title: Detection of human coronaviruses in simultaneously collected stool samples and nasopharyngeal swabs from hospitalized children with acute gastroenteritis.
abstract: BACKGROUND
  Human coronaviruses (HCoVs) are a well-known cause of respiratory infections but their role in gastrointestinal infections is unclear. The objective of our study was to assess the significance of HCoVs in the etiology of acute gastroenteritis (AGE) in children <6  years of age.
  
  
  METHODS
  Stool samples and nasopharyngeal (NP) swabs collected from 260 children hospitalized for AGE (160 also had respiratory symptoms) and 157 otherwise healthy control children admitted for elective surgery were tested for the presence of four HCoVs using real time RT-PCR. Registered at ClinicalTrials.gov (reg. NCT00987519).
  
  
  RESULTS
  HCoVs were more frequent in patients with AGE than in controls (23/260, 8.8% versus 4/151, 2.6%; odds ratio, OR 3.3; 95% confidence interval, CI 1.3-10.0; P = 0.01). Three of four HCoV-positive members in the control group, asymptomatic when sampled, recalled gastrointestinal or respiratory symptoms within the previous 14  days. In patients with AGE, HCoVs were present in NP samples more often than in stools (22/256, 8.6%, versus 6/260, 2.3%; P = 0.0004). In 5/6 children with HCoVs detected in stools, the viruses were also detected in NP swabs. Patients had a significantly higher probability of HCoV detection in stool (OR 4; 95% CI 1.4-15.3; P = 0.006) and also in stool and/or NP (OR 3.3, 95% CI 1.3-10.0; P = 0.01) than healthy controls. All four HCoVs species were detected in stool and NP samples.
  
  
  CONCLUSIONS
  Although HCoVs were more frequently detected in patients with AGE than in the control group, high prevalence of HCoVs in NP swabs compounded by their low occurrence in stool samples and detection of other viruses in stool samples, indicate that HCoVs probably play only a minor role in causing gastrointestinal illness in children <6 years old.
authors: Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia. monika.jevsnik@mf.uni-lj.si
authors: Monika
authors: M
authors: Jevšnik
authors: Andrej
authors: A
authors: Steyer
authors: Tamara
authors: T
authors: Zrim
authors: Marko
authors: M
authors: Pokorn
authors: Tatjana
authors: T
authors: Mrvič
authors: Štefan
authors: Š
authors: Grosek
authors: Franc
authors: F
authors: Strle
authors: Lara
authors: L
authors: Lusa
authors: Miroslav
authors: M
authors: Petrovec
mesh_terms: D000208:Acute Disease; D002648:Child; D002675:Child, Preschool; D017934:Coronavirus / Q000302:isolation & purification*; D018352:Coronavirus Infections / Q000175:diagnosis* / Q000821:virology; D005243:Feces / Q000821:virology*; D005260:Female; D005759:Gastroenteritis / Q000175:diagnosis* / Q000821:virology; D006760:Hospitalization; D006801:Humans; D008297:Male; D009305:Nasopharynx / Q000821:virology*; D020133:Reverse Transcriptase Polymerase Chain Reaction
references: J Clin Microbiol. 2003 Apr;41(4):1548-57
references: 12682144
references: J Infect Dis. 1974 Mar;129(3):271-6
references: 4816305
references: Lancet. 2003 May 24;361(9371):1767-72
references: 12781535
references: J Clin Microbiol. 2009 Nov;47(11):3486-92
references: 19759228
references: J Virol. 2005 May;79(9):5428-36
references: 15827157
references: N Engl J Med. 2003 May 15;348(20):1967-76
references: 12690091
references: Gastroenterology. 2003 Oct;125(4):1011-7
references: 14517783
references: J Virol Methods. 2006 Jan;131(1):92-8
references: 16137772
references: J Clin Microbiol. 2006 Sep;44(9):3231-5
references: 16954253
references: Lancet. 2003 Apr 19;361(9366):1319-25
references: 12711465
references: Pediatrics. 2007 Jan;119(1):e70-6
references: 17130280
references: J Clin Virol. 2005 Aug;33(4):306-11
references: 15994117
references: Eur J Clin Microbiol Infect Dis. 2009 Nov;28(11):1305-10
references: 19705175
references: Influenza Other Respir Viruses. 2007 Jul;1(4):167-75
references: 19432632
references: J Virol Methods. 2007 Dec;146(1-2):341-54
references: 17854913
references: Postgrad Med J. 1979 Feb;55(640):135-42
references: 461276
references: Arch Virol. 2007;152(10):1885-900
references: 17564760
references: J Clin Virol. 2004 Oct;31(2):123-9
references: 15364268
references: J Clin Virol. 2010 May;48(1):27-30
references: 20233673
references: J Infect Dis. 2005 Dec 1;192(11):1898-907
references: 16267760
references: J Clin Microbiol. 2004 Mar;42(3):981-6
references: 15004041
references: J Clin Microbiol. 2006 Jul;44(7):2382-8
references: 16825353
references: J Clin Virol. 2010 Jun;48(2):131-3
references: 20362494
references: J Med Virol. 2006 Dec;78(12):1609-15
references: 17063525
references: J Clin Microbiol. 2009 Jun;47(6):1674-9
references: 19339472
references: Clin Infect Dis. 2006 Mar 1;42(5):634-9
references: 16447108