Dominguez Samuel R, Robinson Christine C, Holmes Kathryn V
Department of Pediatrics, The Children's Hospital, University of Colorado Denver School of Medicine, Aurora, CO 80045, USA.
J Med Virol. 2009 Sep;81(9):1597-604. doi: 10.1002/jmv.21541.
Lower respiratory tract infections are the leading cause of death in children worldwide. Studies on the epidemiology and clinical associations of the four human non-SARS human coronaviruses (HCoVs) using sensitive polymerase chain reaction (PCR) assays are needed to evaluate the clinical significance of HCoV infections worldwide. Pediatric respiratory specimens (1,683) submitted to a diagnostic virology laboratory over a 1-year period (December 2004-November 2005) that were negative for seven respiratory viruses by conventional methods were tested for RNA of four HCoVs using sensitive RT-PCR assays. Coronavirus RNAs were detected in 84 (5.0%) specimens: HCoV-NL63 in 37 specimens, HCoV-OC43 in 34, HCoV-229E in 11, and HCoV-HKU1 in 2. The majority of HCoV infections occurred during winter months, and over 62% were in previously healthy children. Twenty-six (41%) coronavirus positive patients had evidence of a lower respiratory tract infection (LRTI), 17 (26%) presented with vomiting and/or diarrhea, and 5 (8%) presented with meningoencephalitis or seizures. Respiratory specimens from one immunocompromised patient were persistently positive for HCoV-229E RNA for 3 months. HCoV-NL63-positive patients were nearly twice as likely to be hospitalized (P = 0.02) and to have a LRTI (P = 0.04) than HCoV-OC43-positive patients. HCoVs are associated with a small, but significant number (at least 2.4% of total samples submitted), of both upper and lower respiratory tract illnesses in children in Colorado. Our data raise the possibility that HCoV may play a role in gastrointestinal and CNS disease. Additional studies are needed to investigate the potential roles of HCoVs in these diseases.
下呼吸道感染是全球儿童死亡的主要原因。需要开展研究，利用灵敏的聚合酶链反应（PCR）检测方法，对四种人类非SARS冠状病毒（HCoV）的流行病学和临床关联进行评估，以评价全球范围内HCoV感染的临床意义。在一年期间（2004年12月至2005年11月）提交至一家诊断病毒学实验室的1683份儿科呼吸道标本，经传统方法检测对七种呼吸道病毒呈阴性，利用灵敏的逆转录PCR（RT-PCR）检测方法对四种HCoV的RNA进行了检测。在84份（5.0%）标本中检测到冠状病毒RNA：37份标本中检测到HCoV-NL63，34份中检测到HCoV-OC43，11份中检测到HCoV-229E，2份中检测到HCoV-HKU1。大多数HCoV感染发生在冬季月份，超过62%的感染发生在之前健康的儿童中。26例（41%）冠状病毒阳性患者有下呼吸道感染（LRTI）的证据，17例（26%）出现呕吐和/或腹泻，5例（8%）出现脑膜脑炎或癫痫发作。一名免疫功能低下患者的呼吸道标本连续3个月对HCoV-229E RNA呈阳性。HCoV-NL63阳性患者住院（P = 0.02）和发生LRTI（P = 0.04）的可能性几乎是HCoV-OC43阳性患者的两倍。在科罗拉多州的儿童中，HCoV与数量虽少但相当显著（至少占提交总样本的2.4%）的上呼吸道和下呼吸道疾病相关。我们的数据增加了HCoV可能在胃肠道和中枢神经系统疾病中起作用的可能性。需要开展更多研究来调查HCoV在这些疾病中的潜在作用。
