Endemic Non–SARS-CoV-2 Human Coronaviruses in a Community-Based Australian Birth Cohort

Abstract

Background and objectives: The COVID-19 pandemic has drawn attention to the Coronavirus family of viruses. However, in community settings there is relatively limited information on these viruses in healthy children. Our objective was to explore the epidemiology of the four endemic (non-SARS-CoV-2) human coronaviruses (HCoV) by species, including acute illness episodes, risk factors and healthcare burden in a cohort of Australian children in the first 2-years of life. Methods: The Observational Research in Childhood Infectious Diseases (ORChID) community-based cohort was a prospective study describing acute respiratory illnesses in children from birth until their second birthday. Parents recorded daily symptoms, maintained an illness-burden diary and collected weekly nasal swabs, which were tested for 17 respiratory viruses, including HCoVs, by real-time polymerase chain reaction assays. Results: 158 children participating in ORChID provided 11,126 weekly swabs, of which 168 were HCoV positive involving 130 incident episodes. HCoV-NL63 and HCoV-OC43 were most commonly detected and accounted for two-thirds of episodes. While 30 children had different HCoVs detected on different occasions, seven were reinfected with the same species 4-16 months later. The incidence of HCoV in the first 2-years of life was 0.76 episodes per child-year (95% confidence interval [CI] 0.63-0.91) with incidence greatest in the second year (1.06; 95%CI 0.84-1.33) and during Winter (1.32; 95%CI 1.02-1.71). Only 50% of HCoV episodes were symptomatic, of which 48.4% led to healthcare contact. Conclusions: In children, HCoV infections are common, recurrent and frequently asymptomatic. Future studies should determine transmission pathways and immune mechanisms.

Human bocavirus-1 infections in Australian children aged < 2 years: a birth cohort study

“…Nevertheless, 41.2% of these children had healthcare contact, 23.5% received antibiotics, but none was admitted to hospital. These proportions are similar to those observed with other common viruses detected in ORChID participants: parainfluenza (59%, 60%, 54%, 30%, 2%), seasonal coronaviruses (50%, 63%, 48%, 18%, 1%), and respiratory syncytial virus (73%, 43%, 57%, 32%, 3%) for ARI symptoms, URI symptoms, healthcare contact, antibiotic treatment, and hospitalisation, respectively [48][49][50]. These results for single HBoV1 detection episodes were not significantly different from episodes where other viruses were present.…”

Original antigenic sin responses to Betacoronavirus spike proteins are observed in a mouse model, but are not apparent in children following SARS-CoV-2 infection

“…The Betacoronaviruses, HKU1 and OC43, and Alphacoronaviruses, 229E and NL63, cause seasonal respiratory illnesses in both adults and children worldwide. Seroprevalence data indicate that infection with HCoVs occurs during early childhood [1], and the majority of adults are seropositive with antibody titers that wane over time [2,3]. Cross-reactive antibodies are elicited within genera, but less so between Alphacoronaviruses and Betacoronaviruses [4].…”

Antibody persistence and neutralising activity in primary school students and staff: Prospective active surveillance, June to December 2020, England

“…Antibody persistence after infection is, therefore, an important component in assessing duration of protection. This is particularly the case in children who can have multiple re-infections with endemic coronaviruses, at least in part due to antibody waning [ 11 , 12 ] Evidence to date has demonstrated antibody persistence in children up to 62 days after SARS-CoV-2 infection, but data on long-term antibody persistence in children is limited [13] . The COVID-19 S urveillance in school KIDs (sKIDs) study, collected 3 samples between June and December 2020, and, to date, the analysis of these data has focused on transmission within schools.…”