Journal Article

Croup Is Associated with the Novel Coronavirus NL63

van der Hoek, Lia, Stang, Alexander, Pyrc, Krzysztof, Sure, Klaus, Forster, Johannes, Überla, Klaus, Ihorst, Gabriele, Jebbink, Maarten F, Petersen, Gudula, Berkhout, Ben

2005

Overview

The clinical relevance of infections with the novel human coronavirus NL63 (HCoV-NL63) has not been investigated systematically. We therefore determined its association with disease in young children with lower respiratory tract infection (LRTI). Nine hundred forty-nine samples of nasopharyngeal secretions from children under 3 y of age with LRTIs were analysed by a quantitative HCoV-NL63-specific real-time PCR. The samples had been collected from hospitalised patients and outpatients from December 1999 to October 2001 in four different regions in Germany as part of the prospective population-based PRI.DE study and analysed for RNA from respiratory viruses. Forty-nine samples (5.2%), mainly derived from the winter season, were positive for HCoV-NL63 RNA. The viral RNA was more prevalent in samples from outpatients (7.9%) than from hospitalised patients (3.2%, p = 0.003), and co-infection with either respiratory syncytial virus or parainfluenza virus 3 was observed frequently. Samples in which only HCoV-NL63 RNA could be detected had a significantly higher viral load than samples containing additional respiratory viruses (median 2.1 x 10(6) versus 2.7 x 10(2) copies/ml, p = 0.0006). A strong association with croup was apparent: 43% of the HCoV-NL63-positive patients with high HCoV-NL63 load and absence of co-infection suffered from croup, compared to 6% in the HCoV-NL63-negative group, p < 0.0001. A significantly higher fraction (17.4%) of samples from croup patients than from non-croup patients (4.2%) contained HCoV-NL63 RNA. HCoV-NL63 infections occur frequently in young children with LRTI and show a strong association with croup, suggesting a causal relationship.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Child, Preschool / Coronavirus - classification / Coronavirus - genetics / Coronavirus - isolation & purification / Coronaviruses / Croup - virology / Epidemiology/Public Health / Female / Germany / Humans / Infant / Infant, Newborn / Infections / Infectious Diseases / Influenza / Inpatients / Male / Microbiology / Outpatients / Parainfluenza Virus 3, Human - genetics / Parainfluenza Virus 3, Human - isolation & purification / Pediatrics / Respiratory diseases / Respiratory Medicine / Respiratory syncytial virus / Respiratory Syncytial Virus, Human - genetics / Respiratory Syncytial Virus, Human - isolation & purification / Respiratory Tract Infections - virology / RNA, Viral - metabolism / Seasons / Testing laboratories / Time Factors / Viral Load / Virology / Viruses