Epidemiology of Severe Acute Respiratory Syndrome Coronavirus 2 Emergence Amidst Community-Acquired Respiratory Viruses. (29th July 2020)

• Record Type: Journal Article
• Authors: Leuzinger, Karoline; Roloff, Tim; Gosert, Rainer; Sogaard, Kirstin; Naegele, Klaudia; Rentsch, Katharina; Bingisser, Roland; Nickel, Christian H; Pargger, Hans; Bassetti, Stefano; Bielicki, Julia; Khanna, Nina; Tschudin Sutter, Sarah; Widmer, Andreas; Hinic, Vladimira; Battegay, Manuel; Egli, Adrian; Hirsch, Hans H
• Is Part Of: Journal of infectious diseases. Volume 222:Number 8(2020)
• Page Start: 1270
• Page End: 1279
• Publication Date: 2020-07-29
• Subjects: COVID-19 -- respiratory virus -- multiplex -- nucleic acid testing -- coinfection; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jiaa464
• Languages: English
• ISSNs: 0022-1899

Abstract

Abstract: Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in China as the cause of coronavirus disease 2019 in December 2019 and reached Europe by late January 2020, when community-acquired respiratory viruses (CARVs) are at their annual peak. We validated the World Health Organization (WHO)–recommended SARS-CoV-2 assay and analyzed the epidemiology of SARS-CoV-2 and CARVs. Methods: Nasopharyngeal/oropharyngeal swabs (NOPS) from 7663 patients were prospectively tested by the Basel S-gene and WHO-based E-gene (Roche) assays in parallel using the Basel N-gene assay for confirmation. CARVs were prospectively tested in 2394 NOPS by multiplex nucleic acid testing, including 1816 (75%) simultaneously for SARS-CoV-2. Results: The Basel S-gene and Roche E-gene assays were concordant in 7475 cases (97.5%) including 825 (11%) SARS-CoV-2 positives. In 188 (2.5%) discordant cases, SARS-CoV-2 loads were significantly lower than in concordant positive ones and confirmed in 105 (1.4%). Adults were more frequently SARS-CoV-2 positive, whereas children tested more frequently CARV positive. CARV coinfections with SARS-CoV-2 occurred in 1.8%. SARS-CoV-2 replaced CARVs within 3 weeks, reaching 48% of all detected respiratory viruses followed by rhinovirus/enterovirus (13%), influenza virus (12%), coronavirus (9%), respiratory syncytial virus (6%), and metapneumovirus (6%). Conclusions: Winter CARVs were dominant during the early SARS-CoV-2 pandemic, impacting infection control and treatment decisions, but were rapidly replaced, suggesting competitive infection. We hypothesize that preexisting immune memory and innate immune interference contribute to the different SARS-CoV-2 epidemiology among adults and children. Abstract : Community-acquired respiratory viruses were dominant during the early severe acute respiratory syndrome coronavirus 2 pandemic in winter 2020, but were rapidly replaced, suggesting competitive infection. Preexisting immune memory and innate immune interference may contribute to the different epidemiology among adults and children.