Linking digital surveillance and in-depth virology to study clinical patterns of viral respiratory infections in vulnerable patient populations

Patrick E Obermeier; Albert Heim; Barbara Biere; Elias Hage; Maren Alchikh; Tim Conrad; Brunhilde Schweiger; Barbara A Rath

doi:10.1016/j.isci.2022.104276

Linking digital surveillance and in-depth virology to study clinical patterns of viral respiratory infections in vulnerable patient populations

iScience. 2022 Apr 21;25(5):104276. doi: 10.1016/j.isci.2022.104276. eCollection 2022 May 20.

Authors

Patrick E Obermeier^{1

2

3}, Albert Heim⁴, Barbara Biere⁵, Elias Hage⁴, Maren Alchikh^{1

2

3}, Tim Conrad⁶, Brunhilde Schweiger⁵, Barbara A Rath^{1

2

3}

Affiliations

¹ Vienna Vaccine Safety Initiative, Pediatric Infectious Diseases, Berlin, Germany.
² Charité University Medical Center, Department of Pediatrics, Berlin, Germany.
³ UMR Chrono-environnement, Université Bourgogne Franche-Comté, Besançon, France.
⁴ National Reference Laboratory for Adenoviruses, Hannover Medical School, Hannover, Germany.
⁵ National Reference Centre for Influenza, Robert Koch-Institute, Berlin, Germany.
⁶ Department of Mathematics and Computer Science, Freie Universität Berlin, Berlin, Germany.

Abstract

To improve the identification and management of viral respiratory infections, we established a clinical and virologic surveillance program for pediatric patients fulfilling pre-defined case criteria of influenza-like illness and viral respiratory infections. The program resulted in a cohort comprising 6,073 patients (56% male, median age 1.6 years, range 0-18.8 years), where every patient was assessed with a validated disease severity score at the point-of-care using the ViVI ScoreApp. We used machine learning and agnostic feature selection to identify characteristic clinical patterns. We tested all patients for human adenoviruses, 571 (9%) were positive. Adenovirus infections were particularly common and mild in children ≥1 month of age but rare and potentially severe in neonates: with lower airway involvement, disseminated disease, and a 50% mortality rate (n = 2/4). In one fatal case, we discovered a novel virus: HAdV-80. Standardized surveillance leveraging digital technology helps to identify characteristic clinical patterns, risk factors, and emerging pathogens.

Keywords: Health sciences; Medical surveillance; Virology.