Kanwar Anubhav, Selvaraju Suresh, Esper Frank
Department of Internal Medicine, Division of Infectious Diseases and HIV Medicine and.
Department of Pathology, MetroHealth Medical Center, Cleveland, Ohio.
Open Forum Infect Dis. 2017 Mar 25;4(2):ofx052. doi: 10.1093/ofid/ofx052. eCollection 2017 Spring.
Human coronaviruses (CoV) have been long recognized as a common cause of respiratory tract disease including severe respiratory tract illness. Coronavirus-HKU1 has been described predominantly among children less than 5 years of age in the United States with few studies characterizing the disease spectrum among adults.
Nasopharyngeal specimens of patients with respiratory symptoms were analyzed for CoV-HKU1 by NxTAG Respiratory Pathogen Panel multiplex assay from February 7, 2016 to April 30, 2016. Epidemiologic, clinical, and laboratory data were collected on adults (patients >18 years) whose samples screened positive.
Of 832 adult respiratory specimens screened, 13 (1.6%) cases of CoV-HKU1 were identified. Adults age ranged between 23 and 75 years and 6 (46%) were males. All of whom had 1 or more respiratory symptoms, and 5 (38%) also reported 1 or more gastrointestinal symptoms. Eleven (85%) reported history of smoking and 5 (38%) used inhaled steroids. Seven (54%) required hospitalization, 5 (71%) of these needed supplemental oxygen, and 2 (29%) were admitted to intensive care. Median length of hospitalization was 5 days. Eight (62%) received antibiotics despite identification of CoV-HKU1. Infectious work-up in 1 patient who died did not reveal any other pathogen. In 2 (15%) CoV-HKU1-positive adults, the only viral coinfection detected was influenza A.
Coronavirus-HKU1 accounted for 1.6% of adult respiratory infections and should be considered in differential diagnosis of severe respiratory illnesses among adults.
人类冠状病毒(CoV)长期以来一直被认为是包括严重呼吸道疾病在内的呼吸道疾病的常见病因。在美国,冠状病毒-HKU1主要在5岁以下儿童中被发现,针对成人疾病谱特征的研究较少。
2016年2月7日至2016年4月30日期间,采用NxTAG呼吸道病原体检测板多重检测法对有呼吸道症状患者的鼻咽标本进行冠状病毒-HKU1分析。收集样本筛查呈阳性的成人(年龄>18岁)的流行病学、临床和实验室数据。
在832份成人呼吸道标本筛查中,鉴定出13例(1.6%)冠状病毒-HKU1感染病例。成人年龄在23至75岁之间,6例(46%)为男性。所有患者均有1种或更多呼吸道症状,5例(38%)还报告有1种或更多胃肠道症状。11例(85%)有吸烟史,5例(38%)使用吸入性类固醇。7例(54%)需要住院治疗,其中5例(71%)需要补充氧气,2例(29%)入住重症监护病房。住院时间中位数为5天。尽管鉴定出冠状病毒-HKU1,仍有8例(62%)接受了抗生素治疗。1例死亡患者的感染检查未发现任何其他病原体。在2例(15%)冠状病毒-HKU1阳性成人中,检测到的唯一病毒合并感染是甲型流感。
冠状病毒-HKU1占成人呼吸道感染的1.6%,在成人严重呼吸道疾病的鉴别诊断中应予以考虑。