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ORIGINAL RESEARCH article

Front. Cell. Infect. Microbiol.
Sec. Clinical Infectious Diseases
Volume 14 - 2024 | doi: 10.3389/fcimb.2024.1482787
This article is part of the Research Topic Cellular and host immune responses in the context of dual viral infection View all 4 articles

Impact of Co-infections and Immune Responses on Clinical Severity of Human Adenovirus 3 and 7 Infections in Hospitalized Children with Lower Respiratory Tract Infections: A Comparative Study

Provisionally accepted
Xiaolin Ma Xiaolin Ma 1Ya-nan Wang Ya-nan Wang 1Ri De Ri De 2*Hailan Yao Hailan Yao 2*Feng He Feng He 2Yi Wang Yi Wang 2Wei Wang Wei Wang 2*Chao Yan Chao Yan 2Qinwei Song Qinwei Song 1Chunjie Guo Chunjie Guo 1*Wen Li Wen Li 1Cao Ling Cao Ling 1*Ling Cao Ling Cao 2*Chun-Mei Zhu Chun-Mei Zhu 1*
  • 1 Children's Hospital of Capital Institute of Pediatrics, Beijing, China
  • 2 Capital Institute of Pediatrics, Beijing, Beijing Municipality, China

The final, formatted version of the article will be published soon.

    Background: The pathogenic distribution of co-infections and immunological status of patients infected with human adenovirus serotypes 3 or 7 (HAdV-3 or HAdV-7) were poorly understood. Methods: This study involved a retrospective analysis of respiratory specimens collected from enrolled children with lower respiratory tract infections (LRTIs), positive for HAdV-3 or HAdV-7 from January 2017 to December 2019. Demographic data, clinical features, laboratory and radiographic findings were compared to delineate the impact of co-infections, and immune responses on clinical severity of HAdV-3 or HAdV-7 infections. Results: Among 1311cases enrolled, there were 66 infected with HAdV-3 and 58 with HAdV-7. HAdV-7-infected patients exhibited more prolonged fever (100% vs 89.4%, p=0.014), pneumonia (100% vs 89.4%, p=0.014), hypoxia (34.5% vs 12.1%, p=0.003), higher propensity for aspartate aminotransferase exceeding 80U/L (21.1% vs 4.7%, p=0.006), D-Dimer exceeding 1.65mg/L (64.9% vs 12.5%, p<0.001), consolidation (50.0% vs 27.4%, p=0.011), and pleural effusion (32.8% vs 6.5%, p<0.001), co-infections with Mycoplasma pneumoniae (77.1% vs 32.6%, p<0.001), and multiple infections (56.8% vs 41.3%, p=0.007), compared to those with HAdV-3 infections. Immune cell analysis indicated that HAdV-7 infections led to a more pronounced decrease in CD3+ T cells (1596.8 vs 2444.8 cells/𝛍l, p=0.042), CD8+ cytotoxic T cells (668.6 vs 774.0 cells/𝛍l, p=0.045), and increased NK cell percentages (11.5% vs 9.0%, p=0.044) compared to HAdV-3 infections. Conclusions: Hospitalized children with HAdV-7-associated LRTIs exhibit greater severity, multiple infections, and significant potential for greater cellular immune dysregulation compared to those with HAdV-3 infection, indicating a more severe clinical course and distinct pathogenic profiles.

    Keywords: Human adenovirus serotypes 3, Human adenovirus serotypes 7, Lower respiratory tract infections, Co-infections, Immune responses, Children

    Received: 18 Aug 2024; Accepted: 06 Dec 2024.

    Copyright: © 2024 Ma, Wang, De, Yao, He, Wang, Wang, Yan, Song, Guo, Li, Ling, Cao and Zhu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Ri De, Capital Institute of Pediatrics, Beijing, Beijing Municipality, China
    Hailan Yao, Capital Institute of Pediatrics, Beijing, Beijing Municipality, China
    Wei Wang, Capital Institute of Pediatrics, Beijing, Beijing Municipality, China
    Chunjie Guo, Children's Hospital of Capital Institute of Pediatrics, Beijing, China
    Cao Ling, Children's Hospital of Capital Institute of Pediatrics, Beijing, China
    Ling Cao, Capital Institute of Pediatrics, Beijing, Beijing Municipality, China
    Chun-Mei Zhu, Children's Hospital of Capital Institute of Pediatrics, Beijing, China

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