title: Human coronavirus and severe acute respiratory infection in Southern Brazil.
abstract: Human coronaviruses (HCoVs) are an important cause of respiratory tract infection and are responsible for causing the common cold in the general population. Thus, adequate surveillance of HCoV is essential. This study aimed to analyze the impact of HCoV infections and their relation to severe acute respiratory infection (SARI) in a hospitalized population in Southern Brazil. A cross-sectional study was conducted at a tertiary care hospital, and assessed inpatients under investigation for SARI by the hospital epidemiology department, and all patients who had nasopharyngeal aspirates collected from January 2012 to December 2013 to detect respiratory viruses (RVs). Viral infection was detected by multiplex reverse transcriptase polymerase chain reaction (RT-PCR), with primers specific to the subtypes HCoV-229E/NL63 and OC43/HKU1. The overall positivity rate was 58.8% (444/755), and HCoVs were detected in 7.6% (n = 34) of positive samples. Children below two years of age were most frequently affected (62%). Comorbidities were more likely to be associated with HCoVs than with other RVs. Immunosuppression was an independent risk factor for HCoV infection (OR = 3.5, 95% CI 1.6-7.6). Dyspnea was less frequently associated with HCoV infection (p < 0.001), and HCoV accounted for 6% of the SARI cases. Three patients infected with HCoV (9%) died from respiratory infection. HCoVs are important respiratory pathogens, especially in hospitalized children under 2 years of age and in immunosuppressed patients. They may account for a small proportion of SARI diagnoses, increased need for mechanical ventilation, intensive care unit admission, and death.
authors.affiliation: a Division of Infectious Diseases , Universidade Federal do Paraná , Curitiba , Brazil.
authors.forename: Hygor
authors.initials: H
authors.lastname: Trombetta
authors.affiliation: a Division of Infectious Diseases , Universidade Federal do Paraná , Curitiba , Brazil.
authors.forename: Heloisa Z
authors.initials: HZ
authors.lastname: Faggion
authors.affiliation: a Division of Infectious Diseases , Universidade Federal do Paraná , Curitiba , Brazil.
authors.forename: Jaqueline
authors.initials: J
authors.lastname: Leotte
authors.affiliation: b Laboratory of Virology , Universidade Federal do Paraná , Curitiba , Brazil.|c Department of Clinical Analysis , Universidade Federal do Paraná , Curitiba , Brazil.
authors.forename: Meri B
authors.initials: MB
authors.lastname: Nogueira
authors.affiliation: b Laboratory of Virology , Universidade Federal do Paraná , Curitiba , Brazil.
authors.forename: Luine R R
authors.initials: LR
authors.lastname: Vidal
authors.affiliation: a Division of Infectious Diseases , Universidade Federal do Paraná , Curitiba , Brazil.|b Laboratory of Virology , Universidade Federal do Paraná , Curitiba , Brazil.
authors.forename: Sonia M
authors.initials: SM
authors.lastname: Raboni
mesh_terms: D001938:Brazil; D017934:Coronavirus / Q000235:genetics*; D018352:Coronavirus Infections / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D006801:Humans; D007223:Infant; D012141:Respiratory Tract Infections / Q000453:epidemiology; D020133:Reverse Transcriptase Polymerase Chain Reaction
keywords: Epidemiology; Human Coronavirus; RT-PCR multiplex; Respiratory infections; Severe acute respiratory infection