Kuypers Jane, Martin Emily T, Heugel Judson, Wright Nancy, Morrow Rhoda, Englund Janet A
Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA.
Pediatrics. 2007 Jan;119(1):e70-6. doi: 10.1542/peds.2006-1406. Epub 2006 Nov 27.
Coronaviruses cause upper respiratory illness and occasionally lower tract disease in susceptible populations. In this study we examined the prevalence of 4 human coronaviruses, including subtypes OC43, 229E, and the recently described NL63 and HKU1 in a pediatric population presenting to a children's hospital.
Specimens collected over a 1-year period from pediatric patients presenting with acute respiratory illness were analyzed for the presence of 4 coronavirus subtypes using consensus and subtype-specific real-time reverse-transcription polymerase chain reaction assays. The demographic and clinical characteristics associated with coronavirus infection were examined retrospectively.
Coronaviruses were detected in 66 of 1043 children. Eight, 11, 19, and 28 specimens were positive for subtypes 229E, NL63, OC43, and HKU1, respectively. Coronaviruses were detected throughout the study period; all 4 of the subtypes were present simultaneously in December. The acute clinical features were similar across subtypes. Of 32 children infected with a coronavirus as the sole respiratory pathogen, 13 had lower respiratory tract disease. Children whose only detectable respiratory virus was a coronavirus were more likely to have underlying chronic disease than were children coinfected with another respiratory virus.
Although 4 subtypes of coronavirus were detected, the recently discovered coronavirus subtypes NL63 and HKU1 accounted for the majority of coronaviruses detected in our cohort of mostly hospitalized children with respiratory symptoms. New subtypes likely represent a substantial portion of previously unexplained respiratory illnesses.
冠状病毒可在易感人群中引起上呼吸道疾病，偶尔也会导致下呼吸道疾病。在本研究中，我们调查了4种人类冠状病毒，包括OC43、229E亚型，以及最近发现的NL63和HKU1在一家儿童医院就诊的儿科人群中的流行情况。
对在1年时间内收集的患有急性呼吸道疾病的儿科患者的样本，使用通用和亚型特异性实时逆转录聚合酶链反应检测法分析4种冠状病毒亚型的存在情况。回顾性研究与冠状病毒感染相关的人口统计学和临床特征。
在1043名儿童中，66名检测出冠状病毒。分别有8份、11份、19份和28份样本对229E、NL63、OC43和HKU1亚型呈阳性。在整个研究期间均检测到冠状病毒；12月时所有4种亚型同时出现。各亚型的急性临床特征相似。在32名仅感染冠状病毒作为唯一呼吸道病原体的儿童中，13名患有下呼吸道疾病。与感染另一种呼吸道病毒的儿童相比，仅检测到冠状病毒作为唯一呼吸道病毒的儿童更有可能患有潜在的慢性疾病。
尽管检测到4种冠状病毒亚型，但在我们这个主要是有呼吸道症状的住院儿童队列中，最近发现的冠状病毒亚型NL63和HKU1占检测到的冠状病毒的大多数。新亚型可能占以前无法解释的呼吸道疾病的很大一部分。
