SARS-CoV-2 and endemic coronaviruses: Comparing symptom presentation and severity of symptomatic illness among Nicaraguan children

Abstract

It has been proposed that as SARS-CoV-2 transitions to endemicity, children will represent the greatest proportion of SARS-Co-V-2 infections as they currently do with endemic coronavirus infections. While SARS-CoV-2 infection severity is low for children, it is unclear if SARS-CoV-2 infections are distinct in symptom presentation, duration, and severity from endemic coronavirus infections in children. We compared symptom risk and duration of endemic coronavirus infections from 2011-2016 with SARS-CoV-2 infections from March 2020-September 2021 in a Nicaraguan pediatric cohort. Respiratory samples were collected from participants that met testing criteria and blood samples were collected annually. Respiratory samples were tested for each of the endemic coronaviruses from 2011-2016 and for SARS-CoV-2 from 2020-2021 via rt-PCR. 2021 blood samples were tested for SARS-CoV-2 antibodies and a subset of 2011-2016 blood samples from four-years-old participants were tested for endemic coronavirus antibodies. By April 2021, 854 (49%) active participants were ELISA positive for SARS-CoV-2 antibodies. Most participants had antibodies against one alpha and one beta coronavirus by age four. We observed 595 symptomatic endemic coronavirus infections from 2011-2016 and 121 symptomatic with SARS-CoV-2 infections from March 2020-September 2021. Symptom presentation of SARS-CoV-2 infection and endemic coronavirus infections were very similar, and SARS-CoV-2 symptomatic infections were as or less severe on average than endemic coronavirus infections. This suggests that, for children, SARS-CoV-2 may be just another endemic coronavirus. However, questions about the impact of variants and the long-term effects of SARS-CoV-2 remain.

Prevalence and clinical impact of mono- and co-infections with endemic coronaviruses 229E, OC43, NL63, and HKU-1 during the COVID-19 pandemic

“…Pooled data from this study show that respiratory disease symptoms in patients with endemic coronaviruses are more similar to those in patients with proven SARS-CoV-2 than in those infected with other respiratory agents. A similar claim was reported in another study [ 45 ]. This study also reported a relatively high rate of pneumonia cases due to epidemic coronaviruses, which are also characteristic of patients infected with SARS-CoV-2.…”

Burden and seasonality of primary and secondary symptomatic common cold coronavirus infections in Nicaraguan children

“…Respiratory symptoms are recorded from each clinic visit by study physicians as well as from symptom diaries by parents/guardians. Participants with diagnosed cases of pneumonia, bronchiolitis, bronchitis, or bronchial hyperreactivity were considered to have LRI 25 …”

“…Participants with diagnosed cases of pneumonia, bronchiolitis, bronchitis, or bronchial hyperreactivity were considered to have LRI. 25 Blood samples were collected annually from participants between February and April each year. To evaluate the frequency of secondary ccCoV infections, blood samples that were collected within 1 year before a ccCoV PCR+ infection were tested for IgG antibodies to the spike protein for each ccCoV via an enzyme-linked immunosorbent assay following previously developed protocols.…”