Nonsevere Acute Respiratory Syndrome Human Coronaviruses in Children Hospitalized with Acute Lower Respiratory Infection

BACKGROUND: The nonzoonotic (nonsevere acute respiratory syndrome (SARS)/Middle East respiratory syndrome) human coronaviruses (HCoVs) are usually considered as the causative agent for acute respiratory infection. We studied the characteristics and outcome of children with non-SARS HCoV acute lower respiratory infection (ALRI). METHODS: This was a cross-sectional study from a tertiary care teaching hospital in eastern India. RESULTS: Of 137 samples tested positive for respiratory viruses, 13 were due to HCoV (7 boys, median age: 2 years). Cough was the most common symptom, followed by breathing difficulty and fever. An underlying comorbid condition present in 38.4%. Co-infection with other viruses was seen in 69% of cases. Chest radiograph was abnormal in 69.3% of children. Antibiotics were administered in 53.8%. The median length of hospitalization was 5 d, irrespective of underlying disease. There was no mortality. CONCLUSIONS: HCoV is an uncommon but increasingly recognized cause of ALRI in hospitalized children. No severe illness was found in children with underlying comorbidities. This study underscores the importance of HCoV in causation of childhood ALRI, necessitating a surveillance system in India.