title: Epidemiology of human coronavirus NL63 infection among hospitalized patients with pneumonia in Taiwan.
abstract: OBJECTIVE
  Human coronavirus (HCoV) NL63 is recognized in association with upper or lower respiratory tract illnesses in children. This study surveyed the prevalence of HCoV-NL63 and influenza viruses in patients with influenza-like illness in Taiwan during 2010-2011.
  
  
  METHODS
  Throat samples from 107 hospitalized patients with pneumonia and 175 outpatients with influenza-like illness were examined using real-time polymerase chain reaction assays with virus-specific primers, and then virus-positive specimens were confirmed by sequencing the polymerase chain reaction products.
  
  
  RESULTS
  HCoV-NL63 infection was identified in 8.4% (9/107) of hospitalized patients with pneumonia, but not found in outpatients with influenza-like illness. Age distribution of HCoV-NL63 infection in hospitalized patients with pneumonia indicated that the group aged 16-25 years (20%) had the highest positive rate compared with the other groups, and exhibited a similar age-specific pattern to influenza A/H1N1 infection, but not influenza A/H3N2 and B infections in hospitalized patients. Seasonal prevalence of HCoV-NL63 infection was late winter, overlapping the highest peak of the influenza A/H1N1 epidemic during December 2010 to March 2011 in Taiwan. Co-infection of HCoV-NL63 and influenza A/H1N1 was detected in three hospitalized patients. Clinical manifestation analysis indicated that the main symptoms for HCoV-NL63 infection included fever (88.9%), cough (77.8%), and pneumonia (100%). Co-infection caused significantly higher rates of breathing difficulties, cough, and sore throat than those of single infection with HCoV-NL63 and influenza A/H1N1. Phylogenetic analysis indicated a low level of heterogeneity between Taiwan and global HCoV-NL63 strains.
  
  
  CONCLUSIONS
  Understanding epidemiology of HCoV-NL63 in Taiwan provides an insight for worldwide surveillance of HCoV-NL63 infection.
authors.affiliation: Department of Biotechnology, Asia University, Wufeng, Taichung, Taiwan.
authors.forename: Su-Hua
authors.initials: SH
authors.lastname: Huang
authors.affiliation: Department of Laboratory Medicine, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Mei-Chi
authors.initials: MC
authors.lastname: Su
authors.affiliation: Department of Laboratory Medicine, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Ni
authors.initials: N
authors.lastname: Tien
authors.affiliation: Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichung, Taiwan.
authors.forename: Chien-Jhen
authors.initials: CJ
authors.lastname: Huang
authors.affiliation: Department of Health Risk Management, School of Public, China Medical University, Taichung, Taiwan.
authors.forename: Yu-Ching
authors.initials: YC
authors.lastname: Lan
authors.affiliation: Division of Gastroenterology, Kuang Tien General Hospital, Taichung, Taiwan.
authors.forename: Chen-Sheng
authors.initials: CS
authors.lastname: Lin
authors.affiliation: Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichung, Taiwan.
authors.forename: Chao-Hsien
authors.initials: CH
authors.lastname: Chen
authors.affiliation: Department of Biotechnology, Asia University, Wufeng, Taichung, Taiwan; Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichung, Taiwan. Electronic address: cwlin@mail.cmu.edu.tw.
authors.forename: Cheng-Wen
authors.initials: CW
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001483:Base Sequence; D060085:Coinfection / Q000473:pathology / Q000821:virology; D018352:Coronavirus Infections / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D058957:Coronavirus NL63, Human / Q000145:classification* / Q000302:isolation & purification / Q000472:pathogenicity; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000472:pathogenicity; D007251:Influenza, Human / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D008875:Middle Aged; D010802:Phylogeny; D011014:Pneumonia / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D012367:RNA, Viral / Q000235:genetics; D060888:Real-Time Polymerase Chain Reaction; D012621:Seasons; D017423:Sequence Analysis, RNA; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
chemical_list: D012367:RNA, Viral
keywords: age distribution; human coronavirus NL63; phylogenetic analysis; pneumonia; seasonality