低收入和中等收入国家五岁以下儿童死亡中地方性人类冠状病毒（HCoV-NL63、OC43、229E和HKU-1）的尸检研究：儿童健康与死亡率预防监测（CHAMPS）研究的结果

Post-mortem study of endemic human coronaviruses (HCoV-NL63, OC43, 229E and HKU-1) in deaths of children under five in low- and middle-income countries: Findings from the Child Health and Mortality Prevention Surveillance (CHAMPS) study.

作者信息

Baillie Vicky, Dangor Ziyaad, Blau Dianna M, Mahtab Sana, du Toit Jeanie, Assefa Nega, Oundo Joseph, Kidanemariam Zelalem Teklemariam, Scott J Anthony G, Ameh Soter, Ogbuanu Ikechukwu Udo, Ojulong Julius, Bunn James, Kotloff Karen L, Sow Samba O, Tapia Milagritos D, Keita Adama Mamby, Garrine Marcelino, Mandomando Inacio, Varo Rosauro, Xerinda Elisio G, Rakislova Natalia, Alam Muntasir, El Arifeen Shams, Gurley Emily S, Hossain Mohammad Zahid, Rahman Afruna, Akelo Victor, Onyango Clayton, Onyango Dickens, Mutevedzi Portia C, Whitney Cynthia G, Bassat Quique, Madhi Shabir A

机构信息

South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Johannesburg, South Africa.

Global Health Center, Centers for Disease Control and Prevention, Atlanta, GA, USA.

出版信息

J Clin Virol. 2025 Jun;178:105804. doi: 10.1016/j.jcv.2025.105804. Epub 2025 May 27.

DOI:10.1016/j.jcv.2025.105804

PMID:40460588

Abstract

BACKGROUND

Endemic human coronaviruses (HCoV-229E, HKU1, NL63, and OC43) are common causes of mild or asymptomatic respiratory infections in children but are considered rare causes of death.

METHODS

We evaluated pediatric deaths from January 2017 through December 2022. A panel of experts determined the cause of death (CoD) by reviewing available data, including pathological and molecular findings from minimally invasive tissue sampling (lung tissues, blood, CSF, and nasopharyngeal swabs), clinical records, and verbal autopsies.

RESULTS

Endemic HCoV were detected in the respiratory samples of 3 % (n = 86/3357) of enrolled decedents: 1 % (n = 12/2043) of neonates, 5 % (n = 35/681) of infants and 6 % (n = 39/633) of children deaths. However, HCoVs were attributed as the CoD in only two cases - both involving young infants with underlying birth defects and severe wasting, who succumbed to polymicrobial hospital-acquired infections involving HCoV-OC43, Klebsiella pneumoniae, and Acinetobacter baumannii. Amongst the remaining 84 decedents in whom an HCoV was detected, 82 % (n = 69/84; median Ct of 25.34; range: 15.28-36.17) were deaths attributed to other infections, including 54 % (n = 32/69; median Ct of 23.86; range: 15.28-35.2) with lower respiratory infections determined to be the CoD. The bulk of these deaths (96 %, n = 66/69) were attributed to other pathogens - Plasmodium falciparum (27 %, n = 19/69), K. pneumoniae (23 %, n = 16/69), Streptococcus pneumoniae (20 %, n = 14/69), Escherichia coli (16 %, n = 11/69) and Cytomegalovirus (10 %, n = 7/69).

CONCLUSION

Although endemic HCoV was identified in children who died of respiratory infections, it was rarely attributed to being in the CoD. Nevertheless, further research is warranted to explore the potential role of HCoVs in LRTI pathogenesis and their impact on facilitating more pathogenic infections.

摘要

背景

地方性人类冠状病毒（HCoV - 229E、HKU1、NL63和OC43）是儿童轻度或无症状呼吸道感染的常见病因，但被认为是罕见的死亡原因。

方法

我们评估了2017年1月至2022年12月期间的儿科死亡病例。一个专家小组通过审查可用数据来确定死亡原因（CoD），这些数据包括来自微创组织采样（肺组织、血液、脑脊液和鼻咽拭子）的病理和分子结果、临床记录以及口头尸检。

结果

在登记的死者的呼吸道样本中，3%（n = 86/3357）检测到地方性HCoV：新生儿中为1%（n = 12/2043），婴儿中为5%（n = 35/681），儿童死亡病例中为6%（n = 39/633）。然而，只有两例死亡病例将HCoV列为CoD——均涉及有潜在出生缺陷和严重消瘦的幼儿，他们死于包括HCoV - OC43、肺炎克雷伯菌和鲍曼不动杆菌在内的多种微生物医院获得性感染。在其余84例检测到HCoV的死者中，82%（n = 69/84；中位数Ct为25.34；范围：15.28 - 36.17）的死亡归因于其他感染，其中54%（n = 32/