Epidemiological investigation on human coronovirus infection in hospitalized children with lower respiratory tract infection in Shanghai / 中华传染病杂志

ABSTRACT

Objective To investigate the epidemiological and clinical characteristics of human coronovirus (HCoV ) infection in hospitalized children with acute lower respiratory tract infection (ALRTI)in Shanghai.Methods A retrospective cohort study was conducted between October 2009 and September 2012.Five hundred and fifty-four cases of ALRTI in children under 5 years were enrolled. HCoV and other respiratory viruses in archival nasopharyngeal aspirate specimens were detected by a commercial Seeplex RV12 ACE detection kit.HCoV pan-family reverse transcription polymerase chain reaction (PCR)was performed to screen all known six HCoV,including HCoV-229E,HCoV-OC43, severe acute respiratory syndrome (SARS)-CoV,HCoV-NL63,HCoV-HKU1 ,and real-time PCR was performed to screen Middle East respiratory syndrome (MERS)-CoV.MEGA5 .0 software was used to perform sequence alignment and phylogenetic tree analysis.Results In 554 samples,at least one virus was identified in 273 cases (48.56%)and HCoV was detected in 18 cases (3.25 %),among which 13 were HCoV-OC43/HKU1 positive,5 HCoV-229E/NL63 positive.No high pathogenic MERS-CoV and SARS-CoV were detected.The median age of 18 children with HCoV infection was 18 months (1 -48 months)with 12 boys and 6 girls.Seventeen cases had fever,11 cough,9 tachypenea and 1 wheeze. Seven received oxygen therapy,and 6 were admitted to intensive care unit for treatment.Two who was in ordinary ward were coinfected with adenovirus and human rhinovirus.All 18 cases recovered or improved on discharge.Six was infected in autumn,5 in winter,3 in spring and 4 in summer.Of 8 HCoV-positive samples which were sequenced,each 3 samples belonged to HKU1 and 229E subtypes,respectively,and each 1 belonged to OC43 and NL63 subtypes,respectively.Conclusions HCoV is a relatively common viral pathogen among hospitalized young children with ALRTI in Shanghai.No high pathogenic MERS-CoV is detected.HCoV can cause severe infection with favorable outcome.