title: Clinical and molecular epidemiological features of coronavirus HKU1-associated community-acquired pneumonia.
abstract: 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.
authors.affiliation: Division of Infectious Disease, Department of Microbiology, The University of Hong Kong, Hong Kong, China.
authors.forename: Patrick C Y
authors.initials: PC
authors.lastname: Woo
authors.forename: Susanna K P
authors.initials: SK
authors.lastname: Lau
authors.forename: Hoi-Wah
authors.initials: HW
authors.lastname: Tsoi
authors.forename: Yi
authors.initials: Y
authors.lastname: Huang
authors.forename: Rosana W S
authors.initials: RW
authors.lastname: Poon
authors.forename: Chung-Ming
authors.initials: CM
authors.lastname: Chu
authors.forename: Rodney A
authors.initials: RA
authors.lastname: Lee
authors.forename: Wei-Kwang
authors.initials: WK
authors.lastname: Luk
authors.forename: Gilman K M
authors.initials: GK
authors.lastname: Wong
authors.forename: Beatrice H L
authors.initials: BH
authors.lastname: Wong
authors.forename: Vincent C C
authors.initials: VC
authors.lastname: Cheng
authors.forename: Bone S F
authors.initials: BS
authors.lastname: Tang
authors.forename: Alan K L
authors.initials: AK
authors.lastname: Wu
authors.forename: Raymond W H
authors.initials: RW
authors.lastname: Yung
authors.forename: Honglin
authors.initials: H
authors.lastname: Chen
authors.forename: Yi
authors.initials: Y
authors.lastname: Guan
authors.forename: Kwok-Hung
authors.initials: KH
authors.lastname: Chan
authors.forename: Kwok-Yung
authors.initials: KY
authors.lastname: Yuen
mesh_terms: 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
chemical_list: D008562:Membrane Glycoproteins; D019590:Nucleocapsid Proteins; D064370:Spike Glycoprotein, Coronavirus; D014759:Viral Envelope Proteins