P-2170. Detection of Human Adenovirus with and without Co-detection of Other Respiratory Viruses Among Children with Acute Respiratory Illnesses

TL;DR

This study examines how often human adenovirus is detected alone or with other viruses in children with respiratory illnesses, and how demographics differ between these cases.

Contribution

The study provides new insights into the co-detection patterns of human adenovirus with other respiratory viruses in children.

Findings

Most children with HAdV ARI had co-detection with another respiratory virus.

Children with HAdV alone had different demographics compared to those with co-detections.

The proportion of co-detections varied yearly for some viruses but not others.

Abstract

Human adenovirus (HAdV) is a common cause of acute respiratory illness (ARI) in children and is frequently detected with other viruses (co-detection). The effect of co-detection on HAdV ARIs is incompletely understood, and recently the COVID-19 pandemic has disrupted the seasonality of many respiratory viruses. We aimed to characterize the demographics of children with HAdV ARI and co-detection patterns from 2016 through 2023.Table 1.Demographic characteristics of children with HAdV, stratified by detection status: single HAdV detection vs. HAdV co-detected with one or more respiratory virus(es), December 2016 to August 2023, New Vaccine Surveillance Network.1: The 2017 year includes cases from 12/01/2016 to 12/31/2017. The 2023 year includes cases from 01/01/2023 to 08/31/2023. We performed comparisons using Pearson’s χ2 test for categorical variables and the independent-samples t-test with unequal variances for continuous variables.Table 2.Single HAdV detection and HAdV co-detected with one or more respiratory virus(es), stratified by year, December 2016 to August 2023, New Vaccine Surveillance Network.Abbreviations: HAdV, human adenovirus; ccCoV, common cold coronaviruses; Flu, influenza; HMPV, human metapneumovirus; PIV, parainfluenza virus; HRV/RV, human rhinovirus/enterovirus; RSV, respiratory syncytial virus; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2. 1Cells labeled NA indicate p-value could not be calculated due to zero cell counts. We performed comparisons using Pearson’s χ2 test for categorical variables and the independent-samples t-test with unequal variances for continuous variables.

Demographic characteristics of children with HAdV, stratified by detection status: single HAdV detection vs. HAdV co-detected with one or more respiratory virus(es), December 2016 to August 2023, New Vaccine Surveillance Network.

1: The 2017 year includes cases from 12/01/2016 to 12/31/2017. The 2023 year includes cases from 01/01/2023 to 08/31/2023. We performed comparisons using Pearson’s χ2 test for categorical variables and the independent-samples t-test with unequal variances for continuous variables.

Single HAdV detection and HAdV co-detected with one or more respiratory virus(es), stratified by year, December 2016 to August 2023, New Vaccine Surveillance Network.

Abbreviations: HAdV, human adenovirus; ccCoV, common cold coronaviruses; Flu, influenza; HMPV, human metapneumovirus; PIV, parainfluenza virus; HRV/RV, human rhinovirus/enterovirus; RSV, respiratory syncytial virus; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2. 1Cells labeled NA indicate p-value could not be calculated due to zero cell counts. We performed comparisons using Pearson’s χ2 test for categorical variables and the independent-samples t-test with unequal variances for continuous variables.

The New Vaccine Surveillance Network is an active, prospective, population-based ARI surveillance system at 7 US sites. Children < 18 years old with fever and/or ARI symptoms for < 14 days were enrolled if they were seen in the emergency department or admitted to the hospital. Nasal and/or oropharyngeal swabs were tested for respiratory viruses, and demographic information was collected. Demographics were compared between HAdV single detection and co-detections with other respiratory viruses, and the proportions of HAdV co-detections were compared between years.Figure 1.Seasonality of HAdV single detections and HAdV with other frequently co-detected viruses by percent of tested specimens, December 2016 to August 2023, New Vaccine Surveillance Network.Red line indicates when non pharmacologic interventions against SARS-CoV2 started in the US, March 2020

Seasonality of HAdV single detections and HAdV with other frequently co-detected viruses by percent of tested specimens, December 2016 to August 2023, New Vaccine Surveillance Network.

Red line indicates when non pharmacologic interventions against SARS-CoV2 started in the US, March 2020

From Dec 2016 through Aug 2023, 4,292 of 66,662 (6.4%) children with ARI were positive for HAdV. 1,811 (42.2%) were single detections and 2,481 (57.8%) co-detections. Children with HAdV alone were older, had different racial/ethnic demographics, and were less likely to be privately insured, live with other children, or have an underlying respiratory condition (Table 1). The annual proportion of HAdV co-detections ranged from 43.5% to 66.8% (Table 2). The proportion of co-detections with specific viruses differed year to year for influenza, rhino/enterovirus, and respiratory syncytial virus, but not for common cold coronaviruses, human metapneumovirus, or parainfluenza virus. The variation and seasonality of HAdV-positivity and select co-detected virus fraction is shown in Figure 1.

Most children with HAdV ARI had co-detection with another respiratory virus, with yearly variation in the proportion of co-detections and specific co-detected viruses. The demographics of children with HAdV single infection differed compared to those with co-detections, potentially representing varied exposure histories among different populations of children. These patterns could be relevant to HAdV ARI severity and inform management of HAdV infections.

Rangaraj Selvarangan, PhD, Altona: Grant/Research Support|Biomerieux: Advisor/Consultant|Biomerieux: Grant/Research Support|Biomerieux: Honoraria|Cepheid: Grant/Research Support|Hologic: Grant/Research Support|Hologic: Honoraria|Meridian: Grant/Research Support|Qiagen: Grant/Research Support Marian G. Michaels, MD, MPH, Merck: Grant/Research Support Mary A. Staat, MD, MPH, Centers for Disease Control and Prevention: Grant/Research Support|Cepheid: Grant/Research Support|Merck: Advisor/Consultant|Merck: Grant/Research Support|National Institutes of Health: Grant/Research Support|Up-To-Date: Royalties Elizabeth P. Schlaudecker, MD, MPH, Gilead: Grant/Research Support|Pfizer: Grant/Research Support|Sanofi Pasteur: Advisor/Consultant Geoffrey A. Weinberg, MD, Inhalon Biopharma: Advisor/Consultant|Merck & Co: Honoraria Janet A. Englund, MD, AstraZeneca: Board Member|AstraZeneca: Grant/Research Support|Cidarra: Member Data Safety Monitoring Board|GlaxoSmithKline: Advisor/Consultant|GlaxoSmithKline: Grant/Research Support|Meissa Vaccines: Advisor/Consultant|Merck: Advisor/Consultant|Merck: Grant/Research Support|Moderna: Advisor/Consultant|Moderna: Grant/Research Support|Pfizer: Advisor/Consultant|Pfizer: Grant/Research Support|Shionogi: Grant/Research Support James Chappell, MD, PhD, Merck: Grant support for etiologic studies of acute respiratory illness in hospitalized children, Amman, Jordan Natasha B. Halasa, MD, CSL-Seqirus: Advisor/Consultant|Merck: Grant/Research Support

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