435. The Clinical Epidemiology of Human Coronavirus (HCoV) Infections among Hospitalized Children
Session: Poster Abstract Session: Pediatric Infections
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • SSanderson. IDSA Poster (HCoV) 2013.pdf (824.1 kB)
  • Background: HCoV causes illness ranging from the common cold to life-threatening pneumonia. Little is known about the burden of HCoV infection in hospitalized children.

    Methods: We conducted a retrospective cohort study of hospitalized children <18 years with HCoV infection from 5/2012-4/2013 at Primary Children’s Medical Center. Demographic, clinical, and financial data were obtained from Intermountain Healthcare’s Enterprise Data Warehouse. Multiplex PCR for 17 respiratory viruses including 4 HCoV subtypes was performed for children admitted with respiratory illness.

    Results: Of 1,247 hospitalized children tested, 105 (8.4%) were positive for HCoV. HCoV subtypes included HKU1 (55%), OC43 (38%), NL63 (7%) and 229E (4%). Thirty-three children (31%) had a chronic medical condition, 28 (27%) were admitted to the ICU, 9 (9%) required mechanical ventilation and 1 (1%) died (Table). One child had bacteremia (H. influenzae type B) and 2 had UTI (E. coli). The median hospital length of stay was 2 days (IQR: 2-4) and did not vary by age. The median cost per hospitalization was $5,387 (IQR: $3,390-9,385) and was similar across age groups. A second virus, most commonly RSV, was detected in 50% of cases. Children co-infected with RSV were younger than children infected with HCoV alone (P<0.01). ICU admission, hospital cost and length of stay were similar among children with HCoV alone and those co-infected with RSV.

    Inpatient Characteristics

    All HCoV

    (n=105)

    HCoV Only

    (n=53)

    HCOV + RSV

    (n=42)

    Age

       <12 mo

    50 (48%)

    23 (43%)

    20 (48%)

       1-4 yrs

    37 (35%)

    14 (26%)

    22 (52%)

       5-17 yrs

    18 (17%)

    16 (30%)

    0 (0%)

    Chronic condition

    33 (31%)

    17 (32%)

    10 (24%)

    ICU admission

    28 (27%)

    13 (25%)

    11 (26%)

    Mechanical ventilation

    9 (9%)

    5 (9%)

    3 (7%)

    Death

    1 (1%)

    0 (0%)

    1 (2%)

    Median length of stay, days

    2.0

    (IQR:  1.7-4.1)

    2.0

    (IQR:  1.5-3.3)

    2.3

    (IQR:  1.8-4.7)

    Median total hospital cost, $

    5,387

    (IQR:  3,391-9,385)

    5,030

    (IQR:  3,923-8,227)

    5,370

    (IQR:  3,254-9,546)

    Conclusion: HCoV was frequently detected in children hospitalized for respiratory illness. Viral co-detection was common, making it difficult to establish the independent impact of HCoV. However, the similar outcomes in children with HCoV alone compared with those with HCoV and RSV detected suggests that HCoV detection is associated with a substantial clinical and economic burden.

    Susan K. Sanderson, DNP1, Chris Stockmann, MSc1, Andrew Pavia, MD, FIDSA, FSHEA1, Carrie L. Byington, MD1, Anne J. Blaschke, MD, PhD1, Emily A. Thorell, MD, MSci1, Adam L. Hersh, MD, PhD1, Amy Herbener, MD1, Pricilla Cowan1, E. Kent Korgenski, MS2,3, Judy Daly, PhD4 and Krow Ampofo, MD1, (1)Department of Pediatrics, Division of Pediatric Infectious Diseases, University of Utah School of Medicine, Salt Lake City, UT, (2)Department of Pediatrics, Pediatric Clinical Program, University of Utah School of Medicine and Intermountain Healthcare, Salt Lake City, UT, (3)Department of Pediatrics, University of Utah Health Sciences Center, University of Utah School of Medicine, Salt Lake City, UT, (4)Primary Children's Medical Center, Salt Lake CIty, UT

    Disclosures:

    S. K. Sanderson, None

    C. Stockmann, None

    A. Pavia, None

    C. L. Byington, BioFire Diagnostics: Collaborator and Grant Investigator, Grant recipient and Licensing agreement or royalty

    A. J. Blaschke, BioFire Diagnostics, Inc.: Collaborator, Licensing agreement or royalty

    E. A. Thorell, None

    A. L. Hersh, None

    A. Herbener, None

    P. Cowan, None

    E. K. Korgenski, None

    J. Daly, None

    K. Ampofo, None

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