Department of Medicine, Rochester General Hospital.
J Infect Dis. 2013 Nov 15;208(10):1634-42. doi: 10.1093/infdis/jit393. Epub 2013 Aug 6.
The incidence and clinical impact of coronavirus (CoV) infection in elderly persons and those with underlying cardiopulmonary disease over a long duration is not well described. We determined the incidence and clinical impact of 229E and OC43 CoV in this population during 4 consecutive winters, and compared illnesses to influenza A, respiratory syncytial virus, and human metapneumovirus.
CoV 229E and OC43 were detected by reverse transcription polymerase chain reaction and serology in 4 adult populations under surveillance for acute respiratory illness during the winters of 1999-2003. Cohorts included healthy young adults, healthy elderly adults, high-risk adults with underlying cardiopulmonary disease, and a hospitalized group.
Three hundred ninety-eight CoV infections were identified, with annual infection rates ranging from 2.8% to 26% in prospective cohorts, and prevalence ranging from 3.3% to 11.1% in the hospitalized cohort. The incidence of infections with each strain was similar, although asymptomatic infection and viral coinfection was significantly more common with 229E than OC43 infection. Although the incidence and clinical manifestations were similar for each strain, OC43-infected subjects tended to seek more medical care, as OC43 was twice as common as 229E among the hospitalized cohort.
CoV infections in the elderly are frequent, likely causing substantial medical disease burden.
长期以来，老年人和患有潜在心肺疾病的人感染冠状病毒（CoV）的发病率和临床影响尚未得到充分描述。我们在连续四个冬季确定了 229E 和 OC43 CoV 在该人群中的发病率和临床影响，并将疾病与甲型流感、呼吸道合胞病毒和人类偏肺病毒进行了比较。
在 1999-2003 年冬季对急性呼吸道疾病进行监测的四个成年人群中，通过逆转录聚合酶链反应和血清学检测到 CoV 229E 和 OC43。队列包括健康的年轻成年人、健康的老年成年人、患有潜在心肺疾病的高危成年人和住院组。
共发现 398 例 CoV 感染，前瞻性队列的年感染率从 2.8%到 26%不等，住院队列的患病率从 3.3%到 11.1%不等。两种菌株的感染发生率相似，尽管无症状感染和病毒合并感染在 229E 中比 OC43 感染更为常见。尽管两种菌株的发病率和临床表现相似，但 OC43 感染的患者往往寻求更多的医疗护理，因为 OC43 在住院患者中的发病率是 229E 的两倍。
老年人 CoV 感染很常见，可能会导致大量的医疗疾病负担。
