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

加拿大魁北克省急诊科就诊的成人急性呼吸道感染患者中肠道病毒D68的临床表现

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Abstract

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.

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