1752. Seasonal Human Coronavirus in Pediatric Patients enrolled by the New Vaccine Surveillance Network, 2016-2020
Authors: Musa Samar , Zhang Xueyan , Balasubramani G K , Halasa Natasha B , Stewart Laura S , Schuster Jennifer E , Selvarangan Rangaraj , Weinberg Geoffrey A , Szilagyi Peter G , Klein Eileen J , Englund Janet A , Avadhanula Vasanthi , Piedra Pedro A , Quigley Christina M , Staat Mary A , Perez Ariana , Moline Heidi L , Williams John V , Michaels Marian G 
Published: November 2023

Abstract

Background
The COVID-19 pandemic highlighted the potential pathogenicity of betacoronaviruses. This elucidates the need to further investigate human coronaviruses (HCoV), which includes both alpha and betacoronaviruses, to better understand their seasonality and severity among children.

Methods
The New Vaccine Surveillance Network (NVSN) enrolled children at 7 pediatric medical centers in the United States seen at the emergency department (ED) or hospitalized with acute respiratory infection (ARI), during 12/1/2016–9/28/2020. Respiratory specimens were collected and tested using real-time reverse transcription polymerase-chain reaction assays. The frequency of seasonal HCoV (HCoV-229E, HCoV-HKU1, HCoV-NL63, and HCoV-OC43) detections was measured and symptoms were reported by parent interview. Descriptive statistics were performed to compare HCoV-positive inpatients to those seen in the ED. SARS-CoV-2 infections were excluded.

Results
Of 34,455 children enrolled, 925 (2.7%) were positive for HCoV, of which 398 (43%) were inpatients and (57%) were ED patients (Table). 346 detections (37.4%) were HCoV-OC43, 298 (32.3%) HCoV-NL63, 186 (20.2%) HCoV-HKU1, and 107 (11.6%) HCoV-229E. More than one coronavirus was detected in 12 children (1.3%). HCoV were primarily detected between October and April of each season; 1 to 2 types dominated each year but not consecutively (Figure). Among HCoV-positive children, 527 (57.0%) received their highest level of care in the ED while 398 (43.0%) were hospitalized. HCoV-229E was the most common HCoV detected among inpatients (57.0%), followed by HCoV-HKU1-(45.2%); HCoV-OC43- (40.8%); and HCoV-NL63 (38.9%). Among those positive for a HCoV age, race, and insurance status were significantly associated with hospitalization.

Conclusion
HCoV followed a winter-season circulation pattern, but with variation in the predominant type across years. HCoV-OC43 accounted for the largest number of HCoV infections whereas HCoV-229E had the highest proportion hospitalized. Further surveillance is required to evaluate the impact of the emergent circulation of SARS-CoV-2 on seasonal HCoVs.

Disclosures
Natasha B. Halasa, MD, MPH, Merck: Grant/Research Support|Quidell: Grant/Research Support|Quidell: donation of kits|Sanofi: Grant/Research Support|Sanofi: vaccine support Rangaraj Selvarangan, BVSc, PhD, D(ABMM), FIDSA, FAAM, Abbott: Honoraria|Altona Diagnostics: Grant/Research Support|Baebies Inc: Advisor/Consultant|BioMerieux: Advisor/Consultant|BioMerieux: Grant/Research Support|Bio-Rad: Grant/Research Support|Cepheid: Grant/Research Support|GSK: Advisor/Consultant|Hologic: Grant/Research Support|Lab Simply: Advisor/Consultant|Luminex: Grant/Research Support Geoffrey A. Weinberg, MD, Merck & Co: Honoraria Janet A. Englund, MD, Ark Biopharma: Advisor/Consultant|AstraZeneca: Advisor/Consultant|AstraZeneca: Grant/Research Support|GlaxoSmithKline: Grant/Research Support|Meissa Vaccines: Advisor/Consultant|Merck: Grant/Research Support|Moderna: Advisor/Consultant|Moderna: Grant/Research Support|Pfizer: Advisor/Consultant|Pfizer: Grant/Research Support|Sanofi Pasteur: Advisor/Consultant Pedro A. Piedra, MD, Ark Bioscience: Advisor/Consultant|Ark Bioscience: Grant/Research Support|GSK: Grant/Research Support|Icosavax: Advisor/Consultant|Icosavax: Grant/Research Support|Mapp Biologics: Grant/Research Support|Meissa Vaccines: Grant/Research Support|Moderna: Advisor/Consultant|Novavax: Advisor/Consultant|Novavax: Grant/Research Support|Sanofi-Pasteur: Grant/Research Support|Shionogi: Advisor/Consultant|Shionogi: Grant/Research Support|Takeda: Advisor/Consultant Mary A. Staat, MD, MPH, CDC: Grant/Research Support|Cepheid: Grant/Research Support|Merck: Grant/Research Support|NIH: Grant/Research Support|Pfizer: Grant/Research Support|Up-To-Date: Honoraria John V. Williams, MD, Merck: Grant/Research Support|Quidel: Board Member Marian G. Michaels, MD, MPH, Merck: Grant/Research Support|Viracor: Grant/Research Support