title: Coronavirus and Other Respiratory Illnesses Comparing Older with Young Adults.
abstract: BACKGROUND
  Study of human coronavirus and other virus-associated respiratory illnesses is needed to describe their clinical effects on chronically ill, older adults.
  
  
  METHODS
  A prospective study during 2009 to 2013 clinically assessed acute respiratory illnesses soon after onset and 3 to 4 weeks later in patients aged ≥60 years with chronic lung and heart diseases (group 1, 100 subjects) and healthy adults aged 18 to 40 years (group 2, 101 subjects). Respiratory secretions were tested for nucleic acids of a panel of respiratory viruses. An increase in antibody titer was assessed for 4 coronavirus strains.
  
  
  RESULTS
  Virus-associated illnesses (29 [39.1%] of 74 illnesses in group 1 and 59 [48.7%] of 121 illnesses in group 2) occurred in all calendar quarters, most commonly in the first and fourth quarters. Coronaviruses (group 1: 14 [18.9%] illnesses; group 2: 26 [21.5%] illnesses) and enteroviruses/rhinoviruses (group 1: 14 [18.9%] illnesses; group 2: 37 [30.6%] illnesses) were most common. Virus co-infections occurred in 10 illnesses. Illnesses with 9 to 11 symptoms were more common in group 1 (17 [23.0%]) than in group 2 (15 [12.4%]) (P < .05). Compared with group 2, more group 1 subjects reported dyspnea, more severe disease of longer duration, and treatment for acute illness with prednisone and antibiotics. Coronavirus-associated illnesses (percent of illnesses, group 1 vs group 2) were characterized by myalgias (21% vs 68%, P < .01), chills (50% vs 52%), dyspnea (71% vs 24%, P < .01), headache (64% vs 72%), malaise (64% vs 84%), cough (86% vs 68%), sputum production (86% vs 60%), sore throat (64% vs 80%), and nasal congestion (93% vs 96%).
  
  
  CONCLUSIONS
  Respiratory illnesses were commonly associated with coronaviruses and enteroviruses/rhinoviruses affecting chronically ill, older patients more than healthy, young adults.
authors.affiliation: Section of Infectious Diseases, VA St Louis Health Care System, and Division of Infectious Diseases, Allergy & Immunology, Saint Louis University School of Medicine, St Louis, Mo. Electronic address: gorsegj@slu.edu.
authors.forename: Geoffrey J
authors.initials: GJ
authors.lastname: Gorse
authors.affiliation: Research Service, VA St Louis Health Care System, and Division of Infectious Diseases, Allergy & Immunology, Saint Louis University School of Medicine, St Louis, Mo.
authors.forename: Mary M
authors.initials: MM
authors.lastname: Donovan
authors.affiliation: Research Service, VA St Louis Health Care System, and Division of Infectious Diseases, Allergy & Immunology, Saint Louis University School of Medicine, St Louis, Mo.
authors.forename: Gira B
authors.initials: GB
authors.lastname: Patel
authors.affiliation: Research Service, VA St Louis Health Care System, and Washington University in St Louis, St Louis, Mo.
authors.forename: Sumitra
authors.initials: S
authors.lastname: Balasubramanian
authors.affiliation: Section of Infectious Diseases, VA St Louis Health Care System, and Division of Infectious Diseases, Allergy & Immunology, Saint Louis University School of Medicine, St Louis, Mo.
authors.forename: Rodney H
authors.initials: RH
authors.lastname: Lusk
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000150:complications; D002908:Chronic Disease; D060085:Coinfection / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D018352:Coronavirus Infections / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D017281:Cost of Illness; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008171:Lung Diseases / Q000150:complications; D008297:Male; D008875:Middle Aged; D008923:Missouri / Q000453:epidemiology; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D012307:Risk Factors; D012621:Seasons; D012720:Severity of Illness Index; D055815:Young Adult
keywords: Cardiopulmonary disease; Coronavirus; Elderly; Epidemiology; Rhinovirus; Severity of illness; Upper respiratory infection