Croup Is Associated with the Novel Coronavirus NL63

Abstract

BackgroundThe 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).Methods and FindingsNine 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 × 106 versus 2.7 × 102 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.ConclusionHCoV-NL63 infections occur frequently in young children with LRTI and show a strong association with croup, suggesting a causal relationship.

Human Coronavirus-NL63 Infection is not Associated with Acute Kawasaki Disease

“…Interestingly, a large study of pediatric patients in Europe found that HCoV-NL63 infection is associated with croup. 9 Thus, although HCoV-NL63 is likely a common respiratory infection in children, we and others found no association with acute KD.…”

Identification of residues in the receptor-binding domain (RBD) of the spike protein of human coronavirus NL63 that are critical for the RBD–ACE2 receptor interaction

“…Since then, two additional human coronaviruses, HCoV-NL63 (NL63) and HCoV-HKU1, have been identified (van der Hoek et al, 2004;Woo et al, 2005). NL63 has been found to be associated with diseases in the upper and lower respiratory tracts, such as bronchiolitis, conjunctivitis, croup and pneumonia in young children and immunocompromised adults (Arden et al, 2005;Bastien et al, 2005;Ebihara et al, 2005;Gerna et al, 2006;Kaiser et al, 2005;van der Hoek et al, 2005. So far, NL63 infections have been reported in 12 countries across Europe, Asia and North America, indicating that it is circulating among the human population worldwide (Arden et al, 2005;Bastien et al, 2005;Han et al, 2007;Koetz et al, 2006;Lau et al, 2006;Suzuki et al, 2005;Vabret et al, 2005).…”

Bocavirus Infection in Hospitalized Children, South Korea

“…H uman respiratory syncytial virus (HRSV), human metapneumovirus (HMPV), parainfluenzavirus, coronavirus, and adenovirus are commonly detected viruses in children with acute lower respiratory tract infections (LRTI) (1)(2)(3)(4)(5). Recently, human bocavirus (HBoV) was identified as a cause of human respiratory tract infections in Sweden (6).…”