Epidemiological and clinical features of human coronavirus in hospitalized children with respiratory infections in Chongqing

Abstract

Objective To detect the existence of Middle East respiratory syndrome coronavirus (MERS-CoV) in the hospitalized children with respiratory infection in Chongqing area and study the clinical symptoms associated with the detection of 4 human coronaviruses (HCoV): HCoV-229E, HCoV-OC43, HCoV-NL63 and HCoV-HKU1 types. Methods Nasopharyngeal aspirates collected over a 4-year period (from Jul.2009 to Jun.2013) from pediatric inpatients with respiratory infection were analyzed for the presence of 5 coronavirus subtypes by using multi-nested polymerase chain reaction and sensitive real-time polymerase chain reaction assays.The clinical characteristics associated with coronavirus infection were examined. Results MERS-CoV was not found and other 4 coronaviruses were positive in 74(3.38%) of 2 188 children, in which 31(1.42%), 21(0.96%), 6(0.27%) and 15 (0.69%) specimens were positive for subtypes HCoV-229E, HCoV-NL63, HCoV-OC43, and HCoV-HKU1, respectively, and 1 case was co-detected with HCoV-229E and HCoV-NL63.HCoV infection was sporadic in the whole year, of which HCoV-229E and HCoV-NL63 infection mainly occurred in summer and autumn, while HCoV-OC43 in summer and HCoV-HKU1 in winter.Of the 74 children, 56(75.7%) were male, 36(48.6%)were at ages of 0-6 months and 19(25.7%)at 7-12 months, and 20(27.0%) had underlying diseases .The clinical symptoms of HCoV infection included cough(66/74 cases, 89.2%), sputum(53/74 cases, 71.6%), wheezing(39/74 cases, 52.7%), fever(33/74 cases, 44.6%)and diarrhea(26/74 cases, 35.1%). Most patients were diagnosed as pneumonia(54/74 cases, 73.0%), including 10 cases of severe pneumonia.Fifty patients were co-infected with another respiratory virus, in which respiratory syncytial virus was the mostly detected.HKU1 was the most likely to detect in the co-infected group.Patients who were co-infected with another respiratory virus were more likely to have cough and wheezing than sole-infected patients (P<0.05). Conclusions No MERS-CoV existed in the hospitalized children with respiratory infection in Chongqing area and HCoV-229E, HCoV-OC43, HCoV-NL63 and HCoV-HKU1 are of low prevalent.HCoV that primarily infects male infants less than 1 year old and lead to lower respiratory tract infection, especially in children with underlying diseases and plays a role in severe pneumonia disease. Key words: Middle East respiratory syndrome coronavirus; Coronavirus; Molecular epidemiology; Respiratory infection; Child