Background: Human Coronaviruses (HCoV) cause illness ranging from the common cold to life-threatening pneumonia. However, the reported clinical epidemiology and burden of HCoV infection is confounded by frequent co-detection with other respiratory viruses. While different types of HCoV can be detected by laboratory testing, few data exist describing single HCoV infection by type in children.
Methods: We conducted a retrospective cohort study of children <18 years with single HCoV detection from 12/2012-2/2016 at Primary Childrens Hospital, Salt Lake City, UT. Demographic, clinical, and financial data of children with moderate to severe single HCoV infection (hospitalized ≥24 hours) were evaluated by HCoV type (HKU1, OC43, 229E, NL63). Testing was performed using the FilmArray® Respiratory panel, BioFire Diagnostics, LLC, Salt Lake City, UT.
Results: Over the study period, a respiratory virus was detected in 11,714 of 19,150 (61%) children undergoing respiratory viral testing at PCH, with HCoV accounting for 1267 (11%) of detected viruses. Of these, single HCoV infection occurred in 534 children (42% of HCoV detections) comprising the study cohort; 207 (39%) were hospitalized ≥24 hours. The overall median age was 14 months (interquartile range [IQR] 3-46). A chronic medical condition (CMC) was present in 62 (30%) children, with 69 (33%) requiring intensive care unit (ICU) admission and 28 (14%) requiring mechanical ventilation. The median length of stay (LOS) was 2.5 days (IQR 1.5-4.7) and hospital cost was $6,502 (IQR: $3,708-$14,280) (Table). CMCs were noted more frequently in children with HCoV NL63 (32 (43%)) compared to HCoV OC43 (14 (18%)) (p=0.008). ICU admission, mechanical ventilation, median hospital LOS and cost comparable among the different HCoV types. Death from HCoV (3 (1%)) was rare among children with moderate to severe single HCoV infection.
Conclusion: HCoV infection is a common cause of respiratory illness among children. Among children with single HCoV detection, 35% to 42% of each type required hospitalization for ≥24 hours. Outcomes in children with HCoV infection alone were comparable to each other, and associated with a substantial clinical and economic burden for all of the HCoV types.
S. K. Sanderson,
A. Pavia, None
C. L. Byington, None
A. J. Blaschke, BioFire Diagnostics, LLC: Advisor regarding risks associated with FDA-cleared products and Collaborator , Consulting fee and Licensing agreement or royalty
E. Thorell, None
A. L. Hersh, Merck: Grant Investigator , Research grant
E. K. Korgenski, None
J. A. Daly, None
K. Ampofo, None
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