Road, Lucheng District, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Changfu Xu
- Department of Children's Respiration Disease, the Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, 109 West Xueyuan Road, Lucheng District, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Yangming Zheng
- Department of Children's Respiration Disease, the Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, 109 West Xueyuan Road, Lucheng District, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Lin Dong
- Department of Children's Respiration Disease, the Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, 109 West Xueyuan Road, Lucheng District, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Li Lin
- Department of Children's Respiration Disease, the Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, 109 West Xueyuan Road, Lucheng District, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Hailin Zhang
- Department of Children's Respiration Disease, the Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, 109 West Xueyuan Road, Lucheng District, Wenzhou, 325000, Zhejiang, People's Republic of China.
| |
Collapse
|
4
|
Chen Q, Lin L, Zhang N, Yang Y. Adenovirus and Mycoplasma pneumoniae co-infection as a risk factor for severe community-acquired pneumonia in children. Front Pediatr 2024; 12:1337786. [PMID: 38357505 PMCID: PMC10864498 DOI: 10.3389/fped.2024.1337786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 01/18/2024] [Indexed: 02/16/2024] Open
Abstract
Background To investigate the pathogenic characteristics and risk factors of pediatric severe community-acquired pneumonia (CAP). Methods We retrospectively analyzed the clinical data of hospitalized children with severe CAP from April 2014 to June 2019 in China. Data of age, sex and pathogenic results were collected: bacterial and fungal cultures, respiratory viruses from sputum or bronchoalveolar lavage fluid (BALF), serum Mycoplasma pneumoniae (MP)-IgM and Chlamydia Pneumoniae-IgM, and BALF or blood (1-3)-β-D-glucan/galactomannan test. Results A total of 679 children with severe CAP were included in the analysis. The number of cases infected with MP was higher in males than in females. There were significant differences between the ≤1-year and >1-year groups in terms of pathogen. The top three bacteria cultured were Haemophilus influenzae (57/679, 8.4%), Streptococcus pneumoniae (50/679, 7.4%), and Pseudomonas aeruginosa (25/679, 3.7%). The top three viruses detected were adenovirus (AdV, 124/679, 18.3%), respiratory syncytial virus (24/679, 3.5%), and parainfluenza virus (21/679, 3.1%). AdV and MP were the leading pathogens, detected in 18.3% and 32.6% cases, respectively. MP infection increased the risk of AdV infection (OR 3.77, p < 0.0001). MP infection was a risk factor for severe AdV-infected pneumonia, while sex, age, bacteria, Chlamydia Pneumoniae, fungal, and AdV infections were risk factors for severe MP-infected pneumonia. Conclusions AdV and MP were dominant pathogens in children with severe CAP. AdV and MP infection predisposed each other to develop severe illness. AdV-MP co-infection may lead to severe pneumonia.
Collapse
Affiliation(s)
- Qihong Chen
- Department of Pediatrics, The First Affiliated Hospital of Xiamen University, Xiamen, China
- Pediatric Key Laboratory of Xiamen, Xiamen, China
| | - Lihua Lin
- Department of Pediatrics, The First Affiliated Hospital of Xiamen University, Xiamen, China
- Pediatric Key Laboratory of Xiamen, Xiamen, China
| | - Ning Zhang
- Department of Pediatrics, The First Affiliated Hospital of Xiamen University, Xiamen, China
- Pediatric Key Laboratory of Xiamen, Xiamen, China
| | - Yungang Yang
- Department of Pediatrics, The First Affiliated Hospital of Xiamen University, Xiamen, China
- Pediatric Key Laboratory of Xiamen, Xiamen, China
| |
Collapse
|
5
|
Wu Z, Chen X, Wu S, Liu Z, Li H, Mai K, Peng Y, Zhang H, Zhang X, Zheng Z, Fu Z, Chen D. Transcriptome analysis reveals the impact of NETs activation on airway epithelial cell EMT and inflammation in bronchiolitis obliterans. Sci Rep 2023; 13:19226. [PMID: 37932341 PMCID: PMC10628238 DOI: 10.1038/s41598-023-45617-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 10/21/2023] [Indexed: 11/08/2023] Open
Abstract
Bronchiolitis obliterans (BO) is a chronic airway disease that was often indicated by the pathological presentation of narrowed and irreversible airways. However, the molecular mechanisms of BO pathogenesis remain unknown. Although neutrophil extracellular traps (NETs) can contribute to inflammatory disorders, their involvement in BO is unclear. This study aims to identify potential signaling pathways in BO by exploring the correlations between NETs and BO. GSE52761 and GSE137169 datasets were downloaded from gene expression omnibus (GEO) database. A series of bioinformatics analyses such as differential expression analysis, gene ontology (GO), Kyoto encyclopedia of genes and genomes (KEGG), and gene set enrichment analysis (GSEA) were performed on GSE52761 and GSE137169 datasets to identify BO potential signaling pathways. Two different types of BO mouse models were constructed to verify NETs involvements in BO. Additional experiments and bioinformatics analysis using human small airway epithelial cells (SAECs) were also performed to further elucidate differential genes enrichment with their respective signaling pathways in BO. Our study identified 115 differentially expressed genes (DEGs) that were found up-regulated in BO. Pathway enrichment analysis revealed that these genes were primarily involved in inflammatory signaling processes. Besides, we found that neutrophil extracellular traps (NETs) were formed and activated during BO. Our western blot analysis on lung tissue from BO mice further confirmed NETs activation in BO, where neutrophil elastase (NE) and myeloperoxidase (MPO) expression were found significantly elevated. Transcriptomic and bioinformatics analysis of NETs treated-SAECs also revealed that NETs-DEGs were primarily associated through inflammatory and epithelial-to-mesenchymal transition (EMT) -related pathways. Our study provides novel clues towards the understanding of BO pathogenesis, in which NETs contribute to BO pathogenesis through the activation of inflammatory and EMT associated pathways. The completion of our study will provide the basis for potential novel therapeutic targets in BO treatment.
Collapse
Affiliation(s)
- Zhongji Wu
- The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510000, People's Republic of China
| | - Xiaowen Chen
- The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510000, People's Republic of China
| | - Shangzhi Wu
- The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510000, People's Republic of China
| | - Zhenwei Liu
- The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510000, People's Republic of China
| | - Hongwei Li
- The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510000, People's Republic of China
| | - Kailin Mai
- Guangzhou Medical University, Guangzhou, 510000, People's Republic of China
| | - Yinghui Peng
- The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510000, People's Republic of China
| | - Haidi Zhang
- The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510000, People's Republic of China
| | - Xiaodie Zhang
- Guangzhou Medical University, Guangzhou, 510000, People's Republic of China
| | - Zhaocong Zheng
- Guangzhou Medical University, Guangzhou, 510000, People's Republic of China
| | - Zian Fu
- The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510000, People's Republic of China
| | - Dehui Chen
- The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510000, People's Republic of China.
| |
Collapse
|
6
|
Cai S, Zhu CH, Chen FG, Liu F, Gao ML, Xiong Y. [Establishment of a risk model for severe adenovirus pneumonia and prospective study of the timing of intravenous immunoglobulin therapy in children]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2023; 25:619-625. [PMID: 37382132 DOI: 10.7499/j.issn.1008-8830.2211069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
OBJECTIVES To develop a risk prediction model for severe adenovirus pneumonia (AVP) in children, and to explore the appropriate timing for intravenous immunoglobulin (IVIG) therapy for severe AVP. METHODS Medical data of 1 046 children with AVP were retrospectively analyzed, and a risk prediction model for severe AVP was established using multivariate logistic regression. The model was validated with 102 children with AVP. Then, 75 children aged ≤14 years who were considered at risk of developing severe AVP by the model were prospectively enrolled and divided into three groups (A, B and C) in order of visit, with 25 children in each group. Group A received symptomatic supportive therapy only. With the exception of symptomatic supportive therapy, group B received IVIG treatment at a dose of 1g/(kg·d) for 2 consecutive days, before progressing to severe AVP. With the exception of symptomatic supportive therapy, group C received IVIG treatment at a dose of 1 g/(kg·d) for 2 consecutive days after progressing to severe AVP. Efficacy and related laboratory indicators were compared among the three groups after treatment. RESULTS Age<18.5 months, underlying diseases, fever duration >6.5 days, hemoglobin level <84.5 g/L, alanine transaminase level >113.5 U/L, and co-infection with bacteria were the six variables that entered into the risk prediction model for severe AVP. The model had an area under the receiver operating characteristic curve of 0.862, sensitivity of 0.878, and specificity of 0.848. The Hosmer-Lemeshow test showed good consistency between the predicted values and the actual observations (P>0.05). After treatment, group B had the shortest fever duration and hospital stay, the lowest hospitalization costs, the highest effective rate of treatment, the lowest incidence of complications, the lowest white blood cell count and interleukin (IL)-1, IL-2, IL-6, IL-8, IL-10 levels, and the highest level of tumor necrosis factor alpha (P<0.05). CONCLUSIONS The risk model for severe AVP established in this study has good value in predicting the development of severe AVP. IVIG therapy before progression to severe AVP is more effective in treating AVP in children.
Collapse
Affiliation(s)
- Sha Cai
- Department of Infectious Diseases, Jiangxi Provincial Children's Hospital, Nanchang 330000, China
| | - Chun-Hui Zhu
- Department of Infectious Diseases, Jiangxi Provincial Children's Hospital, Nanchang 330000, China
| | - Fang-Gen Chen
- Department of Infectious Diseases, Jiangxi Provincial Children's Hospital, Nanchang 330000, China
| | - Fei Liu
- Department of Infectious Diseases, Jiangxi Provincial Children's Hospital, Nanchang 330000, China
| | - Mei-Ling Gao
- Department of Infectious Diseases, Jiangxi Provincial Children's Hospital, Nanchang 330000, China
| | - Yan Xiong
- Department of Infectious Diseases, Jiangxi Provincial Children's Hospital, Nanchang 330000, China
| |
Collapse
|
7
|
Peng L, Liu S, Xie T, Li Y, Yang Z, Chen Y, Deng L, Huang H, Ding X, Chen M, Lin L, Wei S, Zhong L. Construction and analysis of a nomogram prediction model for post-infectious bronchiolitis obliterans in children with adenovirus pneumonia after invasive mechanical ventilation. BMC Pediatr 2023; 23:81. [PMID: 36797693 PMCID: PMC9933386 DOI: 10.1186/s12887-023-03883-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 02/02/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Post-infectious bronchiolitis obliterans (PIBO) is the most common sequelae in children with adenovirus pneumonia (ADVP). However, there are few studies on the risk factors for PIBO occurrence. This study aims to investigate the risk factors for PIBO in pediatric patients with severe ADVP, especially after invasive mechanical ventilation (IMV), as well as to build a nomogram prediction model. METHODS The clinical data, laboratory and imaging features, and treatment of 863 children with ADVP under 3 years old who were admitted to our hospital from January to December 2019 were retrospectively analyzed. Among them, 66 children with severe ADVP received IMV treatment. The situation and the influencing factors of PIBO in children with severe ADVP were explored, and a nomogram prediction model was constructed. RESULTS Among the 863 cases of ADVP, 46 cases (5.33%) developed PIBO. Duration of fever, IMV, complications, and neutrophil percentage were independent risk factors for PIBO in children with ADVP. Among the 66 patients with ADVP who underwent IMV, 33 patients (50.0%) developed PIBO. Gender, duration of fever, adenovirus (ADV) load, and mixed fungal coinfections were independent risk factors for PIBO. In the nomogram prediction model analysis, the area under the curve (AUC) was 0.857; in addition, Hosmer‒Lemeshow (H-L) detection reflected good alignment (χ2 = 68.75, P < 0.01). CONCLUSIONS A nomogram prediction model, which can be utilized to predict PIBO occurrence in pediatric patients with ADVP after IMV at an early time period, was successfully built.
Collapse
Affiliation(s)
- Li Peng
- grid.477407.70000 0004 1806 9292Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People’s Hospital (the First Affiliated Hospital of Hunan Normal University), Fu-Rong District, 61 Jie-Fang West Road, Changsha, 410005 People’s Republic of China
| | - Silan Liu
- grid.477407.70000 0004 1806 9292Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People’s Hospital (the First Affiliated Hospital of Hunan Normal University), Fu-Rong District, 61 Jie-Fang West Road, Changsha, 410005 People’s Republic of China
| | - Tian Xie
- grid.477407.70000 0004 1806 9292Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People’s Hospital (the First Affiliated Hospital of Hunan Normal University), Fu-Rong District, 61 Jie-Fang West Road, Changsha, 410005 People’s Republic of China
| | - Yu Li
- grid.477407.70000 0004 1806 9292Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People’s Hospital (the First Affiliated Hospital of Hunan Normal University), Fu-Rong District, 61 Jie-Fang West Road, Changsha, 410005 People’s Republic of China
| | - Zhuojie Yang
- grid.477407.70000 0004 1806 9292Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People’s Hospital (the First Affiliated Hospital of Hunan Normal University), Fu-Rong District, 61 Jie-Fang West Road, Changsha, 410005 People’s Republic of China
| | - Yongqi Chen
- grid.477407.70000 0004 1806 9292Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People’s Hospital (the First Affiliated Hospital of Hunan Normal University), Fu-Rong District, 61 Jie-Fang West Road, Changsha, 410005 People’s Republic of China
| | - Liangji Deng
- grid.477407.70000 0004 1806 9292Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People’s Hospital (the First Affiliated Hospital of Hunan Normal University), Fu-Rong District, 61 Jie-Fang West Road, Changsha, 410005 People’s Republic of China
| | - Han Huang
- grid.477407.70000 0004 1806 9292Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People’s Hospital (the First Affiliated Hospital of Hunan Normal University), Fu-Rong District, 61 Jie-Fang West Road, Changsha, 410005 People’s Republic of China
| | - Xiaofang Ding
- grid.477407.70000 0004 1806 9292Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People’s Hospital (the First Affiliated Hospital of Hunan Normal University), Fu-Rong District, 61 Jie-Fang West Road, Changsha, 410005 People’s Republic of China
| | - Min Chen
- grid.477407.70000 0004 1806 9292Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People’s Hospital (the First Affiliated Hospital of Hunan Normal University), Fu-Rong District, 61 Jie-Fang West Road, Changsha, 410005 People’s Republic of China
| | - Lin Lin
- grid.477407.70000 0004 1806 9292Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People’s Hospital (the First Affiliated Hospital of Hunan Normal University), Fu-Rong District, 61 Jie-Fang West Road, Changsha, 410005 People’s Republic of China
| | - Sangzi Wei
- grid.477407.70000 0004 1806 9292Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People’s Hospital (the First Affiliated Hospital of Hunan Normal University), Fu-Rong District, 61 Jie-Fang West Road, Changsha, 410005 People’s Republic of China
| | - Lili Zhong
- Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People's Hospital (the First Affiliated Hospital of Hunan Normal University), Fu-Rong District, 61 Jie-Fang West Road, Changsha, 410005, People's Republic of China.
| |
Collapse
|
8
|
Predictive Value of Adenoviral Load for Bronchial Mucus Plugs Formation in Children with Adenovirus Pneumonia. Can Respir J 2022; 2022:9595184. [PMID: 35979256 PMCID: PMC9377942 DOI: 10.1155/2022/9595184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 06/08/2022] [Accepted: 07/12/2022] [Indexed: 11/17/2022] Open
Abstract
Background. The study aimed to explore risk factors for bronchial mucus plugs (BMP) formation in children with adenovirus (AdV) pneumonia. Methods. A retrospective study was conducted on children with AdV pneumonia who underwent bronchoscopy from January 2019 to December 2019. Children were divided into the BMP group and the control group, depending on whether BMP was formed or not. The clinical information and treatment proposals of the two groups of children were counted and analyzed via multiple logistic regression analysis, ROC curve analysis, and correlation analysis. Results. Among 453 patients with AdV pneumonia, 185 (40.84%) were in the BMP group. Among all the cases, there were 188 patients with a single AdV infection, including 64 (34.04%) in the BMP group and 124 (65.96%) in the control group. The incidence of dyspnea, poor spirits, mixed infections, and other symptoms in the BMP group was higher than in the control group. Children in the BMP group had a longer heat range. C-reactive protein (CRP), lactate dehydrogenase (LDH), D-dimer (DD), and AdV load levels were higher in the MBP group. AdV load, Mycoplasma coinfection, DD, heat range, and LDH were independent risk factors for BMP, among which AdV load was the most significant (AUC = 0.819). AdV load was positively correlated with other risk factors, respectively. AdV load and heat range were independent risk factors for BMP patients with a single AdV infection. Conclusion. AdV load might have important clinical value in predicting BMP development in AdV pneumonia.
Collapse
|
9
|
Flanagan F, Casey A, Reyes-Múgica M, Kurland G. Post-infectious bronchiolitis obliterans in children. Paediatr Respir Rev 2022; 42:69-78. [PMID: 35562287 DOI: 10.1016/j.prrv.2022.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 01/28/2022] [Indexed: 10/19/2022]
Affiliation(s)
- Frances Flanagan
- Division of Pulmonary Medicine, Boston Children's Hospital, 333 Longwood Ave, 5(th) Floor, Boston, MA 02115, United States.
| | - Alicia Casey
- Division of Pulmonary Medicine, Boston Children's Hospital, 333 Longwood Ave, 5(th) Floor, Boston, MA 02115, United States.
| | - Miguel Reyes-Múgica
- Department of Pathology, UPMC Children's Hospital ofPittsburgh, One Children's Hospital Drive, 4401 Penn Avenue, Pittsburgh PA 1522, United States.
| | - Geoffrey Kurland
- Division of Pediatric Pulmonology, UPMC Children's Hospital of Pittsburgh, 4401 Penn Avenue, Pittsburgh, PA 15224, United States.
| |
Collapse
|
10
|
Fatal adenovirus pneumonia in a 15-day-old infant despite extracorporeal life support treatment: A case report. MEDICINE INTERNATIONAL 2022; 2:15. [PMID: 36698502 PMCID: PMC9829201 DOI: 10.3892/mi.2022.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/18/2022] [Indexed: 02/01/2023]
Abstract
Infections are one of the most common causes of severe neonatal diseases and the leading cause of neonatal death. Although respiratory viral infections are widespread, they are still not recognized as the predominant causes of neonatal deaths. Adenovirus infection is uncommon during the neonatal period, and it frequently has a fatal outcome. Furthermore, it is difficult to distinguish from other common bacterial and respiratory viral infections. The present study reports the case of a 15-day-old newborn who presented with coagulation disorders and hypoxemia in September, 2020. Human adenovirus of species D-53 (HAdV-D53) was detected in the blood and sputum. Severe pneumonia rapidly progressed to multiple organ failure syndrome and the patient succumbed to the disease, despite receiving extracorporeal membrane oxygenation.
Collapse
|
11
|
Peng H, Chen F, Zuo Y, Huang B, Yang Y, Dang R. Mortality reduction in pediatric patients with severe fatal human adenoviral pneumonia treated with high titer neutralizing antibodies (NAbs) plasma: a retrospective cohort study. BMC Pediatr 2022; 22:151. [PMID: 35317780 PMCID: PMC8938635 DOI: 10.1186/s12887-022-03225-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 03/14/2022] [Indexed: 11/14/2022] Open
Abstract
Background Severe fatal human adenoviral (HAdV) pneumonia is associated with significant mortality and no effective drug is available for clinical therapy. We evaluated the association and safety of high titer neutralizing antibodies (NAbs) plasma in pediatric patients with severe fatal HAdV pneumonia. Methods A retrospective cohort study was performed between January 2016 to June 2021 in pediatric intensive care unit. Pediatric patients with severe fatal HAdV pneumonia were included and divided into plasma group (conventional treatment plus high titer NAbs plasma treatment) and control group (conventional treatment alone). The primary outcome was mortality in hospital. Secondary outcomes were the duration of fever after adenovirus genotype determined, duration of invasive mechanical ventilation, length of hospital stay. T-test, Mann-Whitney U-test, chi-square test, univariable and multivariable logistic regression analysis, Kaplan-Meier method and log-rank test were adopted to compare differences between two groups. Results A total of 59 pediatric patients with severe fatal HAdV pneumonia were enrolled. They were divided into plasma group (n = 33) and control group (n = 26). The mortality in hospital was 28.8% (17/ 59). Significantly fewer patients progressed to death in plasma group than control group (18.2% vs 42.3%, p = 0.042). Sequential organ failure assessment (SOFA) score, oxygen index (OI) and high titer NAbs plasma treatment were included in multivariable logistic regression analysis for mortality risk factors. Consequentially, SOFA score (Hazard Ratio [HR] 7.686, 95% Confidence Interval [CI] 1.735–34.054, p = 0.007) and without high titer NAbs plasma treatment (HR 4.298, 95%CI 1.030–17.934, p = 0.045) were significantly associated with mortality. In addition, high titer NAbs plasma treatment were associated with faster temperature recovering in survivors (p = 0.031). No serious adverse effects occurred. Conclusions Administration of high titer NAbs plasma were associated with a lower hazard for mortality in pediatric patients with severe fatal HAdV pneumonia. For survivors, high titer NAbs plasma treatment shorten the duration of fever.
Collapse
Affiliation(s)
- Hongyan Peng
- Department of Pediatric Intensive Care Unit, Guangzhou Women and Children's Medical Center, No.318 Renmin Middle Road, Yuexiu District, Guangzhou, 510120, China
| | - Feiyan Chen
- Department of Pediatric Intensive Care Unit, Guangzhou Women and Children's Medical Center, No.318 Renmin Middle Road, Yuexiu District, Guangzhou, 510120, China
| | - Yunlong Zuo
- Department of Pediatric Intensive Care Unit, Guangzhou Women and Children's Medical Center, No.318 Renmin Middle Road, Yuexiu District, Guangzhou, 510120, China
| | - Bolun Huang
- Department of Pediatric Intensive Care Unit, Guangzhou Women and Children's Medical Center, No.318 Renmin Middle Road, Yuexiu District, Guangzhou, 510120, China
| | - Yiyu Yang
- Department of Pediatric Intensive Care Unit, Guangzhou Women and Children's Medical Center, No.318 Renmin Middle Road, Yuexiu District, Guangzhou, 510120, China.
| | - Run Dang
- Department of Pediatric Intensive Care Unit, Guangzhou Women and Children's Medical Center, No.318 Renmin Middle Road, Yuexiu District, Guangzhou, 510120, China.
| |
Collapse
|
12
|
Wang X, Tan X, Li Q. Difference in clinical features and prognosis of severe adenoviral pneumonia in children with different ages. J Med Virol 2022; 94:3303-3311. [PMID: 35218046 DOI: 10.1002/jmv.27680] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 02/08/2022] [Accepted: 02/23/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE This study aims to analyze the difference in clinical features and prognosis of severe adenovirus pneumonia (SAP) in children of different ages, and analyze the risk factors for poor prognosis in children with SAP. METHODS A retrospective observational study was performed to describe the clinical features and analyze the risk factors for death and post-infectious bronchiolitis obliterans (PIBO) in 303 children hospitalized with SAP from January 2015 through to January 2020. The participants were divided into 4 age groups: < 6 months (n = 25, 8.3%); 6-12 months (n = 98, 32.3%); 12-36 months (n = 118, 38.9%); and > 36 months (n = 62, 20.5%). RESULTS Fever rate, peak, and duration were the lowest in the < 6 months group, while no significant difference was found among other age groups. Serum levels of lactate dehydrogenase (LDH) and the load of adenovirus were the lowest in the < 6 months group, and the highest in the 6-12 months and 12-36 months groups, respectively. A total of 80.9% of patients recovered, 3.3% of patients died, and 15.8% of patients were diagnosed PIBO. The mortality rate showed no significance between age groups. The > 36 months group had the highest recovery rate and the lowest incidence of PIBO, while the 6-12 months group had the lowest recovery rate and the highest incidence of PIBO. Independent risk factors for PIBO among all participants from the 4 groups were invasive mechanical ventilation, administration of intravenous steroids, duration of fever, and male gender. Independent risk factors for death among all participants from the 4 groups were hypercapnia, low albumin levels, and invasive mechanical ventilation. Risk factor analysis of different ages was not possible due to the limited sample size. CONCLUSIONS The morbidity, clinical features, and prognosis of SAP are affected by children's ages. Pediatric patients with a longer duration of fever, hypercapnia, low serum albumin levels, invasive mechanical ventilation, and intravenous steroids use are more likely to develop a poor prognosis in SAP, especially if the patient is male. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Xia Wang
- Department of Pediatrics, Second Affiliated Hospital of Army Medical University, Chongqing, 400037, China
| | - Xiangsheng Tan
- The First Hospital Affiliated to Army Medical University, Chongqing, 400038, China
| | - Qubei Li
- Department of the Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China.,National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, 400014, China
| |
Collapse
|
13
|
Rajbanshi A, Giri P, Laha S, Poddar S. Epidemiology, clinical presentation, and respiratory sequelae of severe adenoviral pneumonia in children admitted in a tertiary care pediatric intensive care unit from Eastern India: A single-center observational study. JOURNAL OF PEDIATRIC CRITICAL CARE 2022. [DOI: 10.4103/jpcc.jpcc_84_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
14
|
Fan H, Cui Y, Xu X, Zhang D, Yang D, Huang L, Ding T, Lu G. Validation of a Classification Model Using Complete Blood Count to Predict Severe Human Adenovirus Lower Respiratory Tract Infections in Pediatric Cases. Front Pediatr 2022; 10:896606. [PMID: 35712623 PMCID: PMC9197341 DOI: 10.3389/fped.2022.896606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Human adenovirus (HAdV) lower respiratory tract infections (LRTIs) are prone to severe cases and even cause death in children. Here, we aimed to develop a classification model to predict severity in pediatric patients with HAdV LRTIs using complete blood count (CBC). METHODS The CBC parameters from pediatric patients with a diagnosis of HAdV LRTIs from 2013 to 2019 were collected during the disease's course. The data were analyzed as potential predictors for severe cases and were selected using a random forest model. RESULTS We enrolled 1,652 CBC specimens from 1,069 pediatric patients with HAdV LRTIs in the present study. Four hundred and seventy-four patients from 2017 to 2019 were used as the discovery cohort, and 470 patients from 2013 to 2016 were used as the validation cohort. The monocyte ratio (MONO%) was the most obvious difference between the mild and severe groups at onset, and could be used as a marker for the early accurate prediction of the severity [area under the subject operating characteristic curve (AUROC): 0.843]. Four risk factors [MONO%, hematocrit (HCT), red blood cell count (RBC), and platelet count (PLT)] were derived to construct a classification model of severe and mild cases using a random forest model (AUROC: 0.931 vs. 0.903). CONCLUSION Monocyte ratio can be used as an individual predictor of severe cases in the early stages of HAdV LRTIs. The four risk factors model is a simple and accurate risk assessment tool that can predict severe cases in the early stages of HAdV LRTIs.
Collapse
Affiliation(s)
- Huifeng Fan
- Department of Respiration, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Ying Cui
- Department of Immunology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Xuehua Xu
- Pediatric Intensive Care Unit, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Dongwei Zhang
- Pediatric Intensive Care Unit, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Diyuan Yang
- Department of Respiration, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Li Huang
- Pediatric Intensive Care Unit, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Tao Ding
- Department of Immunology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.,Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-sen University, Guangzhou, China.,Provincial Engineering Technology Research Center for Biological Vector Control, Guangzhou, China
| | - Gen Lu
- Department of Respiration, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| |
Collapse
|
15
|
Lynch JP, Kajon AE. Adenovirus: Epidemiology, Global Spread of Novel Types, and Approach to Treatment. Semin Respir Crit Care Med 2021; 42:800-821. [PMID: 34918322 DOI: 10.1055/s-0041-1733802] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Adenoviruses (AdVs) are DNA viruses that typically cause mild infections involving the upper or lower respiratory tract, gastrointestinal tract, or conjunctiva. Rare manifestations of AdV infections include hemorrhagic cystitis, hepatitis, hemorrhagic colitis, pancreatitis, nephritis, or meningoencephalitis. AdV infections are more common in young children, due to lack of humoral immunity. Epidemics of AdV infection may occur in healthy children or adults in closed or crowded settings (particularly military recruits). The vast majority of cases are self-limited. However, the clinical spectrum is broad and fatalities may occur. Dissemination is more likely in patients with impaired immunity (e.g., organ transplant recipients, human immunodeficiency virus infection). Fatality rates for untreated severe AdV pneumonia or disseminated disease may exceed 50%. More than 100 genotypes and 52 serotypes of AdV have been identified and classified into seven species designated HAdV-A through -G. Different types display different tissue tropisms that correlate with clinical manifestations of infection. The predominant types circulating at a given time differ among countries or regions, and change over time. Transmission of novel strains between countries or across continents and replacement of dominant viruses by new strains may occur. Treatment of AdV infections is controversial, as prospective, randomized therapeutic trials have not been done. Cidofovir has been the drug of choice for severe AdV infections, but not all patients require treatment. Live oral vaccines are highly efficacious in reducing the risk of respiratory AdV infection and are in routine use in the military in the United States but currently are not available to civilians.
Collapse
Affiliation(s)
- Joseph P Lynch
- Division of Pulmonary, Critical Care Medicine, Allergy, and Clinical Immunology, Department of Internal Medicine, The David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Adriana E Kajon
- Infectious Disease Program, Lovelace Biomedical Research Institute, Albuquerque, New Mexico
| |
Collapse
|
16
|
Laya BF, Concepcion NDP, Garcia-Peña P, Naidoo J, Kritsaneepaiboon S, Lee EY. Pediatric Lower Respiratory Tract Infections: Imaging Guidelines and Recommendations. Radiol Clin North Am 2021; 60:15-40. [PMID: 34836562 DOI: 10.1016/j.rcl.2021.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Lower respiratory tract infection (LRTI) remains a major cause of morbidity and mortality in children. Various organisms cause LRTI, including viruses, bacteria, fungi, and parasites, among others. Infections caused by 2 or more organisms also occur, sometimes enhancing the severity of the infection. Medical imaging helps confirm a diagnosis but also plays a role in the evaluation of acute and chronic sequelae. Medical imaging tests help evaluate underlying pathology in pediatric patients with recurrent or long-standing symptoms as well as the immunocompromised.
Collapse
Affiliation(s)
- Bernard F Laya
- Section of Pediatric Radiology, Institute of Radiology, St. Luke's Medical Center-Quezon City, 279 E. Rodriguez Sr. Ave., Quezon City, 1112 Philippines.
| | - Nathan David P Concepcion
- Section of Pediatric Radiology, Institute of Radiology, St. Luke's Medical Center-Quezon City, 279 E. Rodriguez Sr. Ave., Quezon City, 1112 Philippines
| | - Pilar Garcia-Peña
- Autonomous University of Barcelona (AUB), University Hospital Materno-Infantil Vall d'Hebron, Pso. Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Jaishree Naidoo
- Paeds Diagnostic Imaging and Envisionit Deep AI, 2nd Floor, One-on Jameson Building, 1 Jameson Avenue, Melrose Estate, Johannesburg, 2196, South Africa
| | - Supika Kritsaneepaiboon
- Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine, Prince of Songkla University, Kanjanavanich Road, Hat Yai, 90110, Thailand
| | - Edward Y Lee
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA
| |
Collapse
|
17
|
Xu XH, Fan HF, Shi TT, Yang DY, Huang L, Jiang WH, Lu G. Influence of the timing of bronchoscopic alveolar lavage on children with adenovirus pneumonia: a comparative study. BMC Pulm Med 2021; 21:363. [PMID: 34763680 PMCID: PMC8582151 DOI: 10.1186/s12890-021-01708-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 10/26/2021] [Indexed: 12/03/2022] Open
Abstract
Background Adenovirus pneumonia is prone to severe clinical and imaging manifestations in children. Bronchoscopic alveolar lavage (BAL) is an important adjunctive therapy for patients with severe imaging findings. The study aimed to evaluate the effect of the timing on the efficacy of bronchoalveolar lavage in children with adenovirus pneumonia. Methods This study included 134 patients with adenovirus pneumonia treated with BAL at Guangzhou Women and Children's Medical Center from January 2019 to January 2020.They were classified into the severe and mild groups. Based on the timing of BAL, each group was divided into the early BAL layer (received BAL within 1–9 days of the illness course) and the late BAL layer (received BAL within 10–14 days of the illness course). The clinical data of patients with different BAL timings were analyzed in two groups. Results Among the 134 patients, 70 were categorized into the mild group and 64 were categorized into the severe group. Of the 134 patients, 42 patients received BAL early (mild group: n = 21 and severe group: n = 21) and 92 patients received BAL later (mild group: n = 49 and severe group: n = 43). In the mild group, the fever and hospital duration were shorter in patients who received BAL early than in those who received BAL later (p < 0.05). However, in the severe group, there were no statistically significant differences in the fever and hospital duration between patients who received BAL early and those who received BAL later. However, the need for mechanical ventilation and the incidence of BAL complications, such as new need for oxygen, were higher in patients who received BAL early than in those who received BAL later in the severe group (p < 0.05). Conclusion For mild adenovirus pneumonia, early BAL may shorten the fever and hospital duration. However, early BAL in severe cases might not shorten the course of the disease or improve prognosis and may even increase the risks of mechanical ventilation and BAL complications.
Collapse
Affiliation(s)
- Xue-Hua Xu
- Department of Respiratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Hui-Feng Fan
- Department of Respiratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Ting-Ting Shi
- Pediatric Intensive Care Unit, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Di-Yuan Yang
- Department of Respiratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Li Huang
- Pediatric Intensive Care Unit, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Wen-Hui Jiang
- Department of Respiratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Gen Lu
- Department of Respiratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510120, Guangdong, China.
| |
Collapse
|
18
|
Li M, Han XH, Liu LY, Yao HS, Yi LL. Epidemiological characteristics, clinical characteristics, and prognostic factors of children with atopy hospitalised with adenovirus pneumonia. BMC Infect Dis 2021; 21:1051. [PMID: 34627176 PMCID: PMC8502338 DOI: 10.1186/s12879-021-06741-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 09/28/2021] [Indexed: 12/24/2022] Open
Abstract
Background Atopy may be associated with disease severity and a poor prognosis of human adenovirus (HAdV) pneumonia in children. Our aim was to observe the clinical characteristics and pulmonary radiological changes in children with atopy and HAdV pneumonia in China. Methods Children hospitalised with HAdV pneumonia from June 2018 to December 2019 were analysed. All children were divided into atopic with HAdV, non-atopic with HAdV, and atopic without HAdV infection group. Each group was further divided into the mild and severe pneumonia groups according to disease severity. Standard treatment was initiated after admission, and regular follow-up evaluations were conducted at 1 month after discharge. Baseline and clinical characteristics and pulmonary radiological changes in children with and without atopy were evaluated. Risk factors associated with small airway lesions in patients with HAdV pneumonia were analysed. Results The eosinophil count in the atopic group was significantly higher than that in the non-atopic group (P < 0.05). Severe coughing, wheezing, and small airway lesions on chest high-resolution computed tomography (HRCT) upon admission, after discharge and 1 month after discharge were significantly higher in the atopic group (with or without HAdV infection) than in the non-atopic group (P < 0.05). There were significant differences in the number of patients with wheezing and small airway lesions during hospitalisation and after discharge among the three groups (P < 0.05). The risks of small airway lesions in children with a family or personal history of asthma, severe infection, atopy, and HAdV infection were 2.1-, 2.7-, 1.9-, 2.1-, and 1.4-times higher than those in children without these characteristics, respectively. Conclusions Children with atopy and HAdV pneumonia may experience severe coughing in mild cases and wheezing in mild and severe cases. Children with atopy are more susceptible to the development of small airway lesions, recurrent wheezing after discharge and slower recovery of small airway lesions as observed on pulmonary imaging than non-atopic children after HAdV infection. A family or personal history of asthma, atopy, severe infection, and HAdV infection are independent risk factors associated with the development of small airway lesion as observed on chest HRCT.
Collapse
Affiliation(s)
- Miao Li
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, 110004, Liaoning, China.
| | - Xiao-Hua Han
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, 110004, Liaoning, China
| | - Li-Yun Liu
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, 110004, Liaoning, China
| | - Hui-Sheng Yao
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, 110004, Liaoning, China
| | - Li-Li Yi
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, 110004, Liaoning, China
| |
Collapse
|
19
|
Ljubin-Sternak S, Meštrović T, Lukšić I, Mijač M, Vraneš J. Seasonal Coronaviruses and Other Neglected Respiratory Viruses: A Global Perspective and a Local Snapshot. Front Public Health 2021; 9:691163. [PMID: 34291031 PMCID: PMC8287126 DOI: 10.3389/fpubh.2021.691163] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 06/04/2021] [Indexed: 02/02/2023] Open
Abstract
Respiratory viral infections are the leading cause of morbidity and mortality in the world; however, there are several groups of viruses that are insufficiently routinely sought for, and can thus be considered neglected from a diagnostic and clinical standpoint. Timely detection of seasonality of certain respiratory viruses (e.g., enveloped viruses such as seasonal coronaviruses) in the local context can aid substantially in targeted and cost-effective utilization of viral diagnostic approaches. For the other, non-enveloped and year-round viruses (i.e., rhinovirus, adenovirus, and bocavirus), a continuous virological diagnosis needs to be implemented in clinical laboratories to more effectively address the aetiology of respiratory infections, and assess the overall impact of these viruses on disease burden. While the coronavirus disease 2019 (COVID-19) pandemic is still actively unfolding, we aimed to emphasize the persistent role of seasonal coronaviruses, rhinoviruses, adenoviruses and bocaviruses in the aetiology of respiratory infections. Consequently, this paper concentrates on the burden and epidemiological trends of aforementioned viral groups on a global level, but also provides a snapshot of their prevalence patterns in Croatia in order to underscore the potential implications of viral seasonality. An overall global prevalence in respiratory tract infections was found to be between 0.5 and 18.4% for seasonal coronaviruses, between 13 and 59% for rhinoviruses, between 1 and 36% for human adenoviruses, and between 1 and 56.8% for human bocaviruses. A Croatian dataset on patients with respiratory tract infection and younger than 18 years of age has revealed a fairly high prevalence of rhinoviruses (33.4%), with much lower prevalence of adenoviruses (15.6%), seasonal coronaviruses (7.1%), and bocaviruses (5.3%). These insights represent a relevant discussion point in the context of the COVID-19 pandemic where the testing of non-SARS-CoV-2 viruses has been limited in many settings, making the monitoring of disease burden associated with other respiratory viruses rather difficult.
Collapse
Affiliation(s)
- Sunčanica Ljubin-Sternak
- Clinical Microbiology Department, Andrija Štampar Teaching Institute of Public Health, Zagreb, Croatia.,Medical Microbiology Department, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Tomislav Meštrović
- Clinical Microbiology and Parasitology Unit, Zora Profozić Polyclinic, Zagreb, Croatia.,University Centre Varaždin, University North, Varaždin, Croatia
| | - Ivana Lukšić
- Clinical Microbiology Department, Andrija Štampar Teaching Institute of Public Health, Zagreb, Croatia
| | - Maja Mijač
- Clinical Microbiology Department, Andrija Štampar Teaching Institute of Public Health, Zagreb, Croatia.,Medical Microbiology Department, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Jasmina Vraneš
- Clinical Microbiology Department, Andrija Štampar Teaching Institute of Public Health, Zagreb, Croatia.,Medical Microbiology Department, University of Zagreb School of Medicine, Zagreb, Croatia
| |
Collapse
|
20
|
Yan Y, Jing S, Feng L, Zhang J, Zeng Z, Li M, Zhao S, Ou J, Lan W, Guan W, Wu X, Wu J, Seto D, Zhang Q. Construction and Characterization of a Novel Recombinant Attenuated and Replication-Deficient Candidate Human Adenovirus Type 3 Vaccine: "Adenovirus Vaccine Within an Adenovirus Vector". Virol Sin 2021; 36:354-364. [PMID: 32458297 PMCID: PMC7248191 DOI: 10.1007/s12250-020-00234-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 04/13/2020] [Indexed: 01/09/2023] Open
Abstract
Human adenoviruses (HAdVs) are highly contagious and result in large number of acute respiratory disease (ARD) cases with severe morbidity and mortality. Human adenovirus type 3 (HAdV-3) is the most common type that causes ARD outbreaks in Asia, Europe, and the Americas. However, there is currently no vaccine approved for its general use. The hexon protein contains the main neutralizing epitopes, provoking strong and lasting immunogenicity. In this study, a novel recombinant and attenuated adenovirus vaccine candidate against HAdV-3 was constructed based on a commercially-available replication-defective HAdV-5 gene therapy and vaccine vector. The entire HAdV-3 hexon gene was integrated into the E1 region of the vector by homologous recombination using a bacterial system. The resultant recombinants expressing the HAdV-3 hexon protein were rescued in AD293 cells, identified and characterized by RT-PCR, Western blots, indirect immunofluorescence, and electron microscopy. This potential vaccine candidate had a similar replicative efficacy as the wild-type HAdV-3 strain. However, and importantly, the vaccine strain had been rendered replication-defective and was incapable of replication in A549 cells after more than twenty-generation passages in AD293 cells. This represents a significant safety feature. The mice immunized both intranasally and intramuscularly by this vaccine candidate raised significant neutralizing antibodies against HAdV-3. Therefore, this recombinant, attenuated, and safe adenovirus vaccine is a promising HAdV-3 vaccine candidate. The strategy of using a clinically approved and replication-defective HAdV-5 vector provides a novel approach to develop universal adenovirus vaccine candidates against all the other types of adenoviruses causing ARDs and perhaps other adenovirus-associated diseases.
Collapse
Affiliation(s)
- Yuqian Yan
- Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Shuping Jing
- Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, China
- Microbiological Laboratory, Zhuhai Center for Disease Control and Prevention, Zhuhai, 519000, China
| | - Liqiang Feng
- Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, 510530, China
| | - Jing Zhang
- Guangdong Provincial Key Laboratory of Virology, Institute of Medical Microbiology, Jinan University, Guangzhou, 510632, China
| | - Zhiwei Zeng
- Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Min Li
- Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Shan Zhao
- Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Junxian Ou
- Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Wendong Lan
- Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Wenyi Guan
- Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Xiaowei Wu
- Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Jianguo Wu
- Guangdong Provincial Key Laboratory of Virology, Institute of Medical Microbiology, Jinan University, Guangzhou, 510632, China
| | - Donald Seto
- Bioinformatics and Computational Biology Program, School of Systems Biology, George Mason University, Manassas, VA, 20110, USA
| | - Qiwei Zhang
- Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, China.
- Guangdong Provincial Key Laboratory of Virology, Institute of Medical Microbiology, Jinan University, Guangzhou, 510632, China.
| |
Collapse
|
21
|
Wen S, Lin Z, Zhang Y, Lv F, Li H, Zhang X, Lin L, Zhu HH, Xu Z, Li C, Zhang H. The Epidemiology, Molecular, and Clinical of Human Adenoviruses in Children Hospitalized With Acute Respiratory Infections. Front Microbiol 2021; 12:629971. [PMID: 33664719 PMCID: PMC7921318 DOI: 10.3389/fmicb.2021.629971] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 01/27/2021] [Indexed: 12/19/2022] Open
Abstract
Introduction Human adenovirus (HAdV) is a common pathogen in children with acute respiratory infections (ARIs). The aim was to describe the epidemiology, molecular, and clinical characteristics of HAdV among children hospitalized with ARIs in Wenzhou in southeastern China. Methodology From January 2018 to December 2019, nasopharyngeal swab or sputum specimens were prospectively collected from hospitalized children with ARIs. HAdV was detected using direct immunofluorescence. We used a multiplex PCR assay combined with capillary electrophoresis targeting the hexon gene’s hypervariable region to identify HAdV types 1, 2, 3, 4, 5, 7, 14, 21, 37, 40, 41, and 55. We analyzed the epidemiological, molecular, and clinical data according to the HAdV type. Results HAdVs were detected in 1,059 (3.5%) of the total of 30,543 children tested. A total of 947 cases with monotype HAdV identified by the PCR assay were included in the analysis. HAdV-3 (415/947, 43.8%), HAdV-7 (318/947, 33.6%), HAdV-2 (108/947, 11.4%), and HAdV-1 (70/947, 7.4%) were the predominant types. Of the 550 (58.1%) cases detected from December 2018 to August 2019, HAdV-3, and HAdV-7 were the main types. The main diagnoses included 358 cases of pneumonia, 232 cases of tonsillitis, 198 cases of bronchitis, and 159 cases of upper respiratory tract infection (URTI). Among children with pneumonia the main types were HAdV-7 (51.1%), HAdV-3 (36.9%), and HAdV-1 (2.2%). Among children with bronchitis, the main types were HAdV-3 (48.0%), HAdV-7 (28.3%), and HAdV-2 (10.6%). Among children with URTIs, the main types were HAdV-3 (49.7%), HAdV-7 (22.6%), and HAdV-2 (13.2%). Among children with tonsillitis, the main types were HAdV-3 (47.4%), HAdV-2 (22.4%), and HAdV-7 (18.5%). In total, 101 (55.2%) patients required supplemental oxygen, 15 (8.2%) required critical care, and 1 child (0.5%) with HAdV-7 pneumonia died. Conclusion HAdV-3 -7, -2, and -1 were the predominant types identified in hospitalized children with ARIs in Wenzhou. From December 2018 to August 2019, there were outbreaks of HAdV-3 and -7. There were significant differences in HAdV types among children with pneumonia, tonsillitis, bronchitis, and URTI. HAdV-7 can cause more severe pneumonia in children than HAdV-3.
Collapse
Affiliation(s)
- Shunhang Wen
- Department of Children's Respiration Disease, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Zupan Lin
- Department of Children's Respiration Disease, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yue Zhang
- Department of Pediatrics, The Third Affiliated Hospital, Wenzhou Medical University, Wenzhou, China
| | - Fangfang Lv
- Department of Children's Respiration Disease, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Haiyan Li
- Department of Children's Respiration Disease, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Xueya Zhang
- Department of Children's Respiration Disease, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Li Lin
- Department of Children's Respiration Disease, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Hui-Hui Zhu
- Department of Children's Respiration Disease, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Zhi Xu
- Ningbo Health Gene Technologies Ltd., Ningbo, China
| | - Changchong Li
- Department of Children's Respiration Disease, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Hailin Zhang
- Department of Children's Respiration Disease, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| |
Collapse
|
22
|
Yu X, Ma Y, Gao Y, You H. Epidemiology of Adenovirus Pneumonia and Risk Factors for Bronchiolitis Obliterans in Children During an Outbreak in Jilin, China. Front Pediatr 2021; 9:722885. [PMID: 34650942 PMCID: PMC8506152 DOI: 10.3389/fped.2021.722885] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/02/2021] [Indexed: 01/13/2023] Open
Abstract
Background: Jilin Province, located in northeastern China, recently experienced a human adenovirus (HAdV) epidemic. Few studies involving hospitalized pediatric patients with pneumonia caused by HAdV in our region exist. HAdV pneumonia can lead to severe long-term respiratory sequelae, such as post-infectious bronchiolitis obliterans (PIBO), which has a poor prognosis and greatly influences the quality of life of pediatric patients. However, studies on the risk factors for PIBO are limited. Objective: To describe the HAdV pneumonia prevalence and determine potential risk factors for PIBO development among hospitalized children in Jilin Province, China. Methods: The data of 187 children with HAdV pneumonia (10 months-12 years old) admitted to the First Hospital of Jilin University during an outbreak between October 2018 and January 2020 were retrospectively studied. We analyzed the epidemiological characteristics of HAdV pneumonia, focusing on severe HAdV pneumonia (66 cases). The risk factors for BO development were determined by comparing the demographic and clinical data of the BO and non-BO groups. Results: The largest number of HAdV pneumonia cases occurred in January 2019 (severe n = 18, general n = 21), followed by December 2018 (severe n = 14, general n = 11), June 2019 (general n = 17), July 2019 (general, n = 14), and May 2019 (general, n = 13). In total, 91.98% of the children with HAdV pneumonia were <6 years old (172/187), and 50% of the pediatric patients with severe HAdV pneumonia were <2 years old (33/66). We found that 30.3% of the severe cohort developed BO (20/66), and the strongest independent risk factors for PIBO were persistent wheezing (OR 181.776, 95% CI, 3.385-9,761.543) and acute respiratory failure (OR 51.288, 95% CI, 1.858-1,415.441) during a severe pneumonia episode. Conclusions: The largest number of HAdV pneumonia cases, especially severe cases, occurred in winter in Northeast China, followed by summer. The majority of children admitted with HAdV pneumonia were <6 years old, and half of severe HAdV pneumonia patients were <2 years old. Children who had persistent wheezing or acute respiratory failure during the acute phase of severe HAdV pneumonia were prone to the development of BO.
Collapse
Affiliation(s)
- Xiuhua Yu
- Department of Pediatrics, First Hospital of Jilin University, Changchun, China
| | - Yucong Ma
- Department of Pediatrics, First Hospital of Jilin University, Changchun, China
| | - Yang Gao
- Department of Pediatrics, First Hospital of Jilin University, Changchun, China
| | - Hailong You
- Department of Pediatrics, First Hospital of Jilin University, Changchun, China
| |
Collapse
|
23
|
Zhong H, Dong X. Analysis of Clinical Characteristics and Risk Factors of Severe Adenovirus Pneumonia in Children. Front Pediatr 2021; 9:566797. [PMID: 34712627 PMCID: PMC8546294 DOI: 10.3389/fped.2021.566797] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 09/17/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: To analyze the clinical characteristics of adenovirus pneumonia (ADVP) in children and explore risk factors for severe ADVP. Methods: Clinical data from 7,008 hospitalized children with community-acquired pneumonia and 211 with ADVP were retrospectively analyzed between July 2014 and June 2019. Eighty-six patients were diagnosed with severe pneumonia, and related risk factors were analyzed. Results: ADVP accounts for 3.01% (211/7008) of CAP in hospitalized children. Among 211 patients, 167 (64.9%) children aged 1-5 years old, and the onset was in winter and spring for 126 (59.7%) children. All patients had cough, and 116 (92.8%) patients with mild cases and 82 (95.4%) patients with severe cases had varying degrees of fever. The duration of fever in the severe ADVP group and mild ADVP group was 7.3 and 5.4 days, respectively. The average hospital stays were 9.8 and 5.8 days, respectively. There was no significant difference in the levels of WBC and ESR between the two groups, but the levels of N%, CRP, PCT and LDH in children with severe ADVP were significantly higher than those in the mild ADVP group. The univariate analysis showed that there were significant differences between the severe ADVP group and the mild ADVP group in ≥7 days of fever and high IgE (P < 0.05). There was no significant difference in sex, age, onset season, mycoplasma infection, bacterial infection between the two groups (P > 0.05). The multivariate logistic analysis showed that ≥7 days of fever and high IgE were independent risk factors for severe ADVP (P < 0.05). Conclusions: Children with severe ADVP have long fever duration, a strong inflammatory response and immune function disturbance. Fever duration (≥7 days) and high IgE were independent risk factors for severe ADVP.
Collapse
Affiliation(s)
- Haiqin Zhong
- Department of Respiratory Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaoyan Dong
- Department of Respiratory Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| |
Collapse
|
24
|
Singh D, Rajbanshi A, Giri PP. A case of post adenoviral bronchiectasis being managed at home with humidified high flow nasal cannula (HHFNC). Respir Med Case Rep 2020; 31:101233. [PMID: 33083219 PMCID: PMC7552089 DOI: 10.1016/j.rmcr.2020.101233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 09/14/2020] [Accepted: 09/15/2020] [Indexed: 11/20/2022] Open
Abstract
Human adenovirus is an important cause of febrile illness affecting mainly respiratory system ranging from pharyngitis, coryza to fatal pneumonia. Though most of the infections are trivial and results in complete recovery but it may result in considerable morbidities and mortalities in selected patients who developed severe adenoviral infections especially Pneumonia(ADVP)/Lower respiratory tract infection(LRTI). Severe adenoviral pneumonia is notorious to produce long term sequelae in the form of post infectious bronchiolitis obliterans (PIBO) or even bronchiectasis. Here we present a case of a ten months old boy developed bronchiectasis as a sequela of severe adenoviral LRTI and needed prolonged and recurrent respiratory support in the pediatric intensive care unit(PICU) and ultimately discharged on home Humidified high flow nasal cannula(HHFNC).
Collapse
Affiliation(s)
- Divya Singh
- Junior Resident, Institute of Child Health, India
| | - Argha Rajbanshi
- Junior Resident, Institute of Child Health, India
- Corresponding author. Biresh Guha street, Park circus, Kolkata, West Bengal, 700017, India.,
| | - Prabhas Prasun Giri
- Associate Professor and Incharge of Pediatric Intensive Care Unit, Institute of Child Health, India
| |
Collapse
|
25
|
Aydin M, Naumova EA, Paulsen F, Zhang W, Gopon F, Theis C, Lutz S, Ehrke-Schulz E, Arnold WH, Wirth S, Ehrhardt A. House Dust Mite Exposure Causes Increased Susceptibility of Nasal Epithelial Cells to Adenovirus Infection. Viruses 2020; 12:v12101151. [PMID: 33050625 PMCID: PMC7600414 DOI: 10.3390/v12101151] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/04/2020] [Accepted: 10/07/2020] [Indexed: 02/06/2023] Open
Abstract
Adenovirus (AdV) infections in the respiratory tract may cause asthma exacerbation and allergic predisposition, and the house dust mite (HDM) may aggravate virus-induced asthma exacerbations. However, the underlying mechanisms of whether and how AdV affects asthmatic patients remains unclear. To address this question, we investigated nasal epithelial cells (NAEPCs) derived from a pediatric exacerbation study cohort for experimental analyses. We analyzed twenty-one different green-fluorescent protein- and luciferase-tagged AdV types in submerged 2D and organotypic 3D cell culture models. Transduction experiments revealed robust transduction of AdV type 5 (AdV5) in NAEPCs, which was associated with an increased uptake of AdV5 in the presence of HDM. In healthy and asthmatic NAEPCs exposed to HDM before infection, we observed a time- and dose-dependent increase of AdV5 uptake associated with upregulation of entry receptors for AdV5. Furthermore, electron microscopic and histologic analyses of 3D cell cultures revealed an impairment of the respiratory cilia after HDM exposition. This ex vivo pilot study shows the impact of AdV infection and HDM exposition in a primary cell culture model for asthma.
Collapse
Affiliation(s)
- Malik Aydin
- Children’s Hospital, Center for Clinical and Translational Research (CCTR), Helios University Medical Center Wuppertal, Witten/Herdecke University, 42283 Wuppertal, Germany; (M.A.); (S.W.)
- Laboratory of Clinical Molecular Genetics & Epigenetics, Center for Biomedical Education and Research, School of Life Sciences (ZBAF), Faculty of Health, Witten/Herdecke University, 42283 Wuppertal, Germany
| | - Ella A. Naumova
- Department of Biological and Material Sciences in Dentistry, Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany; (E.A.N.); (W.H.A.)
| | - Friedrich Paulsen
- Institute of Functional and Clinical Anatomy, Friedrich Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany;
- Department of Topographic Anatomy and Operative Surgery, Sechenov University, 119146 Moscow, Russia
| | - Wenli Zhang
- Institute of Virology and Microbiology, Center for Biomedical Education and Research (ZBAF), Department of Human Medicine, Faculty of Health, Witten/Herdecke University, 58453 Witten, Germany; (W.Z.); (E.E.-S.)
| | - Felix Gopon
- Clinics for Anesthesiology, Helios University Medical Center Wuppertal, Center for Clinical and Translational Research (CCTR), Witten/Herdecke University, 42283 Wuppertal, Germany; (F.G.); (C.T.)
| | - Christian Theis
- Clinics for Anesthesiology, Helios University Medical Center Wuppertal, Center for Clinical and Translational Research (CCTR), Witten/Herdecke University, 42283 Wuppertal, Germany; (F.G.); (C.T.)
| | - Sören Lutz
- Children’s Hospital, Helios Hospital Niederberg, Teaching Hospital of University Hospital Essen, 42549 Velbert, German;
| | - Eric Ehrke-Schulz
- Institute of Virology and Microbiology, Center for Biomedical Education and Research (ZBAF), Department of Human Medicine, Faculty of Health, Witten/Herdecke University, 58453 Witten, Germany; (W.Z.); (E.E.-S.)
| | - Wolfgang H. Arnold
- Department of Biological and Material Sciences in Dentistry, Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany; (E.A.N.); (W.H.A.)
| | - Stefan Wirth
- Children’s Hospital, Center for Clinical and Translational Research (CCTR), Helios University Medical Center Wuppertal, Witten/Herdecke University, 42283 Wuppertal, Germany; (M.A.); (S.W.)
| | - Anja Ehrhardt
- Institute of Virology and Microbiology, Center for Biomedical Education and Research (ZBAF), Department of Human Medicine, Faculty of Health, Witten/Herdecke University, 58453 Witten, Germany; (W.Z.); (E.E.-S.)
- Correspondence:
| |
Collapse
|
26
|
Li Z, Cai S, Sun Y, Li L, Ding S, Wang X. When STING Meets Viruses: Sensing, Trafficking and Response. Front Immunol 2020; 11:2064. [PMID: 33133062 PMCID: PMC7550420 DOI: 10.3389/fimmu.2020.02064] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 07/29/2020] [Indexed: 12/19/2022] Open
Abstract
To effectively defend against microbial pathogens, the host cells mount antiviral innate immune responses by producing interferons (IFNs), and hundreds of IFN-stimulated genes (ISGs). Upon recognition of cytoplasmic viral or bacterial DNAs and abnormal endogenous DNAs, the DNA sensor cGAS synthesizes 2',3'-cGAMP that induces STING (stimulator of interferon genes) undergoing conformational changes, cellular trafficking, and the activation of downstream factors. Therefore, STING plays a pivotal role in preventing microbial pathogen infection by sensing DNAs during pathogen invasion. This review is dedicated to the recent advances in the dynamic regulations of STING activation, intracellular trafficking, and post-translational modifications (PTMs) by the host and microbial proteins.
Collapse
Affiliation(s)
- Zhaohe Li
- Key Laboratory of Marine Drugs of Ministry of Education, School of Medicine and Pharmacy, Ocean University of China, Qingdao, China
| | - Siqi Cai
- Key Laboratory of Marine Drugs of Ministry of Education, School of Medicine and Pharmacy, Ocean University of China, Qingdao, China
| | - Yutong Sun
- Key Laboratory of Marine Drugs of Ministry of Education, School of Medicine and Pharmacy, Ocean University of China, Qingdao, China
| | - Li Li
- Key Laboratory of Marine Drugs of Ministry of Education, School of Medicine and Pharmacy, Ocean University of China, Qingdao, China.,Center for Innovation Marine Drug Screening and Evaluation, Pilot National Laboratory for Marine Science and Technology, Qingdao, China.,Marine Biomedical Research Institute of Qingdao, Qingdao, China
| | - Siyuan Ding
- Department of Molecular Microbiology, School of Medicine, Washington University in St. Louis, St. Louis, MO, United States
| | - Xin Wang
- Key Laboratory of Marine Drugs of Ministry of Education, School of Medicine and Pharmacy, Ocean University of China, Qingdao, China.,Center for Innovation Marine Drug Screening and Evaluation, Pilot National Laboratory for Marine Science and Technology, Qingdao, China.,Marine Biomedical Research Institute of Qingdao, Qingdao, China
| |
Collapse
|
27
|
Qi L, Wang Y, Wang H, Deng J. Adenovirus 7 Induces Interlukin-6 Expression in Human Airway Epithelial Cells via p38/NF-κB Signaling Pathway. Front Immunol 2020; 11:551413. [PMID: 33072092 PMCID: PMC7538593 DOI: 10.3389/fimmu.2020.551413] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 08/20/2020] [Indexed: 01/09/2023] Open
Abstract
Human Adenovirus (AdV) infection is very common and usually has a significant impact on children. AdV-induced inflammation is believed to be one of the main causes of severe symptoms. However, an inflammatory response profile in the airway in AdV-infected children is still lacking, and the mechanism underlying AdV-induced inflammation in the airway is also poorly understood. In the current study, we determined the expression of a panel of inflammation cytokines in the airway samples from AdV 7 infected children and further investigated the molecular mechanism underlying AdV 7-induced cytokine expression. Our results showed that eight out of 13 tested inflammatory cytokines were significantly increased in nasal washes of AdV 7-infected children comparing to healthy control, with IL-6 showing the highest enhancement. AdV 7 infection of bronchial epithelial cell line and primary airway epithelial cells confirmed that AdV 7 increased IL-6 mRNA and protein expression in an infection dose-dependent manner. Promoter analysis revealed that AdV 7 infection transactivated IL-6 promoter and a NF-κB binding site in IL-6 promoter was involved in the transactivation. Further analysis showed that upon AdV 7 infection, NF-κB p65 was phosphorylated and translocated into nucleus and bound onto IL-6 promoter. Signaling pathway analysis revealed that p38/NF-κB pathway was involved in AdV 7 infection induced IL-6 elevation. Taken together, our study shows that AdV 7 infection triggers the expression of a range of inflammatory cytokines including IL-6 in the airway of infected children, and AdV 7 enhances IL-6 expression by transactivating IL-6 promoter via p38/NF-κB signaling pathway. Findings of our current study have provided more information toward a better understanding of AdV-induced airway inflammation, which might also benefit the development of intervention strategies.
Collapse
Affiliation(s)
- Lifeng Qi
- Department of Neonatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.,Department of Infectious Disease, Shenzhen Children's Hospital, Shenzhen, China
| | - Yajuan Wang
- Department of Neonatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.,Department of Neonatology, Children's Hospital, Capital Institute of Pediatrics, Beijing, China
| | - Heping Wang
- Department of Respiratory Diseases, Shenzhen Children's Hospital, Shenzhen, China
| | - Jikui Deng
- Department of Infectious Disease, Shenzhen Children's Hospital, Shenzhen, China
| |
Collapse
|
28
|
Coleman KK, Wong CC, Jayakumar J, Nguyen TT, Wong AWL, Yadana S, Thoon KC, Chan KP, Low JG, Kalimuddin S, Dehghan S, Kang J, Shamsaddini A, Seto D, Su YCF, Gray GC. Adenoviral Infections in Singapore: Should New Antiviral Therapies and Vaccines Be Adopted? J Infect Dis 2020; 221:566-577. [PMID: 31563943 PMCID: PMC7107482 DOI: 10.1093/infdis/jiz489] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 09/25/2019] [Indexed: 01/09/2023] Open
Abstract
Background A number of serious human adenovirus (HAdV) outbreaks have been recently reported: HAdV-B7 (Israel, Singapore, and USA), HAdV-B7d (USA and China), HAdV-D8, -D54, and -C2 (Japan), HAdV-B14p1 (USA, Europe, and China), and HAdV-B55 (China, Singapore, and France). Methods To understand the epidemiology of HAdV infections in Singapore, we studied 533 HAdV-positive clinical samples collected from 396 pediatric and 137 adult patients in Singapore from 2012 to 2018. Genome sequencing and phylogenetic analyses were performed to identify HAdV genotypes, clonal clusters, and recombinant or novel HAdVs. Results The most prevalent genotypes identified were HAdV-B3 (35.6%), HAdV-B7 (15.4%), and HAdV-E4 (15.2%). We detected 4 new HAdV-C strains and detected incursions with HAdV-B7 (odds ratio [OR], 14.6; 95% confidence interval [CI], 4.1–52.0) and HAdV-E4 (OR, 13.6; 95% CI, 3.9–46.7) among pediatric patients over time. In addition, immunocompromised patients (adjusted OR [aOR], 11.4; 95% CI, 3.8–34.8) and patients infected with HAdV-C2 (aOR, 8.5; 95% CI, 1.5–48.0), HAdV-B7 (aOR, 3.7; 95% CI, 1.2–10.9), or HAdV-E4 (aOR, 3.2; 95% CI, 1.1–8.9) were at increased risk for severe disease. Conclusions Singapore would benefit from more frequent studies of clinical HAdV genotypes to identify patients at risk for severe disease and help guide the use of new antiviral therapies, such as brincidofovir, and potential administration of HAdV 4 and 7 vaccine.
Collapse
Affiliation(s)
- Kristen K Coleman
- Emerging Infectious Diseases Programme, Duke-NUS Medical School, Singapore
| | - Chui Ching Wong
- Department of Microbiology, Singapore General Hospital, Singapore
| | - Jayanthi Jayakumar
- Emerging Infectious Diseases Programme, Duke-NUS Medical School, Singapore
| | - Tham T Nguyen
- Emerging Infectious Diseases Programme, Duke-NUS Medical School, Singapore
| | - Abigail W L Wong
- Department of Infectious Diseases, Singapore General Hospital, Singapore
| | - Su Yadana
- Emerging Infectious Diseases Programme, Duke-NUS Medical School, Singapore
| | - Koh C Thoon
- Department of Paediatrics, Infectious Disease Service, KK Women's and Children's Hospital, Singapore
| | - Kwai Peng Chan
- Department of Microbiology, Singapore General Hospital, Singapore.,Academic Clinical Programme for Pathology, Duke-NUS Medical School, Singapore
| | - Jenny G Low
- Emerging Infectious Diseases Programme, Duke-NUS Medical School, Singapore.,Department of Infectious Diseases, Singapore General Hospital, Singapore
| | - Shirin Kalimuddin
- Department of Infectious Diseases, Singapore General Hospital, Singapore
| | - Shoaleh Dehghan
- Bioinformatics and Computational Biology Program, School of Systems Biology, George Mason University, Manassas, Virginia, USA.,Chemistry Department, American University, Washington, District of Columbia, USA
| | - June Kang
- Bioinformatics and Computational Biology Program, School of Systems Biology, George Mason University, Manassas, Virginia, USA
| | - Amirhossein Shamsaddini
- Bioinformatics and Computational Biology Program, School of Systems Biology, George Mason University, Manassas, Virginia, USA
| | - Donald Seto
- Bioinformatics and Computational Biology Program, School of Systems Biology, George Mason University, Manassas, Virginia, USA
| | - Yvonne C F Su
- Emerging Infectious Diseases Programme, Duke-NUS Medical School, Singapore
| | - Gregory C Gray
- Emerging Infectious Diseases Programme, Duke-NUS Medical School, Singapore.,Division of Infectious Diseases, Global Health Institute, and Nicholas School of the Environment, Duke University, Durham, North Carolina, USA.,Global Health Center, Duke Kunshan University, Kunshan, China
| |
Collapse
|
29
|
Chen Q, Liu J, Liang W, Chen Y, Dou M, Liu Z, Chen Y, Zheng Z, Zhu B, Lin Y. Clinical Features, Replication Competence, and Innate Immune Responses of Human Adenovirus Type 7 Infection. J Infect Dis 2020; 223:1390-1399. [PMID: 32840612 DOI: 10.1093/infdis/jiaa524] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 08/14/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Epidemiologic reports suggest that the most severe or fatal adenoviral disease in children might be associated with human adenovirus (HAdV) type 7. However, the pathogenesis of HAdV-7-induced severe disease remains poorly understood. METHODS HAdV-3 and HAdV-7 replication kinetics and the host response to infection were compared using ex vivo human lung tissue cultures. Furthermore, cytokine and chemokine levels and the presence of adenovirus DNA in the serum of hospitalized children infected with HAdV-7 (n = 65) or HAdV-3 (n = 48) were measured (using a multiplex immunoassay and Taqman real-time polymerase chain reaction, respectively). RESULTS Among 471 HAdV-positive specimens, HAdV-3 or HAdV-7 was the most prevalent genotype during 2014-2016 or 2018, respectively. The incidence of severe pneumonia was higher in HAdV-7-infected than in HAdV-3-infected individuals (30.1% vs 4.5%, respectively). HAdV-7 replicated more efficiently than HAdV-3 ex vivo. Interferon-induced protein 10, interleukin 6, and monocyte chemoattractant protein 1 levels were significantly higher in HAdV-7-infected than in HAdV-3-infected children. Adenovirus DNA was detected in serum samples from 40% and 4.2% of HAdV-7- and HAdV-3-infected children, respectively. Furthermore, viremia was strongly associated with severe clinical presentations. CONCLUSIONS The pathogenesis of HAdV-7-induced severe disease was probably associated with high replication competence and hyperinflammatory responses. The detection of adenovirus DNA in blood may be useful in assessing risk for severe disease.
Collapse
Affiliation(s)
- Qigao Chen
- Department of Laboratory Medicine, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jun Liu
- Department of Thoracic Oncology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Weiwen Liang
- Department of Laboratory Medicine, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yi Chen
- Central Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Min Dou
- Department of Laboratory Medicine, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhongmin Liu
- Department of Laboratory Medicine, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yuan Chen
- Department of Laboratory Medicine, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhongli Zheng
- Department of Laboratory Medicine, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Bing Zhu
- Central Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Yongping Lin
- Department of Laboratory Medicine, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,KingMed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, China
| |
Collapse
|
30
|
Zou L, Yi L, Yu J, Song Y, Liang L, Guo Q, Zhuang X, Zhang Y, Kang M, Wu J. Adenovirus infection in children hospitalized with pneumonia in Guangzhou, China. Influenza Other Respir Viruses 2020; 15:27-33. [PMID: 32761743 PMCID: PMC7767961 DOI: 10.1111/irv.12782] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 06/10/2020] [Accepted: 06/18/2020] [Indexed: 01/21/2023] Open
Abstract
Background HAdV infection can cause a variety of diseases. Although infections with HAdVs often are mild, life‐threatening respiratory disease can occur. Pneumonia is one of the more serious types of HAdV‐induced respiratory disease in children. In this study, we determined the prevalence and genotype of HAdVs among children hospitalized with pneumonia in Guangzhou, China. Methods Nasopharyngeal swabs (NPSs) were collected from children hospitalized with pneumonia in Guangzhou, China, from January 2013 to June 2019. HAdVs were detected by real‐time polymerase chain reaction assay, and hexon, fiber, and penton gene were amplified and used for phylogenetic analysis. Epidemiological data were analyzed using SPSS16.0 software. Results and Conclusions A total of 1778 children hospitalized with pneumonia were enrolled. The overall HAdV detection rate was 3.26%. And the yearly detection rate varied from around 2.5% in 2013‐2017 to around 6% in 2018‐2019. Children >5 years had the highest HAdV infection rate. 92.86% of HAdV sequences obtained in this study were belonged to species B, and no recombination was observed. HAdV‐B7 and HAdV‐B3 were the common types detected in the study period, with the predominant HAdV genotype shifted from HAdV‐B3 in 2015‐2016 to HAdV‐B7 in 2017‐2018. The discrepancies in HAdV detection rates in different study period and changes of HAdV predominant types over time highlighted the importance of continued surveillance.
Collapse
Affiliation(s)
- Lirong Zou
- Guangdong Provincial Center for Diseases Control and prevention, Guangzhou, China
| | - Lina Yi
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Centre for Disease Control and Prevention, Guangzhou, China
| | - Jianxiang Yu
- Guangdong Provincial Center for Diseases Control and prevention, Guangzhou, China
| | - Yinchao Song
- Guangdong Provincial Center for Diseases Control and prevention, Guangzhou, China
| | - Lijun Liang
- Guangdong Provincial Center for Diseases Control and prevention, Guangzhou, China
| | - Qianfang Guo
- Guangdong Provincial Center for Diseases Control and prevention, Guangzhou, China
| | - Xue Zhuang
- Guangdong Provincial Center for Diseases Control and prevention, Guangzhou, China
| | | | - Min Kang
- Guangdong Provincial Center for Diseases Control and prevention, Guangzhou, China
| | - Jie Wu
- Guangdong Provincial Center for Diseases Control and prevention, Guangzhou, China.,Southern Medical University, Guangzhou, China
| |
Collapse
|
31
|
[Clinical features of children with severe adenovirus pneumonia and hemophagocytic syndrome: an analysis of 30 cases]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2020. [PMID: 32669172 PMCID: PMC7389625 DOI: 10.7499/j.issn.1008-8830.2003080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To study the clinical features of children with severe adenovirus pneumonia (SAP) and hemophagocytic syndrome (HPS). METHODS A retrospective analysis was performed from the chart review data of 30 children with SAP and HPS who were admitted from January 2014 to June 2019. According to the prognosis, the children were divided into a good prognosis group (n=18) and a poor prognosis group (n=12). RESULTS Among the 30 children with SAP and HPS, the ratio of male to female was 2:1. The median age of onset was 1 year and 3 months (range 3 months to 5 years), and the mean course of fever was 19±7 d. Of the 30 children, 28 (93%) experienced disease onset in January to June. High-throughput gene detection of serum pathogens showed that 16 (53%) children were positive for human adenovirus type 7 (HAdV-7), and the other 14 (47%) children were positive for HAdV antigen based on immunofluorescence assay for throat swab, with unknown type. Of all 30 children, 29 (97%) had respiratory complications, 24 (80%) had cardiovascular complications, 16 (53%) had gastrointestinal complications, and 9 (30%) had toxic encephalopathy. Eighteen children (60%) improved or recovered and 12 (40%) did not recover (3 died). Compared with the good prognosis group, the poor prognosis group had a significantly longer course from onset to diagnosis of HPS (P<0.05), significantly higher levels of fibrinogen and tumor necrosis factor-α (P<0.05), and a significantly lower level of interferon-γ (P<0.05). The mean follow-up time was 6±2 months; 11 (41%) children recovered, 1 (4%) experienced recurrence of HPS, and 15 (56%) had the sequela of post-infectious bronchiolitis obliterans (PIBO). CONCLUSIONS HPS may be observed in children with SAP, and PIBO is the most common sequela of SAP.
Collapse
|
32
|
Zhang HY, Li CJ, Long Y, Sun DM, Wang RG, Zhang Y. [Clinical features of children with severe adenovirus pneumonia and hemophagocytic syndrome: an analysis of 30 cases]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2020; 22:744-748. [PMID: 32669172 PMCID: PMC7389625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 05/13/2020] [Indexed: 11/12/2023]
Abstract
OBJECTIVE To study the clinical features of children with severe adenovirus pneumonia (SAP) and hemophagocytic syndrome (HPS). METHODS A retrospective analysis was performed from the chart review data of 30 children with SAP and HPS who were admitted from January 2014 to June 2019. According to the prognosis, the children were divided into a good prognosis group (n=18) and a poor prognosis group (n=12). RESULTS Among the 30 children with SAP and HPS, the ratio of male to female was 2:1. The median age of onset was 1 year and 3 months (range 3 months to 5 years), and the mean course of fever was 19±7 d. Of the 30 children, 28 (93%) experienced disease onset in January to June. High-throughput gene detection of serum pathogens showed that 16 (53%) children were positive for human adenovirus type 7 (HAdV-7), and the other 14 (47%) children were positive for HAdV antigen based on immunofluorescence assay for throat swab, with unknown type. Of all 30 children, 29 (97%) had respiratory complications, 24 (80%) had cardiovascular complications, 16 (53%) had gastrointestinal complications, and 9 (30%) had toxic encephalopathy. Eighteen children (60%) improved or recovered and 12 (40%) did not recover (3 died). Compared with the good prognosis group, the poor prognosis group had a significantly longer course from onset to diagnosis of HPS (P<0.05), significantly higher levels of fibrinogen and tumor necrosis factor-α (P<0.05), and a significantly lower level of interferon-γ (P<0.05). The mean follow-up time was 6±2 months; 11 (41%) children recovered, 1 (4%) experienced recurrence of HPS, and 15 (56%) had the sequela of post-infectious bronchiolitis obliterans (PIBO). CONCLUSIONS HPS may be observed in children with SAP, and PIBO is the most common sequela of SAP.
Collapse
Affiliation(s)
- Hua-Yong Zhang
- Department of Cardiology, Wuhan Children's Hospital/Wuhan Maternal and Child Healthcare Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430016, China.
| | | | | | | | | | | |
Collapse
|
33
|
Le YH, Nguyen KC, Coleman KK, Nguyen TT, Than ST, Phan HH, Nguyen MD, Ngu ND, Phan DT, Hoang PVM, Trieu LP, Bailey ES, Warkentien TE, Gray GC. Virus detections among patients with severe acute respiratory illness, Northern Vietnam. PLoS One 2020; 15:e0233117. [PMID: 32396550 PMCID: PMC7217455 DOI: 10.1371/journal.pone.0233117] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 04/28/2020] [Indexed: 01/02/2023] Open
Abstract
Severe acute respiratory illness (SARI) is a major cause of death and morbidity in low- and middle-income countries, however, the etiologic agents are often undetermined due to the lack of molecular diagnostics in hospitals and clinics. To examine evidence for select viral infections among patients with SARI in northern Vietnam, we studied 348 nasopharyngeal samples from military and civilian patients admitted to 4 hospitals in the greater Hanoi area from 2017–2019. Initial screening for human respiratory viral pathogens was performed in Hanoi, Vietnam at the National Institute of Hygiene and Epidemiology (NIHE) or the Military Institute of Preventative Medicine (MIPM), and an aliquot was shipped to Duke-NUS Medical School in Singapore for validation. Patient demographics were recorded and used to epidemiologically describe the infections. Among military and civilian cases of SARI, 184 (52.9%) tested positive for one or more respiratory viruses. Influenza A virus was the most prevalent virus detected (64.7%), followed by influenza B virus (29.3%), enterovirus (3.8%), adenovirus (1.1%), and coronavirus (1.1%). Risk factor analyses demonstrated an increased risk of influenza A virus detection among military hospital patients (adjusted OR, 2.0; 95% CI, 1.2–3.2), and an increased risk of influenza B virus detection among patients enrolled in year 2017 (adjusted OR, 7.9; 95% CI, 2.7–22.9). As influenza A and B viruses were commonly associated with SARI and are treatable, SARI patients entering these hospitals would benefit if the hospitals were able to adapt onsite molecular diagnostics.
Collapse
Affiliation(s)
- Yen H. Le
- Military Institute of Preventive Medicine, Hanoi, Vietnam
| | - Khanh C. Nguyen
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Kristen K. Coleman
- Emerging Infectious Diseases Programme, Duke-National University of Singapore, Singapore
| | - Tham T. Nguyen
- Emerging Infectious Diseases Programme, Duke-National University of Singapore, Singapore
| | - Son T. Than
- Emerging Infectious Diseases Programme, Duke-National University of Singapore, Singapore
| | - Hai H. Phan
- Hai Phong Provincial Preventive Medicine Center, Hai Phong, Vietnam
| | - Manh D. Nguyen
- Military Institute of Preventive Medicine, Hanoi, Vietnam
| | - Nghia D. Ngu
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Dan T. Phan
- Military Institute of Preventive Medicine, Hanoi, Vietnam
| | | | - Long P. Trieu
- Military Institute of Preventive Medicine, Hanoi, Vietnam
| | - Emily S. Bailey
- Division of Infectious Diseases, Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | | | - Gregory C. Gray
- Emerging Infectious Diseases Programme, Duke-National University of Singapore, Singapore
- Division of Infectious Diseases, Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Global Health Center, Duke Kunshan University, Kunshan, China
- * E-mail:
| |
Collapse
|
34
|
Correction: Epidemiology, clinical presentation and respiratory sequelae of adenovirus pneumonia in children in Kuala Lumpur, Malaysia. PLoS One 2018; 13:e0209720. [PMID: 30566518 PMCID: PMC6300253 DOI: 10.1371/journal.pone.0209720] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|