1298. Epidemiology and Clinical Characteristics of Human Coronavirus
Session: Poster Abstract Session: Viral Epidemiology
Saturday, October 22, 2011
Room: Poster Hall B1
Background: Human coronavirus (HCoV) is a cause of the common cold similar to rhinovirus. Emergence of severe acute respiratory syndrome (SARS) epidemic has renewed interest in this pathogen. Data on epidemiology and clinical features of HCoV are limited in adult populations. This is a comprehensive study of HCoV infections spanning 4 years in inpatient and outpatient populations with comparison to influenza A (Flu A), RSV and human metapneumovirus (hMPV) infections.

Methods: Prospective cohorts included three groups: healthy adults ≥65 yo, adults with chronic cardiopulmonary disease, and healthy adults 19 to 40 yo. Subjects were evaluated for symptoms of acute respiratory illness (ARI) from November 15 to April 15 for the years 1999 to 2003. During the same period hospitalized patients who were ≥ 65 yo or had underlying cardiopulmonary disease were also recruited. HCoV 229E and OC43 infection were diagnosed by + nasal RT-PCR or >4-fold rises in serum HCoV-specific IgG. HCoV illness characteristics and outcomes were compared with other viral infections.

Results: Over 4 years, 2920 patients were recruited. HCoV infections accounted for 13.5% of ARI in the healthy elderly, 10.5% of adults with cardiopulmonary disease, and 14.6% of young healthy adults. In contrast, 5% of hospitalized patients were infected with HCoV. Asymptomatic HCoV serologic responses comprised 29.4% of infections in prospective cohorts and were significantly more common than with Flu A or RSV. HCoV caused typical upper respiratory tract symptoms, with lower rates of cough, wheezing, and antibiotic use than Flu A, RSV, or hMPV. Of patients hospitalized with HCoV, the mean age was 73 years and 90% had underlying cardiopulmonary disease. Although a lower percent of  HCoV illnesses were associated with hospitalization than other viruses, of those hospitalized with HCoV, 12.3% required ventilator support and 7.4% died.

Conclusion: In this comprehensive epidemiologic study, HCoV was found to be a common cause of ARI in adults. Although clinical illness associated with HCoV infections are milder than other major respiratory viruses, severe illness resulting in respiratory failure and death can occur in elderly or frail adults.


Subject Category: C. Clinical studies of bacterial infections and antibacterials including sexually transmitted diseases and mycobacterial infections (surveys, epidemiology, and clinical trials)

Jae Hyun Shin, MD1, Edward Walsh, MD1,2 and Ann Falsey, MD1,2, (1)Rochester General Hospital, Rochester, NY, (2)University of Rochester, Rochester, NY

Disclosures:

J. H. Shin, None

E. Walsh, None

A. Falsey, None

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