Post-mortem study of endemic human coronaviruses (HCoV-NL63, OC43, 229E and HKU-1) in deaths of children under five in low- and middle-income countries: Findings from the Child Health and Mortality Prevention Surveillance (CHAMPS) study

IF 4 3区 医学 Q2 VIROLOGY
Vicky Baillie , Ziyaad Dangor , Dianna M. Blau , Sana Mahtab , Jeanie du Toit , Nega Assefa , Joseph Oundo , Zelalem Teklemariam Kidanemariam , J. Anthony G. Scott , Soter Ameh , Ikechukwu Udo Ogbuanu , Julius Ojulong , James Bunn , Karen L. Kotloff , Samba O. Sow , Milagritos D. Tapia , Adama Mamby Keita , Marcelino Garrine , Inacio Mandomando , Rosauro Varo , Shabir A. Madhi
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引用次数: 0

Abstract

Background

Endemic human coronaviruses (HCoV-229E, HKU1, NL63, and OC43) are common causes of mild or asymptomatic respiratory infections in children but are considered rare causes of death.

Methods

We evaluated pediatric deaths from January 2017 through December 2022. A panel of experts determined the cause of death (CoD) by reviewing available data, including pathological and molecular findings from minimally invasive tissue sampling (lung tissues, blood, CSF, and nasopharyngeal swabs), clinical records, and verbal autopsies.

Results

Endemic HCoV were detected in the respiratory samples of 3 % (n = 86/3357) of enrolled decedents: 1 % (n = 12/2043) of neonates, 5 % (n = 35/681) of infants and 6 % (n = 39/633) of children deaths. However, HCoVs were attributed as the CoD in only two cases — both involving young infants with underlying birth defects and severe wasting, who succumbed to polymicrobial hospital-acquired infections involving HCoV-OC43, Klebsiella pneumoniae, and Acinetobacter baumannii. Amongst the remaining 84 decedents in whom an HCoV was detected, 82 % (n = 69/84; median Ct of 25.34; range: 15.28–36.17) were deaths attributed to other infections, including 54 % (n = 32/69; median Ct of 23.86; range: 15.28–35.2) with lower respiratory infections determined to be the CoD. The bulk of these deaths (96 %, n = 66/69) were attributed to other pathogens – Plasmodium falciparum (27 %, n = 19/69), K. pneumoniae (23 %, n = 16/69), Streptococcus pneumoniae (20 %, n = 14/69), Escherichia coli (16 %, n = 11/69) and Cytomegalovirus (10 %, n = 7/69).

Conclusion

Although endemic HCoV was identified in children who died of respiratory infections, it was rarely attributed to being in the CoD. Nevertheless, further research is warranted to explore the potential role of HCoVs in LRTI pathogenesis and their impact on facilitating more pathogenic infections.
低收入和中等收入国家五岁以下儿童死亡中地方性人类冠状病毒(HCoV-NL63、OC43、229E和HKU-1)的死后研究:儿童健康和死亡预防监测(CHAMPS)研究的结果
流行性人类冠状病毒(HCoV-229E、HKU1、NL63和OC43)是儿童轻度或无症状呼吸道感染的常见原因,但被认为是罕见的死亡原因。方法:我们评估了2017年1月至2022年12月期间的儿科死亡病例。专家小组通过审查现有数据确定死因,包括微创组织取样(肺组织、血液、脑脊液和鼻咽拭子)的病理和分子结果、临床记录和死因推断。结果死亡病例中3% (n = 86/3357)、新生儿中1% (n = 12/2043)、婴幼儿中5% (n = 35/681)、死亡儿童中6% (n = 39/633)的呼吸道样本中检出致病性HCoV。然而,hcov仅在两例病例中被认为是CoD,这两例均涉及具有潜在出生缺陷和严重消瘦的年幼婴儿,他们死于包括HCoV-OC43、肺炎克雷伯菌和鲍曼不动杆菌在内的多微生物医院获得性感染。在检出HCoV的其余84例死者中,82% (n = 69/84;中位Ct为25.34;范围:15.28 - 36.17%)是由其他感染导致的死亡,包括54% (n = 32/69;中位Ct为23.86;范围:15.28-35.2),以下呼吸道感染为CoD。这些死亡中的大部分(96%,n = 66/69)归因于其他病原体——恶性疟原虫(27%,n = 19/69)、肺炎克雷伯菌(23%,n = 16/69)、肺炎链球菌(20%,n = 14/69)、大肠杆菌(16%,n = 11/69)和巨细胞病毒(10%,n = 7/69)。结论虽然在呼吸道感染死亡的儿童中发现了地方性HCoV,但很少归因于CoD。然而,需要进一步研究hcov在LRTI发病机制中的潜在作用及其对促进更多致病性感染的影响。
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来源期刊
Journal of Clinical Virology
Journal of Clinical Virology 医学-病毒学
CiteScore
22.70
自引率
1.10%
发文量
149
审稿时长
24 days
期刊介绍: The Journal of Clinical Virology, an esteemed international publication, serves as the official journal for both the Pan American Society for Clinical Virology and The European Society for Clinical Virology. Dedicated to advancing the understanding of human virology in clinical settings, the Journal of Clinical Virology focuses on disseminating research papers and reviews pertaining to the clinical aspects of virology. Its scope encompasses articles discussing diagnostic methodologies and virus-induced clinical conditions, with an emphasis on practicality and relevance to clinical practice. The journal publishes on topics that include: • new diagnostic technologies • nucleic acid amplification and serologic testing • targeted and metagenomic next-generation sequencing • emerging pandemic viral threats • respiratory viruses • transplant viruses • chronic viral infections • cancer-associated viruses • gastrointestinal viruses • central nervous system viruses • one health (excludes animal health)
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