title: Detection of four human coronaviruses in respiratory infections in children: a one-year study in Colorado.
abstract: Lower respiratory tract infections are the leading cause of death in children worldwide. Studies on the epidemiology and clinical associations of the four human non-SARS human coronaviruses (HCoVs) using sensitive polymerase chain reaction (PCR) assays are needed to evaluate the clinical significance of HCoV infections worldwide. Pediatric respiratory specimens (1,683) submitted to a diagnostic virology laboratory over a 1-year period (December 2004-November 2005) that were negative for seven respiratory viruses by conventional methods were tested for RNA of four HCoVs using sensitive RT-PCR assays. Coronavirus RNAs were detected in 84 (5.0%) specimens: HCoV-NL63 in 37 specimens, HCoV-OC43 in 34, HCoV-229E in 11, and HCoV-HKU1 in 2. The majority of HCoV infections occurred during winter months, and over 62% were in previously healthy children. Twenty-six (41%) coronavirus positive patients had evidence of a lower respiratory tract infection (LRTI), 17 (26%) presented with vomiting and/or diarrhea, and 5 (8%) presented with meningoencephalitis or seizures. Respiratory specimens from one immunocompromised patient were persistently positive for HCoV-229E RNA for 3 months. HCoV-NL63-positive patients were nearly twice as likely to be hospitalized (P = 0.02) and to have a LRTI (P = 0.04) than HCoV-OC43-positive patients. HCoVs are associated with a small, but significant number (at least 2.4% of total samples submitted), of both upper and lower respiratory tract illnesses in children in Colorado. Our data raise the possibility that HCoV may play a role in gastrointestinal and CNS disease. Additional studies are needed to investigate the potential roles of HCoVs in these diseases.
authors.affiliation: Department of Pediatrics, The Children's Hospital, University of Colorado Denver School of Medicine, Aurora, CO 80045, USA. samuel.dominguez@ucdenver.edu
authors.forename: Samuel R
authors.initials: SR
authors.lastname: Dominguez
authors.forename: Christine C
authors.initials: CC
authors.lastname: Robinson
authors.forename: Kathryn V
authors.initials: KV
authors.lastname: Holmes
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003120:Colorado / Q000453:epidemiology; D017934:Coronavirus / Q000145:classification / Q000302:isolation & purification*; D018352:Coronavirus Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012367:RNA, Viral / Q000235:genetics; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology / Q000821:virology*; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods; D012621:Seasons
chemical_list: D012367:RNA, Viral