A Longitudinal Study of the Epidemiology of Seasonal Coronaviruses in an African Birth Cohort

Abstract

Background Since non-epidemic, seasonal human coronaviruses (sHCoV) commonly infect children, an improved understanding of the epidemiology of these infections may offer insights into the context of severe acute respiratory syndrome (SARS)-CoV-2. We investigated the epidemiology of sHCoV infection during the first year of life, including risk factors and association with lower respiratory tract infection (LRTI). Methods We conducted a nested case-control study of infants enrolled in a birth cohort near Cape Town, South Africa, from 2012 to 2015. LRTI surveillance was implemented, and nasopharyngeal swabs were collected fortnightly over infancy. Quantitative PCR detected respiratory pathogens, including coronaviruses-229E, -NL63, -OC43, and -HKU1. Swabs were tested from infants at the time of LRTI and from the 90 days prior as well as from age-matched control infants from the cohort over the equivalent period. Results In total, 885 infants were included, among whom 464 LRTI events occurred. Of the 4751 samples tested for sHCoV, 9% tested positive, with HCoV-NL63 the most common. Seasonal HCoV detection was associated with LRTI; this association was strongest for coronavirus-OC43, which was also found in all sHCoV-associated hospitalizations. Birth in winter was associated with sHCoV-LRTI, but there were no clear seasonal differences in detection. Co-detection of Streptococcus pneumoniae was weakly associated with sHCoV-LRTI (odds ratio: 1.8; 95% confidence interval: 0.9-3.6); detection of other respiratory viruses or bacteria was not associated with sHCoV status. Conclusions Seasonal HCoV infections were common and associated with LRTI, particularly sHCoV-OC43, which is most closely related to the SARS group of coronaviruses. Interactions of coronaviruses with bacteria in the pathogenesis of LRTI require further study.

Seroprofiling of Antibodies Against Endemic Human Coronaviruses and Severe Acute Respiratory Syndrome Coronavirus 2 in a Human Immunodeficiency Virus Cohort in Lesotho: Correlates of Antibody Response and Seropositivity

“…Prior data on HCoV seasonality in southern Africa are limited. Most previous studies focus on specific, symptomatic populations—notably young children with influenzalike illness [ 8 , 9 , 20 , 21 ]—and few provide serological data. In the present analysis, antibody responses to endemic HCoVs appear to increase over time and peak in winter and spring.…”

Antibodies to Seasonal Coronaviruses Rarely Cross-React With SARS-CoV-2

“…The data on lack of cross-reactivity between different sHCoV also support our previous finding that infection with different sHCoV occurs within short intervals of each other. 10 …”

“…The data on lack of cross-reactivity between different sHCoV also support our previous finding that infection with different sHCoV occurs within short intervals of each other. 10 Several explanations have been proposed for lower rates of infection and mild disease from SARS-CoV-2 globally in children. These include testing practices with lower case ascertainment due to asymptomatic or mild disease, 1 lower expression of angiotensin-converting-enzyme-2 viral receptor in pediatric compared with adult airway epithelial cells, 14 more robust innate immune responses in children 8 or induction of trained immunity following BCG immunization or infection, 15 that protects against SARS-CoV-2 disease.…”

“…We recently reported the epidemiology of sHCoV infection in infants preceding the COVID-19 pandemic in an African birth cohort, the Drakenstein Child Health study (DCHS). 10 By leveraging this unique dataset and matching biobank of samples, we investigated cross-reactivity of antibodies induced by PCR-confirmed sHCoV infection prior to the COVID pandemic against SARS-CoV-2.…”

Differential pre-pandemic IgA reactivity against SARS-CoV-2 and circulating human coronaviruses measured in milk collected in Uganda and the USA

“…A molecular surveillance in neighboring Kenya during 2009-2012 demonstrated overall HCoVs prevalence of 8.4 % among which HCoV OC43 predominated [35]. A molecular longitudinal study of seasonal coronaviruses in South African infants demonstrated an association between HCoV-OC43 and lower respiratory tract infections [36]. About one in two rural Ghanaians had IgG against three HCoVs with antibodies against HCoV-229E and HCoV-OC43 predominating [37].…”