Characterization of Adenovirus Types in US Pediatric ARI Patients, 2016–2019
Overview
This multicenter study characterized human adenovirus (HAdV) types in children hospitalized with acute respiratory illness (ARI) across seven US pediatric hospitals from 2016 to 2019. The most common types identified were HAdV-C1, HAdV-C2, and HAdV-B3, with HAdV-B7 associated with significantly higher odds of severe outcomes.
Background
Human adenovirus (HAdV) is a significant cause of pediatric ARI worldwide, accounting for 5–13% of cases. HAdV is classified into seven species (A-G) with over 100 genotypes, exhibiting diverse clinical presentations ranging from respiratory illness to conjunctivitis and diarrhea. Species B (notably types 3 and 7), C, and E are the primary causes of respiratory infections in children, with HAdV-B7 linked to more severe disease. Understanding type-specific clinical features and severity is essential for targeted prevention and treatment strategies.
Data Highlights
HAdV Type
Number of Cases
HAdV-C1
439
HAdV-C2
393
HAdV-B3
221
HAdV-B7
78
Key Findings
Among 1843 HAdV-positive pediatric ARI cases, 76% (1402) were successfully typed.
HAdV-C1, HAdV-C2, and HAdV-B3 were the most frequently detected types.
Children infected with HAdV-B7 had over twice the odds of severe clinical outcomes compared to other types (adjusted odds ratio 2.05; 95% CI: 1.24–3.40).
Symptom profiles varied by HAdV species; species B cases exhibited more non-respiratory manifestations despite all species showing high rates of upper respiratory symptoms.
HAdV-B7 infections were associated with prolonged fever and longer hospital stays, indicating greater disease severity.
Clinical Implications
Clinicians should consider HAdV type, particularly HAdV-B7, when assessing pediatric ARI severity and prognosis. Recognition of type-specific symptom patterns may guide more tailored management and inform infection control measures. These findings support the need for HAdV typing in clinical and surveillance settings to optimize prevention and treatment strategies.
Conclusion
This study highlights significant heterogeneity in clinical presentation and severity among HAdV types in pediatric ARI, with HAdV-B7 notably linked to more severe disease. Incorporating adenovirus typing into clinical practice could enhance patient care and inform targeted interventions.
References
Probst et al 2023 -- Characterization of Adenovirus Types in Hospitalized US Pediatric Patients with Acute Respiratory Illness from 2016 to 2019
by Tess Stopczynski, Varvara Probst, Adam Gailani, Justin Z Amarin, Olla Hamdan, Haya Hayek, Laura S Stewart, Herdi K Rahman, Rangaraj Selvarangan, Jennifer E Schuster, Christopher J Harrison, Mary E Moffatt, Marian G Michaels, John V Williams, Julie A Boom, Leila C Sahni, Vasanthi Avadhanula, Mary Allen Staat, Elizabeth P Schlaudecker, Christina Quigley, Geoffrey A Weinberg, Peter G Szilagyi, Janet A Englund, Eileen J Klein, Aaron T Curns, Heidi L Moline, Ariana P Toepfer, James D Chappell, Andrew J Spieker, Natasha B Halasa
