| ObjectiveTo fully understand the current situation and changing rules,explore the epidemic characteristics of respiratory adenovirus infection in China,respond to emerging and re-emerging respiratory adenovirus epidemic,and provide preventive and control measures for adenovirus infections.MethodsThe literature data and pathogenetic surveillance data of respiratory adenovirus infection in China from 2009 to 2020 were collected,and the case database was established.The literature data of respiratory adenovirus outbreak investigation and etiological monitoring in China were systematically reviewed through meta-analysis.The difference between the positive detection rate and attack rate of adenovirus infection in different populations was compared.The study was registered in PROSPERO,CRD4202230015.Analyze the characteristics of adenovirus compound infection,symptoms,and prognosis through pathogenetic surveillance data,use chisquare test or Fisher exact probability method to compare the inter-group rate.All statistical tests were bilateral tests,p<0.05 was statistically significant.ResultsA total of 950 articles meeting the selection criteria were included in the literature data(91 about outbreaks,859 about pathogenic monitoring).In the investigation of respiratory adenovirus outbreak,15940 cases were positive,and the attack rate was15.91%(95% CI: 13.85,17.98).The positive number of adenoviruses detected by etiology was 119838,and the positive detection rate was 4.21%(95% CI: 4.07,4.34).Of the 70 outbreaks of adenovirus typing by meta-analysis,nearly half(45.71%)were caused by HAd V-7,with an overall attack rate of 22.32%.Military camps and schools are the main outbreak sites,with significantly different seasonal patterns and attack rates,of which HAd V-55 and HAd V-7 were identified as the main types.In 859hospital-based pathogenic surveillance studies,the positive detection rates of HAd V-3(32.73%)and HAd V-7(27.48%)were significantly higher than those of other virus types.The clinical manifestation mainly depends on the type of adenovirus and the age of the patient.HAd V-55 infection tends to develop into pneumonia with poor prognosis,especially in children under 5 years old.HAd V-7 is more prone to dyspnea and other symptoms.The case-based sentinel hospital monitoring showed that the positive detection rate of adenovirus was 4.47%.A total of 210995 patients with respiratory symptoms were detected,including 9423 patients with HAd V positive,with a positive detection rate of4.47%.Children are susceptible to respiratory adenovirus,their prognosis is worse,and they are more likely to suffer from pneumonia.Elderly people infected with adenovirus are more likely to enter ICU.Adenovirus is more likely to co-infect with rhinovirus,influenza virus,respiratory syncytial virus,Boca virus and parainfluenza virus.ConclusionIn meta-analysis,the incidence of respiratory adenovirus outbreaks in China was15.91%,with the main adenovirus subtypes being HAd V-7 and HAd V-55.In etiological surveillance,the adenovirus positivity rate was 4.21%,and case-based sentinel hospital surveillance yielded an adenovirus positivity rate of 4.47%,with the main types being HAd V-3 and HAd V-7.HAd V-7 is more likely to present with symptoms such as dyspnea,while HAd V-55 is more likely to cause pneumonia.Children are susceptible to respiratory adenovirus and have a worse prognosis and are more likely to develop pneumonia,while older people are more likely to be admitted to the ICU with adenovirus.Schools,army camps and swimming pools are high risk sites for respiratory adenovirus.In clinical management,it is important to note that adenoviruses are prone to co-infection with other respiratory viruses. |
