Clinical and molecular epidemiological features of coronavirus HKU1-associated community-acquired pneumonia.
BACKGROUND
Recently, we described the discovery of a novel group 2 coronavirus, coronavirus HKU1 (CoV-HKU1), from a patient with pneumonia. However, the clinical and molecular epidemiological features of CoV-HKU1-associated pneumonia are unknown.


METHODS
Prospectively collected (during a 12-month period) nasopharyngeal aspirates (NPAs) from patients with community-acquired pneumonia from 4 hospitals were subjected to reverse-transcription polymerase chain reaction, for detection of CoV-HKU1. The epidemiological, clinical, and laboratory characteristics of patients with CoV-HKU1-associated pneumonia were analyzed. The pol, spike (S), and nucleocapsid (N) genes were also sequenced.


RESULTS
NPAs from 10 (2.4%) of 418 patients with community-acquired pneumonia were found to be positive for CoV-HKU1. All 10 cases occurred in spring and winter. Nine of these patients were adults, and 4 had underlying diseases of the respiratory tract. In the 6 patients from whom serum samples were available, all had a 4-fold change in immunoglobulin (Ig) G titer and/or presence of IgM against CoV-HKU1. The 2 patients who died had significantly lower hemoglobin levels, monocyte counts, albumin levels, and oxygen saturation levels on admission and had more-extensive involvement visible on chest radiographs. Sequence analysis of the pol, S, and N genes revealed 2 genotypes of CoV-HKU1.


CONCLUSIONS
CoV-HKU1 accounts for 2.4% of community-acquired pneumonia, with 2 genotypes in the study population. Without performance of diagnostic tests, the illness was clinically indistinguishable from other community-acquired pneumonia illnesses.
Woo
Patrick C Y
PC
Division of Infectious Disease, Department of Microbiology, The University of Hong Kong, Hong Kong, China.
Lau
Susanna K P
SK
Tsoi
Hoi-Wah
HW
Huang
Yi
Y
Poon
Rosana W S
RW
Chu
Chung-Ming
CM
Lee
Rodney A
RA
Luk
Wei-Kwang
WK
Wong
Gilman K M
GK
Wong
Beatrice H L
BH
Cheng
Vincent C C
VC
Tang
Bone S F
BS
Wu
Alan K L
AK
Yung
Raymond W H
RW
Chen
Honglin
H
Guan
Yi
Y
Chan
Kwok-Hung
KH
Yuen
Kwok-Yung
KY
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001483:Base Sequence; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology / Q000821:virology; D017934:Coronavirus / Q000145:classification / Q000235:genetics* / Q000472:pathogenicity; D018352:Coronavirus Infections / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology / Q000821:virology; D005260:Female; D015751:Genes, pol; D006801:Humans; D008297:Male; D008562:Membrane Glycoproteins / Q000235:genetics; D017720:Molecular Epidemiology; D008969:Molecular Sequence Data; D009305:Nasopharynx / Q000821:virology; D019590:Nucleocapsid Proteins / Q000235:genetics; D010802:Phylogeny; D011024:Pneumonia, Viral / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology / Q000821:virology; D020133:Reverse Transcriptase Polymerase Chain Reaction; D017422:Sequence Analysis, DNA; D064370:Spike Glycoprotein, Coronavirus; D014759:Viral Envelope Proteins / Q000235:genetics
D008562:Membrane Glycoproteins; D019590:Nucleocapsid Proteins; D064370:Spike Glycoprotein, Coronavirus; D014759:Viral Envelope Proteins