Clinical presentation of Enterovirus D68 in adults with acute respiratory infections consulting in emergency departments in Quebec, Canada

Objectives

Enterovirus D68 (EV-D68) is mainly studied in children, while data in adults are limited. We described the clinical presentation of EV-D68 in adults, compared with other enterovirus/rhinovirus (EV/RV) infections.

Methods

We used clinical and laboratory data from 1143 adults visiting four emergency departments in Quebec, Canada, for acute respiratory infections (February 2022 to March 2023). We analyzed nasopharyngeal swabs using a multiplex polymerase chain reaction; positive EV/RV samples were further tested with EV-D68–specific polymerase chain reaction assays. We calculated the Pandemic Medical Early Warning Score (PMEWS) to assess severity.

Results

Of 155 (14%) EV/RV samples, 19 (12%) were EV-D68 and occurred from July to October, 2022. Patients with EV-D68 more frequently lived with other people (100% vs 73%, P = 0.02) and tended to have more underlying chronic respiratory diseases (26% vs 20%) and respiratory symptoms (e.g., dyspnea: 84% vs 75%; wheezing: 63% vs 44%; and chest pain: 63% vs 49%), although these differences were not statistically significant. PMEWS, hospitalizations, and median time spent in the emergency department did not differ significantly between the EV-D68 and the other EV/RV group.

Conclusions

Respiratory symptoms tended to be more common among participants with EV-D68 than those with other EV/RV, although disease severity was similar. Larger studies are needed to better characterize EV-D68 infections in adults.