More than just a common cold: Endemic coronaviruses OC43, HKU1, NL63, and 229E associated with severe acute respiratory infection and fatality cases among healthy adults. Issue 2 (2nd August 2020)

• Record Type: Journal Article
• Authors: Veiga, Ana B. Gorini da; Martins, Letícia G.; Riediger, Irina; Mazetto, Alix; Debur, Maria do Carmo; Gregianini, Tatiana S.
• Other Names: Luo Guangxiang (George) guestEditor.; Ly Hinh guestEditor.; Gao Shou‐Jiang guestEditor.
• Is Part Of: Journal of medical virology. Volume 93:Issue 2(2021)
• Page Start: 1002
• Page End: 1007
• Publication Date: 2020-08-02
• Subjects: coronavirus -- epidemiology -- infection -- respiratory tract; Virology -- Periodicals; 616
• DOI: 10.1002/jmv.26362
• Languages: English
• ISSNs: 0146-6615

Abstract

Abstract: Respiratory viral infection can cause severe disease and hospitalization, especially among children, the elderly, and patients with comorbidities. In Brazil, the official surveillance system of severe acute respiratory infection (SARI) investigates influenza A (IAV) and B (IBV) viruses, respiratory syncytial virus (RSV), adenovirus (HAdV), and parainfluenza viruses (hPIV 1–3). In Rio Grande do Sul (RS), Brazil, many fatalities associated with SARI between 2013 and 2017 occurred among patients without underlying diseases and for whom the causative agent had not been identified using official protocols. This cross‐sectional study analyzed the presence of coronaviruses (HCoV), bocavirus (HBoV), metapneumovirus (hMPV), and rhinovirus in patients who died of SARI despite not having comorbidities, and that were negative for IAV, IBV, RSV, HAdV, and hPIV. Nasopharyngeal aspirates/swabs from patients were used for nucleic acid extraction. The presence of HCoVs OC43, HKU1, NL63, and 229E; HBoV; hMPV; and rhinovirus was assessed by quantitative reverse transcription‐polymerase chain reaction. Clinical data were also analyzed. Between 2013 and 2017, 16 225 cases of SARI were reported in RS; 9.8% of the patients died; 20% of all fatal cases were patients without comorbidities and for whom no pathogen was detected using standard protocols. Analysis of 271 of these cases identified HCoV in nine cases; HBoV, hMPV, and rhinovirus were detected in 3, 3, and 10 cases, respectively. Of note, patients infected with HCoV were adults. Results reinforce the importance of including coronaviruses in diagnostic panels used by official surveillance systems because besides their pandemic potential, endemic HCoVs are associated to severe disease in healthy adults. Highlights: Endemic coronaviruses OC43, HKU1, NL63, and 229E are associated with fatality cases of severe acute respiratory infection in adults with no underlying diseases. Respiratory viruses commonly associated to mild disease can cause severe respiratory infection and death in healthy adults. Epidemiological and molecular surveillance of respiratory viruses, including non‐influenza viruses, is important for disease control and prevention.