From the Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim.
Department of Medical Microbiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim.
Pediatr Infect Dis J. 2022 Mar 1;41(3):e95-e101. doi: 10.1097/INF.0000000000003433.
The clinical impact of common human coronavirus (cHCoV) remains unclear. We studied the clinical manifestations of pediatric cHCoV infections and the possible modifying effects of codetected human rhinovirus (RV) and respiratory syncytial virus (RSV).
We used data from an 11-year-long prospective study of hospitalized children with community-acquired respiratory tract infections. Nasopharyngeal aspirates were analyzed with real-time polymerase chain reaction assay for cHCoV OC43, NL63, HKU1 and 229E, and 15 other respiratory viruses. We assessed disease severity based on the clinical factors hospitalization length, oxygen requirement, other respiratory support and supplementary fluids.
cHCoV was detected in 341 (8%) of 4312 children. Among 104 children with single cHCoV detections, 58 (56%) had lower respiratory tract infection (LRTI) and 20 (19%) developed severe disease. The proportion with severe disease was lower among single cHCoV detections compared with single RSV detections (338 of 870; 39%), but similar to single RV detections (136 of 987; 14%). Compared with single cHCoV, codetected cHCoV-RSV was more often associated with LRTI (86 of 89; 97%) and severe disease (adjusted odds ratio, 3.3; 95% confidence interval: 1.6-6.7). LRTI was more frequent in codetected cHCoV-RV (52 of 68; 76%) than single cHCoV, but the risk of severe disease was lower (adjusted odds ratios, 0.3; 95% confidence interval: 0.1-1.0).
cHCoV was associated with severe LRTI in hospitalized children. Viral codetections were present in two-thirds. Codetections of cHCoV-RV were associated with lower proportions of severe disease, suggesting a modifying effect of RV on HCoV.
常见人类冠状病毒（cHCoV）的临床影响仍不清楚。我们研究了儿科 cHCoV 感染的临床表现，以及可能的合并检测到的人类鼻病毒（RV）和呼吸道合胞病毒（RSV）的修饰作用。
我们使用了一项长达 11 年的前瞻性研究中住院的儿童社区获得性呼吸道感染的数据分析。使用实时聚合酶链反应分析鼻咽抽吸物中 cHCoV OC43、NL63、HKU1 和 229E，以及其他 15 种呼吸道病毒。我们根据临床因素住院时间、氧需求、其他呼吸支持和补充液体来评估疾病严重程度。
在 4312 例儿童中，有 341 例（8%）检测到 cHCoV。在 104 例单一 cHCoV 检测的儿童中，有 58 例（56%）为下呼吸道感染（LRTI），有 20 例（19%）发展为严重疾病。与单一 RSV 检测相比，单一 cHCoV 检测的严重疾病比例较低（870 例中有 338 例，39%），但与单一 RV 检测相似（987 例中有 136 例，14%）。与单一 cHCoV 相比，合并检测到的 cHCoV-RSV 更常与 LRTI（89 例中有 86 例，97%）和严重疾病（调整后的优势比，3.3；95%置信区间：1.6-6.7）相关。在合并检测到的 cHCoV-RV 中，LRTI 更为常见（68 例中有 52 例，76%），但严重疾病的风险较低（调整后的优势比，0.3；95%置信区间：0.1-1.0）。
cHCoV 与住院儿童严重的 LRTI 有关。三分之二的病毒合并检测。cHCoV-RV 的合并检测与较低的严重疾病比例相关，提示 RV 对 HCoV 有修饰作用。
