Background
We characterized the global epidemiology and seasonality of human coronaviruses (HCoVs) OC43, NL63, 229E, and HKU1.
Methods
In this systematic review, we searched MEDLINE, EMBASE, Web of Science, SCOPUS, CINAHL and backward citations for studies published until September 1st 2023. We included studies with >12 months consecutive data and tested for >1 HCoV species. Case reports, review articles, animal studies, studies focusing on SARS-CoV-1, SARS-CoV-2, and/or Middle East respiratory syndrome, and those including <100 cases were excluded. Study quality and risk of bias were assessed using Joanna Briggs Institute Critical Appraisal Checklist tools. We reported the prevalence of all HCoVs and individual species. Seasonality was reported for studies that included >100 HCoVs annually. This study is registered with PROSPERO, CRD42022330902.
Results
201 studies (1,819,320 samples) from 68 countries were included. A high proportion were from China (19.4%; n=39), while the Southern Hemisphere was underrepresented. Most were case series (77.1%, n=155) with samples from secondary care (74.1%, n=149). Seventeen (8.5%) studies included asymptomatic controls, while 76 (37.8%) reported results for all four HCoV species. Overall, OC43 was the most prevalent HCoV. Median test-positivity of OC43 and NL63 were higher in children, and 229E and HKU1 in adults. Among 18 studies that described seasonality (17 from Northern Hemisphere), circulation of all HCoVs mostly peaked during cold months.
Conclusions
In our comprehensive review, few studies reported the prevalence of individual HCoVs or seasonality. Further research on the burden and circulation of HCoVs is needed, particularly from Africa, South Asia, and Central/South America.