Coronavirus 229E-related pneumonia in immunocompromised patients

Abstract

Coronaviruses strains 229E and OC43 have been associated with various respiratory illnesses ranging from the self-resolving common cold to severe pneumonia. Although chronic underlying conditions are major determinants of severe respiratory virus infections, few data about coronavirus-related pneumonia in immunocompromised patients are available. Here we report 2 well-documented cases of pneumonia related to coronavirus 229E, each with a different clinical presentation. Diagnosis was made on the basis of viral culture and electron microscopy findings that exhibited typical crown-like particles and through amplification of the viral genome by reverse transcriptase-polymerase chain reaction. On the basis of this report, coronaviruses should be considered as potential causative microorganisms of pneumonia in immunocompromised patients.

Figure 1

Electron micrograph of culture medium from the bronchoalveolar lavage—fluid specimen obtained from patient 1. Note the presence of coronavirus particles with thin, club-shaped spikes (arrowhead). Negatively stained with 2% phosphotungstic acid buffered solution, pH 7.0. Line is 0.1 µm in length.

Figure 2

Ethidium bromide stain of a 2% agarose gel, showing RT-PCR amplification products of coronavirus M gene with 229E strain—specific primers. Lane 1, Supernatant of the HUH7 cell culture for patient 1. Lane 2, Supernatant of the HUH7 cell culture of another patient with common cold. Lane 3, Supernatant of noninfected HUH7 cells. Lane 4, Negative control extraction. Lane 5, Negative control PCR mix. Lane 6, Positive control strain 229E grown in MRC5 cells. Lane 7, (L) size markers (100 pb).