More than just a common cold: endemic coronaviruses OC43, HKU1, NL63, and 229E associated with severe acute respiratory infection and fatality cases among healthy adults

Respiratory viral infection can cause severe disease and hospitalization, especially among children, the elderly, and patients with comorbidities. In Brazil, the official surveillance system of severe acute respiratory infection (SARI) investigates influenza A (IAV) and B (IBV) viruses, respiratory syncytial virus (RSV), adenovirus (HAdV), and parainfluenza viruses (hPIV 1­3). In Rio Grande do Sul (RS), Brazil, many fatalities associated with SARI between 2013 and 2017 occurred among patients without underlying diseases and for whom the causative agent had not been identified using official protocols. This cross­sectional study analyzed the presence of coronaviruses (HCoV), bocavirus (HBoV), metapneumovirus (hMPV), and rhinovirus in patients who died of SARI despite not having comorbidities, and that were negative for IAV, IBV, RSV, HAdV, and hPIV. Nasopharyngeal aspirates/swabs from patients were used for nucleic acid extraction. The presence of HCoVs OC43, HKU1, NL63, and 229E; HBoV; hMPV; and rhinovirus was assessed by quantitative reverse transcription­polymerase chain reaction. Clinical data were also analyzed. Between 2013 and 2017, 16 225 cases of SARI were reported in RS; 9.8% of the patients died; 20% of all fatal cases were patients without comorbidities and for whom no pathogen was detected using standard protocols. Analysis of 271 of these cases identified HCoV in nine cases; HBoV, hMPV, and rhinovirus were detected in 3, 3, and 10 cases, respectively. Of note, patients infected with HCoV were adults. Results reinforce the importance of including coronaviruses in diagnostic panels used by official surveillance systems because besides their pandemic potential, endemic HCoVs are associated to severe disease in healthy adults.

Etiología viral de la hipoacusia sensorioneural súbita: ¿Mito o realidad? / Viral etiology of sensorineural sudden deafness: myth or reality?

Introducción: La hipoacusia sensorioneural súbita (HSNS), es una causa poco frecuente de hipoacusia. La mayoría son consideradas idiopáticas y sólo en el 10 por ciento-15 por ciento puede descubrirse un factor etiológico. Se han propuesto 4 teorías fisiopatológicas: viral, vascular, inmunológica y por ruptura de membranas. La etiología viral es controversial. Objetivo: Investigar la etiología viral como posible causa de HSNS y evaluar su presencia en relación con el pronóstico de recuperación auditiva. Material y método: Estudio descriptivo observacional de 24 meses, de pacientes con cuadro clínico de HSNS y exámenes compatibles. Previo al tratamiento se tomó hisopado y aspirado nasofaríngeo analizados mediante Microarray. Resultados: Se reclutaron 15 pacientes. En 9 se detectó virus respiratorio sincicial (VRS) y simultáneamente cuatro de ellos además otros virus (bocavirus, herpes VI y VII). No se detectaron casos de virus herpes I y II. No se han evidenciado diferencias en la evolución auditiva en el grupo con muestras positivas para virus. Conclusiones: La etiología viral de HSNS permanece en controversia. El 60 por ciento de los pacientes evaluados resultaron positivos, sin embargo, no hubo ningún virus herpes I ó II en las muestras. El VRS aparece como nuevo agente involucrado, aun cuando se encuentra fuera de temporada habitual.

Introduction: Sudden sensorineural hearing loss (SSHL) is a rare cause of hearing loss. Most are considered idiopathic and only 10-15 percent can discover an etiologic factor. Four pathophysiological theories have been proposed: viral, vascular, immunological and rupture of membranes. The viral etiology is controversial and there are reports with varying results. Aim: To investigate the viral etiology as a cause of HSNS and evaluate their presence in relation to the prognosis of hearing recovery. Material and method: descriptive, observational study of 24 months, patients with symptoms and exams compatible SSHL. Before treatment, nasopharyngeal aspirate was taken and then analyzed using Microarray. Results: Were enrolled 15 patients. In 9 was detected a respiratory syncytial virus (RSV) and four of them simultaneously also other viruses (Bocavirus, Herpes VI and VII). There were no cases of Herpes Virus I and II. There were no evidence differences in auditory development in the group with samples positive for virus. Conclusions: The viral etiology of SSHL remains controversial. 60 percent of patients tested were positive, however, there was no Herpes virus I or II in the samples. RSV appears as a new agent involved, even when was out of regular season.

Bocavirus humano: Estudios en la literatura médica y en Chile / Human bocavirus: Studies in the literature and in Chile

The human bocavirus (HBoV), virus of the Parvoviridae family, discovered by molecular methods in 2005,has been reported in respiratory samples, stool, urine and blood, both in children and adults. Prevalence ratesrange from 0.8% in fecal samples of individuals with acute diarrhea, up to 19% in respiratory samples and blood.HBoV has been detected in up to 43% of nasopharyngeal samples in asymptomatic children. In Chile, HBoV wasdetected in 24.2% of nasopharyngeal swabs in children under 5 years of age with respiratory symptoms of which74% had coinfection with other viruses. In asymptomatic children under 5 years of age, 37.5% of NP sampleswere positive for HBoV. We discuss the role of HBoV as a causal agent of respiratory and/or enteric disease inlight of the high rates of coinfection and asymptomatic infections.