Clinical Scorecard: Characterization of Adenovirus Types in Hospitalized US Pediatric Patients with Acute Respiratory Illness from 2016 to 2019
At a Glance
Category
Detail
Condition
Human adenovirus (HAdV) infection causing acute respiratory illness (ARI) in pediatric patients
Key Mechanisms
HAdV is a non-enveloped, double-stranded DNA virus classified into 7 species (A-G) with over 100 genotypes; species B, C, and E commonly cause respiratory illness with type-specific clinical heterogeneity
Target Population
Children under 18 years old presenting with acute respiratory illness in US pediatric hospitals
Care Setting
Emergency departments and inpatient pediatric hospital settings across multiple US centers
Key Highlights
HAdV contributes to 5–13% of pediatric acute respiratory illnesses worldwide.
HAdV-B7 type is associated with higher odds of severe outcomes including prolonged fever and longer hospital stays.
Clinical presentation varies by HAdV species and type, with species B showing more non-respiratory symptoms compared to species C and E.
Guideline-Based Recommendations
Diagnosis
Use respiratory specimen testing with single-plex real-time PCR assays targeting hexon gene sequences for HAdV typing.
Consider HAdV typing to differentiate species and types due to clinical heterogeneity.
Management
Recognize that HAdV-associated ARI is generally self-limiting in healthy children but monitor younger children and those with underlying conditions closely for severe illness.
Provide supportive care including hospitalization and oxygen support as indicated by severity.
Monitoring & Follow-up
Monitor for severe outcomes such as need for oxygen support, intubation, and ICU admission especially in HAdV-B7 infections.
Track symptom progression and length of hospital stay to assess disease severity.
Risks
Increased risk of severe disease in younger children and those with underlying medical conditions including immunocompromise.
HAdV-B7 infection carries higher risk for severe respiratory illness compared to other types.
Patient & Prescribing Data
Pediatric patients under 18 years hospitalized or seen in emergency departments with acute respiratory illness and confirmed HAdV infection
No specific antiviral treatment detailed; management is primarily supportive with attention to severity markers, especially in HAdV-B7 cases.
Clinical Best Practices
Implement molecular typing of HAdV in pediatric ARI cases to inform prognosis and potential targeted interventions.
Prioritize monitoring and supportive care for children infected with HAdV-B7 due to higher severity risk.
Consider underlying medical conditions and age as important factors in risk stratification for severe HAdV disease.
Use multicenter surveillance data to guide clinical awareness of HAdV type-specific disease patterns.
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
