【病毒外文文獻】2012 Infections with human coronaviruses NL63 and OC43 among hospitalised and outpatient individuals in S_o Paulo, Brazi

693 online memorias ioc fiocruz br Mem Inst Oswaldo Cruz Rio de Janeiro Vol 107 5 693 694 August 2012 Five human coronaviruses HCoVs have been iden tified to date HCoV OC43 and HCoV 229E were first identified in the mid 1960s Hamre of these 212 patients 136 were children and 76 were adults Assays to identify HCoVs in patients were performed using a two step process First an initial pancoronavirus reverse transcription polymerase chain reaction RT PCR screening assay was performed Vi jgen et al 2008 Second species specific RT PCR as says were used to identify the specific HCoV species Dare et al 2007 Amplicons were further character ised by sequencing Epidemiological and clinical data from outpatients were obtained using a standardised questionnaire and data from hospitalised patients were obtained from medical charts The pancoronavirus assay detected five 394 1 2 coronavirus positive samples Within the outpatient group which was comprised only children one 182 0 5 patients was positive Within the hospitalised patient group four 212 1 8 patients were positive two 136 were children 1 4 and two 76 were adults 2 6 HCoV OC43 was documented in two samples from hospitalised patients one of which was a nosocomial infection three HCoV NL63 positive sam ples were identified one of which was obtained from an outpatient and two of which were obtained from hospi talised patients Sequencing confirmed the specificity of the species specific RT PCR assays Coronavirus in fections occurred during the spring autumn and winter and more coronavirus infected cases were documented in 2010 than in 2009 The median age of HCoV infected patients was seven years ranging from 11 months to 46 years Eighty percent 4 5 of infected patients report ed several underlying conditions but no chronic lung disease was reported Table Fever and cough were the most common symptoms at presentation Dyspnea was reported in two cases and bronchospasm was only re ported in the three HCoV NL63 cases Three patients presented with lower respiratory tract infections Two of the hospitalised patients were further admitted to the intensive care unit during their hospital stay Eight days was the median length of the hospital stay for hospita lised coronavirus infected patients ranging from 5 30 days HCoV OC43 infected patients had longer hospital stays than HCoV NL63 infected patients Three of the four hospitalised patients had good outcomes but the diabetic adult died of HCoV NL63 associated pneumo nia nine days after admission The present study is the first Brazilian report of HCoV infections in outpatients Corresponding author taticabeca br Received 20 October 2011 Accepted 11 January 2012 Infections with human coronaviruses NL63 and OC43 among hospitalised and outpatient individuals in S o Paulo Brazil Tatiane Karen Cabe a 1 Emerson Carraro 1 Aripuan Watanabe 1 Celso Granato 1 Nancy Bellei 1 1 Disciplina de Infectologia Laborat rio de Virologia Cl nica Departamento de Medicina Universidade Federal de S o Paulo S o Paulo SP Brasil The incidence and clinical features of human coronaviruses HCoVs among Brazilian patients with respiratory illness are not well known We investigated the prevalence of HCoVs among Brazilian outpatients and hospitalised patients with respiratory illnesses during 2009 and 2010 To identify the HCoVs pancoronavirus and species spe cific reverse transcriptase polymerase chain reaction assays were performed Five of 394 samples were positive for HCoVs 1 2 1 182 0 5 outpatients and 4 212 1 8 hospitalised patients The OC43 and NL63 HCoVs were identified Two patients were admitted to the intensive care unit Underlying chronic disease was reported in cases and one diabetic adult died HCoVs can cause lower respiratory infections and hospitalisation Patients with pre existing conditions and respiratory infections should be evaluated for HCoV infections Key words human coronavirus OC43 human coronavirus NL63 respiratory tract infections Coronaviruses among Brazilian patients Tatiane Karen Cabe a et al 694 and hospitalised patients to describe NL63 infection in an adult patient Because the subjects of our study in cluded both outpatients and hospitalised patients the majority of the patients included in this study were be lieved to have a common cold The composition of our subject pool could be a limitation of our study and might explain the small number of coronavirus positive cases Gaunt et al 2010 detected 0 3 0 85 coronavirus pos itive samples across all ages and we hypothesised that the H1N1 2009 influenza pandemic wave might have influenced the dynamics of the other respiratory virus es mainly in 2009 The coronavirus positive rate found among adults revealed that HCoVs may be representa tive causal agents of respiratory disease among adults as well as children This study is one of the few studies to record a fatal case of HCoV NL63 infection Bastien et al 2005 Cabe a LRTI lower respiratory tract illness HIV human immunodeficiency virus infected present absent