| Objective:Collecting throat swabs from hospitalized patients with AECOPD and detecting 16 respiratory viruses combined with clinical data to analyze the effect of combined respiratory virus infection on patients with AECOPD.Sequencing and typing of viruses with a high detection rate and analysis of the main structural gene recombination and variation after virus isolation can provide a basis for disease treatment and prevention.Methods:From November 2020 to April 2021,284 throat swabs from AECOPD inpatients in a tertiary hospital in Bengbu City,Anhui Province were collected.Fluorescence quantitative PCR method was used to determine the infection of 16 common respiratory viruses,and the cases were divided into virus infection groups according to the positive results In the virus infection group,the symptoms,course of disease,prognosis and other characteristics of hospitalized patients with AECOPD and virus infection were analyzed.The main infection type of adenovirus-positive samples was determined by amplifying and sequencing the gene fragments of the hexon part of the adenovirus-positive samples.For adenovirus-positive samples with a Ct value below 30,the main structural genes were sequenced and recombination evolution analysis was performed after virus isolation.Results:A total of 109 throat swab samples were found to be positive for respiratory virus.Compared with AECOPD patients without virus infection,patients with respiratory virus infection had obvious symptoms of fever and palpitations,more severe heart failure,longer treatment period and poorer prognosis（P<0.05）.Adenovirus accounted for 56.73%（79/140）of all infected viruses,and the partial gene sequence of 31 adenovirus hexon was successfully sequenced,which could be divided into 16 ADV-C1 and 1 ADV-C5;2 ADV-B3 and 3 ADV-B7;2 ADV-D17,2ADV-D19,and 5 ADV-D27,similar to serotypes reported for severe pneumonia.Three strains of C1 adenovirus were successfully isolated,and sequencing showed that the original strain had high homology with the original strain AF534906,and the evolutionary tree of the three major structural genes was evenly located on the same branch of the original strain.Each segment of structural gene has base mutation and amino acid mutation,and the patients with mutation and mutation found in retrospective clinical data have more severe disease deterioration than patients with no mutationConclusions:1.This study is report in Bengbu City that inpatients with AECOPD have a high detection rate of respiratory viruses（38.38%（109/284））,and the treatment prognosis is worse than that of patients with no respiratory viruses detected.Clinically,patients with AECOPD should be screened for respiratory pathogen spectrum,in order to improve the clinical diagnosis and treatment effect。2.This study found that AECOPD adenovirus was the main respiratory infection virus in 56.73%（79/140）and multiple adenovirus serotypes were detected,which was different from the rhinovirus reported in previous research。3.Sequencing of the three isolated adenovirus strains revealed that the main structural genes had many base mutations and amino acid mutations,and the patients were seriously ill.Therefore,continuous detection of the structural genes of respiratory viruses and whole-genome recombination sequencing of viruses with high detection rates can effectively monitor and prevent the outbreak of respiratory viruses caused by them。... |
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