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Human Coronavirus in Young Children Hospitalized for Acute Respiratory Illness and Asymptomatic Controls

Prill, Mila M. MSPH*; Iwane, Marika K. PhD, MPH*; Edwards, Kathryn M. MD; Williams, John V. MD; Weinberg, Geoffrey A. MD§; Staat, Mary A. MD, MPH; Willby, Melisa J. PhD**; Talbot, H. Keipp MD, MPH††; Hall, Caroline B. MD‡‡; Szilagyi, Peter G. MD, MPH§; Griffin, Marie R. MD, MPH§§; Curns, Aaron T. MPH*; Erdman, Dean D. DrPH*for the New Vaccine Surveillance Network

The Pediatric Infectious Disease Journal: March 2012 - Volume 31 - Issue 3 - p 235–240
doi: 10.1097/INF.0b013e31823e07fe
Original Studies

Background: Human coronaviruses (HCoVs) have been detected in children with upper and lower respiratory symptoms, but little is known about their relationship with severe respiratory illness.

Objective: To compare the prevalence of HCoV species among children hospitalized for acute respiratory illness and/or fever (ARI/fever) with that among asymptomatic controls and to assess the severity of outcomes among hospitalized children with HCoV infection compared with other respiratory viruses.

Methods: From December 2003 to April 2004 and October 2004 to April 2005, we conducted prospective, population-based surveillance of children <5 years of age hospitalized for ARI/fever in 3 US counties. Asymptomatic outpatient controls were enrolled concurrently. Nasal/throat swabs were tested for HCoV species HKU1, NL63, 229E, and OC43 by real-time reverse-transcription polymerase chain reaction. Specimens from hospitalized children were also tested for other common respiratory viruses. Demographic and medical data were collected by parent/guardian interview and medical chart review.

Results: Overall, HCoV was detected in 113 (7.6%) of 1481 hospitalized children (83 [5.7%] after excluding 30 cases coinfected with other viruses) and 53 (7.1%) of 742 controls. The prevalence of HCoV or individual species was not significantly higher among hospitalized children than controls. Hospitalized children testing positive for HCoV alone tended to be less ill than those infected with other viruses, whereas those coinfected with HCoV and other viruses were clinically similar to those infected with other viruses alone.

Conclusions: In this study of children hospitalized for ARI/fever, HCoV infection was not associated with hospitalization or with increased severity of illness.

Supplemental Digital Content is available in the text.

From the *Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA; †Departments of Pediatrics and ‡Pediatrics and Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN; §Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY; ¶Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; **Atlanta Research and Education Foundation, Decatur, GA; ††Department of Medicine and Pediatrics, Vanderbilt University Medical Center, Nashville, TN; ‡‡Department of Pediatrics and Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY; and §§Departments of Preventive Medicine and Medicine, Vanderbilt University Medical Center, Nashville, TN.

Accepted for publication October 19, 2011.

Some of these data were presented at the Clinical Virology Symposium; 2008; Daytona Beach, FL.

The findings and conclusions of this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

The project was supported by the US Centers for Disease Control and Prevention and in part by the National Vaccine Program Office (cooperative agreement numbers U38/CCU217969, U01/IP000017, U38/CCU417958, U01/IP000022, U38/CCU522352, U01/IP000147). The testing of specimens collected from October 2001 to September 2003 was paid for by the NIH (VTEU grant N01 AI-25462). K.M.E. received grant funding from Novartis. J.V.W. has served as a consultant for MedImmune, Novartis, and Quidel. G.A.W. was on speaker's bureaus of Merck, GlaxoSmithKline, and Sanofi Pasteur. M.A.S. received funding from MedImmune for RSV studies and was on the MedImmune Advisory Board. H.K.T received salary support and career development from the NIAID (1K23AI074863-01) and research funding from Protein Sciences, Wyeth (Pfizer), VaxInnate, and Sanofi Pasteur. C.B.H. has been on a MedImmune Advisory Board and is a consultant to MedImmune. M.R.G. received grant funding from MedImmune. The authors have no other funding or conflicts of interest to disclose.

Address for correspondence: Mila M. Prill, MSPH, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS A34, Atlanta, GA 30333. E-mail:

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© 2012 by Lippincott Williams & Wilkins, Inc.