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Comparative Study
. 2005 Aug;2(8):e240.
doi: 10.1371/journal.pmed.0020240. Epub 2005 Aug 23.

Croup is associated with the novel coronavirus NL63

Lia van der Hoek  1 , Klaus Sure, Gabriele Ihorst, Alexander Stang, Krzysztof Pyrc, Maarten F Jebbink, Gudula Petersen, Johannes Forster, Ben Berkhout, Klaus Uberla
Affiliations
Comparative Study

Croup is associated with the novel coronavirus NL63

Lia van der Hoek et al. PLoS Med. 2005 Aug.

Abstract

Background: The clinical relevance of infections with the novel human coronavirus NL63 (HCoV-NL63) has not been investigated systematically. We therefore determined its association with disease in young children with lower respiratory tract infection (LRTI).

Methods and findings: Nine hundred forty-nine samples of nasopharyngeal secretions from children under 3 y of age with LRTIs were analysed by a quantitative HCoV-NL63-specific real-time PCR. The samples had been collected from hospitalised patients and outpatients from December 1999 to October 2001 in four different regions in Germany as part of the prospective population-based PRI.DE study and analysed for RNA from respiratory viruses. Forty-nine samples (5.2%), mainly derived from the winter season, were positive for HCoV-NL63 RNA. The viral RNA was more prevalent in samples from outpatients (7.9%) than from hospitalised patients (3.2%, p = 0.003), and co-infection with either respiratory syncytial virus or parainfluenza virus 3 was observed frequently. Samples in which only HCoV-NL63 RNA could be detected had a significantly higher viral load than samples containing additional respiratory viruses (median 2.1 x 10(6) versus 2.7 x 10(2) copies/ml, p = 0.0006). A strong association with croup was apparent: 43% of the HCoV-NL63-positive patients with high HCoV-NL63 load and absence of co-infection suffered from croup, compared to 6% in the HCoV-NL63-negative group, p < 0.0001. A significantly higher fraction (17.4%) of samples from croup patients than from non-croup patients (4.2%) contained HCoV-NL63 RNA.

Conclusion: HCoV-NL63 infections occur frequently in young children with LRTI and show a strong association with croup, suggesting a causal relationship.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Seasonal Distribution of HCoV-NL63
Bars represent the percentage of HCoV-NL63-positive samples per month. Numbers above the columns for each month give the number of HCoV-NL63-positive samples over the number of samples tested.
Figure 2
Figure 2. HCoV-NL63 Viral Load in Single and Double Infections
The median viral load in the two groups is indicated (in red) together with the p-value, showing a significant difference between the singly HCoV-NL63-infected group and the group with a co-infection of either RSV or PIV3.
See this image and copyright information in PMC

Republished in

  • Human coronavirus NL63 infection is associated with croup.
    van der Hoek L, Sure K, Ihorst G, Stang A, Pyrc K, Jebbink MF, Petersen G, Forster J, Berkhout B, Uberla K. van der Hoek L, et al. Adv Exp Med Biol. 2006;581:485-91. doi: 10.1007/978-0-387-33012-9_86. Adv Exp Med Biol. 2006. PMID: 17037582 Free PMC article. No abstract available.

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