2007年秋冬季北京地区成人发热就诊患者中人冠状病毒229E感染状况分析

Characterization of human coronavirus 229E infection among patients with respiratory symptom in Beijing, Oct-Dec,2007

目的了解北京地区成人发热就诊患者中人冠状病毒HCoV-229E感染病原学、临床表现和流行病学特点。方法2007年10月至12月从北京地区发热且有呼吸道症状的就诊成人中采集158份鼻咽拭子标本，利用荧光定量RT—PCR法进行HCoV-229E筛查；利用常规PCR方法扩增HCoV-229E基因片段测序；对感染阳性患者进行HCoV-NL63、HCoV-HKU1及HMPV的共感染筛查、临床表现描述和流行病学特点分析。结果158份鼻咽拭子标本中荧光定量RT—PCR检测出103（65．2％）例HCoV-229E阳性；其中26例存在与HCoV—NL63（3例）、HCoV—HKU1（3例）及HMPV（20例）的混合感染；HCoV-229E阳性标本的临床表现以头痛（70．9％）、咽红（70．9％）、咽痛（69％）、寒颤（68％）、咳嗽（33％）、有痰（21．3％）、流涕（21．4％）和鼻塞（16．5％）为主，少量可见呕吐（6．8％）、呼吸困难（3．9％）和腹泻（1．9％）；统计学分析表明其感染与性别、年龄无关。结论人冠状病毒HCoV-229E感染在秋冬季成人发热就诊患者中为常见病原，可合并感染其他病毒。其临床表现呈上呼吸道感染特征。2007年秋冬季在北京地区成人中可能存在HCoV-229E局部流行。

Objective To know the etiology, prevalence, clinical symptoms associated with the infection of the HCoV-229E in the respiratory specimens sampled from adult patients in Beijing. Methods 158 nasopharyngeal swab specimens were collected from adult patients with fever in Beijing between October and December, 2007. We performed the screening of HCoV-229E by real-time RT-PCR and sequencing of HCoV-229E gene fragments derived from conventional PCR. At meantime, we also screened the HCoV-229E positive samples for the co-infection with HCoV-NL63, HCoV-HKU1 and HMPV by real-time RT-PCR. Finally, demographic and clinical data associated with HCoV-229E infection were examined retrospectively. Results We detected 103 （62.5 % ） of 158 specimens were positive for HCoV-229E by real-time RT-PCR. When tested for other respiratory viruses, 26 HCoV-229E positive patients were found to be co-infected with other viruses. Of which HCoV-NL63 was observed in 3 specimens （11.5%）, HCoV-HKU1 in 3 （11.5%） and HMPV in 20（76.9%）. The main clinical manifestations were noted as ： headache （ in 70.9 % ）, sore throat （ 69 % ）, chills （ 68 % ）, cough （33%）, sputum （21.3%）, rhinorrhea （21.4%）, nasal obstruction （ 16.5% ）, and a few of patients were visible as vomiting （6.8 % ）, dyspnea （3.9 % ）, diarrhea （in 1.9 % ）. The rate of HCoV-229E infection in adult patients was found no relative with age and gender. Conclusion Our data showed that HCoV-229E is a common and important pathogen in adult patients with acute respiratory symptoms but usually resulted in milder influenza-like illnesses. There might have a local outbreak of HCoV-229E infect/on in Beijing, Oct-Dec, 2007.