Epidemiology and clinical characteristics of human coronaviruses OC43, 229E, NL63, and HKU1: a study of hospitalized children with acute respiratory tract infection in Guangzhou, China

Abstract

Human coronaviruses (HCoV) OC43, 229E, NL63, and HKU1 are common respiratory viruses which cause various respiratory diseases, including pneumonia. There is a paucity of evidence on the epidemiology and clinical manifestations of these four HCoV strains worldwide. We collected 11,399 throat swabs from hospitalized children with acute respiratory tract infection from July 2009 to June 2016 in Guangzhou, China. These were tested for four strains of HCoV infection using real-time polymerase chain reaction (PCR). HCoV-positive patients were then tested for 11 other respiratory pathogens. 4.3% (489/11399) of patients were positive for HCoV, of which 3.0% were positive for OC43 (346/11399), 0.6% for 229E (65/11399), 0.5% for NL63 (60/11399), and 0.3% for HKU1 (38/11399). Patients aged 7–12 months had the highest prevalence of HCoV and OC43 when compared with other age groups (p < 0.001). The peak seasons of infection varied depending on the HCoV strain. Patients infected with a single strain of HCoV infection were less likely to present fever (≥ 38 °C) (p = 0.014) and more likely to present pulmonary rales (p = 0.043) than those co-infected with more than one HCoV strain or other respiratory pathogens. There were also significant differences in the prevalence of certain symptoms, including coughing (p = 0.032), pneumonia (p = 0.026), and abnormal pulmonary rales (p = 0.002) according to the strain of HCoV detected. This retrospective study of the prevalence of four HCoV strains and clinical signs among a large population of pediatric patients in a subtropical region of China provides further insight into the epidemiology and clinical features of HCoV.

Severity of coronavirus respiratory tract infections in adults admitted to acute care in Toronto, Ontario

“…This is further supported by phylogenetic data examining OC43 isolates, which showed that the circulating genotypes in southeast Asia changed over time [9]. A recent study in the midwestern USA reported frequent identification of HKU1, whereas a separate study from China reported OC43 to be more prevalent [10,11]. Therefore, determining the regional prevalence is important to understand the burden of these infections.…”

SARS-CoV-2: fear versus data

“…Coronaviridae represent a very important family of animal and human viruses [1,2] that are in permanent circulation. Four common human coronaviruses (HKU1, NL63, OC43 and E229) cause 10-20% of respiratory infections worldwide and are present in all continents [3][4][5][6][7][8][9][10][11][12][13][14] ( Table 1). Mortality is poorly assessed, but it is clear that there are chronic carriers as well as asymptomatic carriers.…”

Discovery of a subgenotype of human coronavirus NL63 associated with severe lower respiratory tract infection in China, 2018

“…Outbreak of severe respiratory infections among children caused by HCoV-NL63 is rarely reported [27,28]. In China, HCoVs (OC43, NL63, HKU1 and 229E) are responsible to about 4.3% of hospitalized children with acute respiratory tract infection [13], and HCoV-OC43 was the predominant circulating HCoV. Little is known about the genetic variability of HCoV-NL63 in China and worldwide since only a few complete genomes are available [10,15,29].…”

“…All the respiratory samples were first screened for HCoV-NL63 infection using TaqMan real-time PCR assays (Guangzhou HuYanSuo Medical Technology Co., Ltd.) [13,15]. HCoV-NL63 positive samples were simultaneously tested for 14 other common respiratory pathogens, including HCoV-229E, HCoV-OC43, HCoV-HKU1, influenza A virus (Flu A), influenza B virus (Flu B), enterovirus (EV), human bocavirus (HBoV), human rhinovirus (HRV), respiratory syncytial virus (RSV), adenovirus (ADV), four types of human parainfluenza virus (HPIV), Mycoplasma pneumoniae (MP), human metapneumovirus (HMPV) and Chlamydia pneumonia (CP).…”

“…Neutralizing activity directed against HCoV-NL63 is common in sera from adults and rarely in infant's serum [12]. During 2009 and 2016, HCoV-NL63 accounted for about 0.5% (60/11399) of all acute respiratory tract infections in hospitalized pediatric patients in Guangzhou, China [13], most of these cases associated with HCoV-NL63 were considered to be evidence of endemic infection and no outbreaks were reported.…”