Characterization of Human Coronavirus Etiology in Chinese Adults with Acute Upper Respiratory Tract Infection by Real-Time RT-PCR Assays

Roujian Lu,Wenjie Tan,Zhong Wang,Jin Xu,Weimin Zhou,Linglin Zhang,Lingjie Xu,Xiaoyan Yu,Wen Wang,Xijie Duan,Li Ruan,Qin Hu,Jianxin Lu,Krzysztof Pyrc

doi:10.1371/journal.pone.0038638

Abstract

BackgroundIn addition to SARS associated coronaviruses, 4 non-SARS related human coronaviruses (HCoVs) are recognized as common respiratory pathogens. The etiology and clinical impact of HCoVs in Chinese adults with acute upper respiratory tract infection (URTI) needs to be characterized systematically by molecular detection with excellent sensitivity.Methodology/Principal FindingsIn this study, we detected 4 non-SARS related HCoV species by real-time RT-PCR in 981 nasopharyngeal swabs collected from March 2009 to February 2011. All specimens were also tested for the presence of other common respiratory viruses and newly identified viruses, human metapneumovirus (hMPV) and human bocavirus (HBoV). 157 of the 981 (16.0%) nasopharyngeal swabs were positive for HCoVs. The species detected were 229E (96 cases, 9.8%), OC43 (42 cases, 4.3%), HKU1 (16 cases, 1.6%) and NL63 (11 cases, 1.1%). HCoV-229E was circulated in 21 of the 24 months of surveillance. The detection rates for both OC43 and NL63 were showed significantly year-to-year variation between 2009/10 and 2010/11, respectively (P<0.001 and P = 0.003), and there was a higher detection frequency of HKU1 in patients aged over 60 years (P = 0.03). 48 of 157(30.57%) HCoV positive patients were co-infected. Undifferentiated human rhinoviruses and influenza (Flu) A were the most common viruses detected (more than 35%) in HCoV co-infections. Respiratory syncytial virus (RSV), human parainfluenza virus (PIV) and HBoV were detected in very low rate (less than 1%) among adult patients with URTI.Conclusions/SignificanceAll 4 non-SARS-associated HCoVs were more frequently detected by real-time RT-PCR assay in adults with URTI in Beijing and HCoV-229E led to the most prevalent infection. Our study also suggested that all non-SARS-associated HCoVs contribute significantly to URTI in adult patients in China.

Highlights

Human coronaviruses (HCoVs) are enveloped viruses with a single-strand RNA genome [1]. 5 species are known to infect humans, 229E and OC43 first were identified in the 1960s, NL63 and HKU1 identified in 2004 and 2005, respectively [1,2,3], and SARS-CoV was identified during the severe acute respiratory syndrome epidemic in 2003 [4,5]
Our study suggested that all non-SARSassociated human coronaviruses (HCoVs) contribute significantly to upper respiratory tract infection (URTI) in adult patients in China
HCoVs were detected by realtime reverse transcription (RT)-PCR in 157 (16.0%) of the 981 specimens: 229E in 96 (9.8%), OC43 in 42 (4.3%), HKU1 in 16 (1.6%) and NL63 in 11(1.1%)

Summary

Introduction

Human coronaviruses (HCoVs) are enveloped viruses with a single-strand RNA genome [1]. 5 species are known to infect humans, 229E and OC43 first were identified in the 1960s, NL63 and HKU1 identified in 2004 and 2005, respectively [1,2,3], and SARS-CoV was identified during the severe acute respiratory syndrome epidemic in 2003 [4,5]. HCoVs are associated with respiratory syndromes ranging from mild upper to severe lower respiratory tract infections including pneumonia and bronchiolitis [1,6,7,8,9]. Most studies have focused on children or adults with more serious respiratory disease including lower respiratory tract infections [1,17,18,19,20,21,22]. Upper respiratory tract infections (URTI) or ‘‘the common cold’’ are a significant health burden, especially among children. In addition to SARS associated coronaviruses, 4 non-SARS related human coronaviruses (HCoVs) are recognized as common respiratory pathogens. The etiology and clinical impact of HCoVs in Chinese adults with acute upper respiratory tract infection (URTI) needs to be characterized systematically by molecular detection with excellent sensitivity

Methods

Results

Conclusion