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. 2025 Jan;44(1):197-207.
doi: 10.1007/s10096-024-04970-0. Epub 2024 Nov 15.

Incidence, clinical manifestations and characterization of Enterovirus in the last decade (2014-2023) in Asturias (Spain). Effect of the SARS-CoV-2 pandemic

Susana Rojo-Alba  1 , José María González-Alba  1 , Zulema Pérez Martínez  1 , Cristina Ochoa Varela  1 , Maria Agustina Alonso Álvarez  2 , Pablo Rubianes Fernández  3 , Mercedes Rodríguez Pérez  1 , Estibaliz Garrido García  2 , José Antonio Boga  1 , Santiago Melón García  1 , Marta Elena Álvarez-Argüelles  4
Affiliations

Incidence, clinical manifestations and characterization of Enterovirus in the last decade (2014-2023) in Asturias (Spain). Effect of the SARS-CoV-2 pandemic

Susana Rojo-Alba et al. Eur J Clin Microbiol Infect Dis. 2025 Jan.

Abstract

Enteroviruses (EVs) are a large group of genotypes that cause a variety of pathologies, some of them very serious. This study analyzed the last 10 years (2014-2023) of EVs diagnosis and classification. In 166,674 samples collected, EVs were found in 9,535 (5.7%) by rt-RT-PCR, and 332 (3.5%) were classified by Sanger methods. Symptoms were analyzed in 7623 cases. EVs were found in 5718/63,829 (8.9%) before, 1384/42,373 (3.3%) during and 2433/60,472 (4%) after the Covid pandemic (p < 0.0001), and in 7249/69,700 (10.4%) children under 6 years and in 2286/96,974 (2.35%) in oldest (p < 0.0001). The positive rate of EVs was high but decreased during the Covid period. In the youngest children EVs-A (associated with exantematohous disorders as well as respiratory manifestations and febrile syndromes) was most common, while EVs-B (frequent in neurological symptoms) was most common in children aged 6-15 years and EVs-D (associated to respiratory manifestations) in adults.

Keywords: Enterovirus; Epidemiology; Genotyping; Surveillance.

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Conflict of interest statement

Declarations. Ethical approval: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013) and has been approved by Hospital Universitario Central de Astuiras Ethical Committee (nº 2020.383). Our study is based on the use of remmants of samples used for routine diagnosis. The retrospective collection of the informed consent belonging to the collection of samples stored by the Mycrobiology Service of HUCA was complicated, so the Ethical committee was asked to exempt informed. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
- Diversity (a) and positivity rate of EV by year and age (b)
Fig. 2
Fig. 2
Clinical disorders associated with EV over time (a), and by age (b). Resp M: respiratory manifestations; FS: febrile syndrome; ED: Exanthematous disorders; NS: neurological symptoms; GI: gastrointestinal symptoms
Fig. 3
Fig. 3
Viral load by specimen (a) and in respiratory specimens by clinical syndromes (b).URS: upper respiratory samples, LRS: lower respiratory samples, CFS: cerebrospinal fluid samples. FS: febril syndrome; ED: Exanthematous disorders; NS: neurological symptoms; GI: gastrointestinal symptoms; LRM: lower respiratory manifestations; URM: upper respiratory manifestations
Fig. 4
Fig. 4
(a) Phylogenetic tree of EVs from Asturias (bold dot) and reference EV of species A (red), species B (green), and species D (blue). (b) Number of EV from each species and symptoms
Fig. 5
Fig. 5
Types of EV by number (a) and proportion (b) according age and sex
See this image and copyright information in PMC

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