Yonsei Med J.  2017 Jan;58(1):174-179. 10.3349/ymj.2017.58.1.174.

Human Coronavirus in the 2014 Winter Season as a Cause of Lower Respiratory Tract Infection

• Kim KY
• Han SY
• Kim HS
• Cheong HM
• Kim SS
• Kim DS

• KMID: 2374204
• DOI: http://doi.org/10.3349/ymj.2017.58.1.174

Abstract

PURPOSE
During the late autumn to winter season (October to December) in the Republic of Korea, respiratory syncytial virus (RSV) is the most common pathogen causing lower respiratory tract infections (LRTIs). Interestingly, in 2014, human coronavirus (HCoV) caused not only upper respiratory infections but also LRTIs more commonly than in other years. Therefore, we sought to determine the epidemiology, clinical characteristics, outcomes, and severity of illnesses associated with HCoV infections at a single center in Korea.
MATERIALS AND METHODS
We retrospectively identified patients with positive HCoV respiratory specimens between October 2014 and December 2014 who were admitted to Severance Children's Hospital at Yonsei University Medical Center for LRTI. Charts of the patients with HCoV infection were reviewed and compared with RSV infection.
RESULTS
During the study period, HCoV was the third most common respiratory virus and accounted for 13.7% of infections. Coinfection was detected in 43.8% of children with HCoV. Interestingly, one patient had both HCoV-OC43 and HCoV-NL63. Mild pneumonia was most common (60.4%) with HCoV, and when combined with RSV, resulted in bronchiolitis. Two patients required care in the intensive care unit. However, compared with that of RSV infection, the disease course HCoV was short.
CONCLUSION
Infections caused by HCoVs are common, and can cause LRTIs. During an epidemic season, clinicians should be given special consideration thereto. When combined with other medical conditions, such as neurologic or cardiologic diseases, intensive care unit (ICU) care may be necessary.

Keyword

Coronavirus; children; clinical severity; respiratory viruses; respiratory syncytial virus

MeSH Terms

Child
Child, Preschool
Coronavirus/*isolation & purification
Coronavirus Infections/epidemiology/*virology
Coronavirus OC43, Human/isolation & purification
Female
Hospitalization
Humans
Infant
Male
Republic of Korea/epidemiology
Respiratory Tract Infections/epidemiology/*virology
Retrospective Studies
Seasons

Figure

• 

  Fig. 1 Age distribution of HCoV and RSV from children <18 years old of age from October 2014 to December 2014. HCoV, human coronavirus; RSV, respiratory syncytial virus.

• 

  Fig. 2 Positive rate of HCoV among respiratory viruses. KCDC, Korean Centers for Disease Control and Prevention; Sev, Severance Children’s Hospital; HCoV, human coronavirus.

Reference

1. Malave A, Elamin EM. Severe Acute Respiratory Syndrome (SARS)-lessons for future pandemics. Virtual Mentor. 2010; 12:719–725.

2. Cleri DJ, Ricketti AJ, Vernaleo JR. Severe acute respiratory syndrome (SARS). Infect Dis Clin North Am. 2010; 24:175–202.

3. Kim T, Jung J, Kim SM, Seo DW, Lee YS, Kim WY, et al. Transmission among healthcare worker contacts with a Middle East respiratory syndrome patient in a single Korean centre. Clin Microbiol Infect. 2016; 22:e11–e13.

4. Ki M. 2015 MERS outbreak in Korea: hospital-to-hospital transmission. Epidemiol Health. 2015; 37:e2015033.

5. Mclntosh K, Englund JA. Coronaviruses and toroviruses, including severe acute respiratory syndrome. In : Cherry J, Demmler-Harrison GJ, Kaplan SL, Steinbach WJ, Hotez P, editors. Feigin and Cherry’s Textbook of pediatric infectious diseases. Philadelphia: Saunders Elsevier;2014. p. 2486–2495.

6. Dijkman R, Jebbink MF, Gaunt E, Rossen JW, Templeton KE, Kuijpers TW, et al. The dominance of human coronavirus OC43 and NL63 infections in infants. J Clin Virol. 2012; 53:135–139.

7. Ham H, Jang J, Jo S, Oh Y, Pak S. Infection frequency and mixed infection on eight viruses from patients with acute respiratory syndromes in Seoul. J Bacteriol Virol. 2014; 44:274–282.

8. Ham H, Jang J, Choi S, Oh S, Jo S, Choi S, et al. Epidemiological characterization of respiratory viruses detected from acute respiratory patients in Seoul. Ann Clin Microbiol. 2013; 16:188–195.

9. Chiu SS, Chan KH, Chu KW, Kwan SW, Guan Y, Poon LL, et al. Human coronavirus NL63 infection and other coronavirus infections in children hospitalized with acute respiratory disease in Hong Kong, China. Clin Infect Dis. 2005; 40:1721–1729.

10. Kristoffersen AW, Nordbø SA, Rognlien AG, Christensen A, Døllner H. Coronavirus causes lower respiratory tract infections less frequently than RSV in hospitalized Norwegian children. Pediatr Infect Dis J. 2011; 30:279–283.

11. Lee J, Storch GA. Characterization of human coronavirus OC43 and human coronavirus NL63 infections among hospitalized children <5 years of age. Pediatr Infect Dis J. 2014; 33:814–820.

12. Greenberg SB. Update on rhinovirus and coronavirus infections. Semin Respir Crit Care Med. 2011; 32:433–446.

13. Gallaher S. SARS: what we have learned so far. Dimens Crit Care Nurs. 2005; 24:51–54.

14. van der Hoek L, Pyrc K, Jebbink MF, Vermeulen-Oost W, Berkhout RJ, Wolthers KC, et al. Identification of a new human coronavirus. Nat Med. 2004; 10:368–373.

15. Pyrc K, Berkhout B, van der Hoek L. Identification of new human coronaviruses. Expert Rev Anti Infect Ther. 2007; 5:245–253.

16. Liu T, Li Z, Zhang S, Song S, Julong W, Lin Y, et al. Viral Etiology of acute respiratory tract infections in hospitalized children and adults in Shandong Province, China. Virol J. 2015; 12:168.

17. Ge X, Han Z, Chen H, Cheng J, Gao M, Sun H. Characterization of acute respiratory infections among 340 infants in Wuxi, Jiangsu Province. Ann Transl Med. 2015; 3:264.

18. Debiaggi M, Canducci F, Ceresola ER, Clementi M. The role of infections and coinfections with newly identified and emerging respiratory viruses in children. Virol J. 2012; 9:247.