Coronavirus causes lower respiratory tract infections less frequently than RSV in hospitalized Norwegian children.
BACKGROUND
We have described occurrence and clinical manifestations of human coronaviruses (HCoV) in hospitalized Norwegian children with respiratory tract infection (RTI) and compared them with a group of respiratory syncytial virus (RSV)-infected children.


METHODS
We used in-house TaqMan multiplex real-time polymerase chain reaction to test nasopharyngeal samples from 536 RTI episodes in 452 children who were admitted during the 2006-2007 winter. Twenty-one viruses, including HCoV-OC43, HCoV-NL63, HCoV-229E, HCoV-HKU1, and RSV were tested. The amount of viral nucleic acid was recorded semiquantitatively based on the cycle threshold value.


RESULTS
A total of 665 positive polymerase chain reaction tests were recorded in 536 nasopharyngeal specimens. Coronavirus was found in 68 (12.7%): HCoV-OC43, n = 44 (8.2%), and HCoV-NL63, n = 24 (4.5%). Only RSV and rhinovirus were detected more frequently. Neither HCoV-229E nor HCoV-HKU1 was detected. Among children with HCoV-OC43, 73.0% tested positive for at least one other virus, compared with 41.2% with HCoV-NL63 and 40.3% with RSV (P = 0.03 and P < 0.01, respectively). Children with HCoV-OC43 and HCoV-NL63 were older than children with RSV (median age, 19 vs. 10 months, P = 0.01). Lower respiratory tract infection (LRTI) was half as common in children with HCoV-OC43 (48.6%) and HCoV-NL63 (47.1%) as in children with RSV (82.3%) (both P < 0.01). After adjusting for age, chronic disease, LRTI, and co-detection of other viruses in a multiple logistic regression analysis, HCoV was associated with a shorter fever period and shorter hospitalization time than RSV.


CONCLUSIONS
HCoV-OC43 and HCoV-NL63 are common among hospitalized Norwegian children with RTI. Children with HCoV-OC43 and HCoV-NL63 have LRTI less frequently and may need a shorter hospital stay than children with RSV.
Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.
Aslak Widerøe
AW
Kristoffersen
Svein Arne
SA
Nordbø
Anne-Gro Wesenberg
AG
Rognlien
Andreas
A
Christensen
Henrik
H
Døllner
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D017934:Coronavirus / Q000145:classification / Q000302:isolation & purification; D018352:Coronavirus Infections / Q000453:epidemiology* / Q000473:pathology; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009305:Nasopharynx / Q000821:virology; D009664:Norway / Q000453:epidemiology; D015995:Prevalence; D018357:Respiratory Syncytial Virus Infections / Q000453:epidemiology* / Q000473:pathology; D012136:Respiratory Syncytial Viruses / Q000302:isolation & purification; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000473:pathology / Q000821:virology*; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods