Comparative study of clinical characteristics between adult patients with adenovirus type 7 and type 55 infections in China during 2012-2018

中华传染病杂志 Pub Date : 2019-04-15 DOI:10.3760/CMA.J.ISSN.1000-6680.2019.04.001

Xia Mei, Weiwei Chen, Wen-gang Li, Wen Xu, Zhe Xu, B. Tu, E. Qin, Lei Shi, Peng Zhao, Min Zhao

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Abstract

Objective To compare and explore the differences of clinical characteristics between human adenovirus type 7 (HAdV7) and type 55 (HAdV55) infections in adults, and to provide evidences for clinical management. Methods The data of clinical manifestations, laboratory examinations, chest computed tomography and prognosis of 214 cases with HAdV7 and 235 cases with HAdV55 infections from 2012 to 2018 were retrospectively collected and analyzed. The chi-square test was used for the categorical variables, and the rank sum test was used for the continuous variables of non-normal distribution. Results Compared with patients in HAdV55, those in HAdV7 group displayed more diarrhea (12.1%[26/214] vs 2.6%[6/235], χ2=15.583), more laryngeal lymphatic follicles (33.2%[71/214] vs 17.9%[42/235], χ2=23.566), more tonsil enlargement (56.5%[121/214] vs 20.0%[47/235], χ2=63.870) with secretions (33.2%[71/214] vs 11.5%[27/235], χ2=30.878), more leukocytosis (24.8%[53/214] vs 14.0%[33/235], χ2=8.318), more monocytosis (78.0%[167/214] vs 52.8%[124/235], χ2=31.364), more thrombocytosis (7.1%[15/212] vs 3.8%[9/235], χ2=5.835), more elevated level of C-reactive protein (80.8%[97/120] vs 64.3%[137/213], χ2=10.020), more abnormalities of liver function (alamne aminotransferase [ALT]: 13.5%[28/207] vs 5.6%[13/232], χ2=8.111) and myocardial enzymes (creatine kinase [CK]: 37.6%[77/205] vs 26.4% [61/231], χ2=6.246), creatine kinase isoenzymes ([CK-MB]: 35.6% [73/205] vs 11.1% [24/216], χ2=35.600), and all the differences were statistically significant (all P<0.05, 0.01). Compared with patients in HAdV7 group, those in HAdV55 group displayed longer duration of diseases (7[5] days vs 6[5] days, Z=-2.632), more sore throat (72.8% [171/235] vs 62.1% [133/214], χ2=0.016), more headache (62.1% [146/235] vs 16.4% [35/214], χ2=97.527), more pharyngeal congestion (93.6% [220/235] vs 74.8%[160/214], χ2=30.602), more leukopenia (14.0% [33/235] vs 24.8% [53/214], χ2=8.318), and more elevated level of lactate dehydrogenase (12.6% [29/230] vs 6.3% [13/205], χ2=4.881), more pneumonia (71.5% [168/235] vs 31.8% [68/214], χ2=70.846) (all P<0.05, 0.01). Conclusions The clinical characteristics of HAdV7 and HAdV55 infections in adults are different. The type 55 infection is more likely to develop to pneumonia, while the type 7 infection has wider tissue tropism. Key words: Adenovirus infections, human; Pneumonia, viral; Clinical characteristics; Case analysis

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2012-2018年中国成人7型和55型腺病毒感染临床特征比较研究

目的比较和探讨成人7型腺病毒(HAdV7)与55型腺病毒(HAdV55)感染的临床特征差异，为临床治疗提供依据。方法回顾性收集2012 ~ 2018年214例HAdV7感染和235例HAdV55感染的临床表现、实验室检查、胸部ct及预后资料进行分析。分类变量采用卡方检验，非正态分布的连续变量采用秩和检验。结果与HAdV55的患者相比,那些在HAdV7集团呈现出更多的腹泻(12.1%(26/214)和2.6%(6/235),χ2 = 15.583),更多的喉淋巴滤泡(33.2%(71/214)和17.9%(42/235),χ2 = 23.566),更多的扁桃体肿大(56.5%(121/214)和20.0%(47/235),χ2 = 63.870)和分泌物(33.2%(71/214)和11.5%(27/235),χ2 = 30.878),更多的白细胞增多(24.8%(53/214)和14.0%(33/235),χ2 = 8.318),更多的单核细胞增多症(78.0%(167/214)和52.8%(124/235),χ2 = 31.364),血小板增多(7.1%[15/212]对3.8%[9/235]，χ2=5.835)， c反应蛋白水平升高(80.8%[97/120]对64.3%[137/213]，χ2=10.020)，肝功能异常(谷氨转氨酶[ALT]: 13.5%[28/207]对5.6%[13/232]，χ2=8.111)，心肌酶(肌酸激酶[CK]: 37.6%[77/205]对26.4% [61/231]，χ2=6.246)，肌酸激酶同工酶([CK- mb]):35.6% [73/205] vs 11.1% [24/216]， χ2=35.600)，差异均有统计学意义(P均<0.05,0.01)。与HAdV7组患者相比，HAdV55组患者病程更长(7 bbb d vs 6 bbb d, Z=-2.632)，更容易出现喉咙痛(72.8% [171/235]vs 62.1% [133/214]， χ2=0.016)，更容易出现头痛(62.1% [146/235]vs 16.4% [35/214]， χ2=97.527)，更容易出现咽阻塞(93.6% [220/235]vs 74.8%[160/214]， χ2=30.602)，更容易出现白细胞减少(14.0% [33/235]vs 24.8% [53/214]， χ2=8.318)，更容易出现乳酸脱氢酶升高(12.6% [29/230]vs 6.3% [13/205]， χ2=4.881)。肺炎发生率为71.5%[168/235]比31.8% [68/214]，χ2=70.846 (P均<0.05,0.01)。结论成人HAdV7和HAdV55感染的临床特点不同。55型感染更容易发展为肺炎，而7型感染具有更广泛的组织亲和性。关键词:腺病毒感染;人;病毒性肺炎;临床特点;案例分析

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来源期刊

中华传染病杂志

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期刊介绍： The Chinese Journal of Infectious Diseases was founded in February 1983. It is an academic journal on infectious diseases supervised by the China Association for Science and Technology, sponsored by the Chinese Medical Association, and hosted by the Shanghai Medical Association. The journal targets infectious disease physicians as its main readers, taking into account physicians of other interdisciplinary disciplines, and timely reports on leading scientific research results and clinical diagnosis and treatment experience in the field of infectious diseases, as well as basic theoretical research that has a guiding role in the clinical practice of infectious diseases and is closely integrated with the actual clinical practice of infectious diseases. Columns include reviews (including editor-in-chief reviews), expert lectures, consensus and guidelines (including interpretations), monographs, short monographs, academic debates, epidemic news, international dynamics, case reports, reviews, lectures, meeting minutes, etc.