126. Characterization of Human Coronavirus-OC43 (HCoV-OC43) and HCoV-NL63 Infections among Hospitalized Children < 2 Years of Age
Session: Oral Abstract Session: Potpourri of Pediatric Infections
Thursday, October 3, 2013: 10:45 AM
Room: The Moscone Center: 250-262
Background: This study was performed to investigate the clinical characteristics of HCoV-OC43 and HCoV-NL63 in hospitalized pediatric patients < 2 years of age in the outbreak setting.

Methods:

Respiratory viruses were detected using the FilmArray Respiratory Panel (BioFire Diagnostics, Salt Lake City) in the Virology Laboratory at St. Louis Children`s Hospital from Nov 2012 to Mar 2013.  We used a standardized data form to extract information from all patients < 2 yrs old with solo detection of HCoV-OC43 (n=34) and HCoV-NL63 (n=27) and randomly selected children < 2 yrs old with solo detection of RSV (n=34), rhinovirus/enterovirus (RV/EV) (n=34) and parainfluenza (PIV) (n=30).  An episode resulting in ICU stay, mechanical ventilation, and/or death was considered a severe case.

Results:

Among 1785 viruses detected, HCoV-OC43 was the third most frequent (7.5%) and HCoV-NL63, the 6th (5.0%). Coinfections were more frequently detected in HCoV-OC43 (38.8%) and HCoV-NL63 (39.3%), compared to RSV (23.2%), RV/EV (22.2%), and PIV (31.0%). There were no fatal cases. The most common diagnoses with HCoV-OC43 and HCoV-NL63 were URI with/ or without fever (HCoV-OC43, 55.9%; HCoV-NL63, 22.2%) and croup. Croup was more common with HCoV-NL63 (29.6%) than with HCoV-OC43 (2.9%, P=0.01) and the other viruses (PIV 20.0%, RSV and RV 5.9% each).  Severe infection and lower respiratory tract infections were less common in HCoV-OC43 (17.6%, 32.4%) and HCoV-NL63 (11.1%, 25.9%) compared to RSV (32.4%, 82.4%) and RV/EV (29.4%, 52.9%) (P=0.04 for severity and P=0.01 for incidence of LRTI for HCoV combined compared to RV/EV and RSV combined.  No respiratory symptoms or fever were present in 14.8% of HCoV-NL63, compared to HCoV-OC43 (2.9%), RSV and RV/EV (0%, each), and PIV (3.3%).

Conclusion: HCoV-OC43 and HCoV-NL63 infections were often associated with LRTI and severe illness in children < 2yrs of age, although less frequently than RSV and RV/EV.  As reported previously, HCoV-NL63 was frequently associated with croup comparable in frequency to PIV.  This association was not seen for HCoV-OC43.  Human coronaviruses are important causes of both URI and LRTI in children < 2 yrs old.

Jina Lee, M, PhD, Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea, Duha Al-Zubeidi, Pediatrics, Washington University School of Medicine, St. Louis, MO and Gregory Storch, MD, FIDSA, St. Louis Children's Hospital, St. Louis, MO

Disclosures:

J. Lee, None

D. Al-Zubeidi, None

G. Storch, Roche Molecular Diagnostics: Consultant, Consulting fee
Primera Dx: Consultant, Consulting fee

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