Human Coronavirus NL63

Burtram C Fielding

Future Microbiol. 2011;6(2):153-159.

Conclusion

The detection of HCoV-NL63 in samples collected in 1981^[36] and 1988^[16] shows that the virus has been circulating and causing disease in the human population for a long time. However, the discovery of HCoV-NL63 and other novel HCoVs does not necessarily represent a sudden increase in emerging infections by 'new' CoVs. Of the CoVs isolated from patients in the 1960s, at least four were shown to be serologically distinct.^[77–79] Unfortunately, these clinical samples were lost before they could be characterized and it will never be known whether these 'old' HCoVs and the current 'new' HCoVs represent the same strains.^[80] HCoV-NL63 infections vary in frequency between years, but appear to peak during the winter months. HCoV-NL63 causes LRTIs and URTIs in 1.0–9.3% of children, the elderly and the immunocompromised, with symptoms ranging from mild to severe. Although unlikely, the high prevalence of coinfections of HCoV-NL63 and other respiratory viruses increases the chances of genetic recombination between these viruses in the host. In theory, these types of recombination events could enable highly pathogenic virus variants to arise.^[81] Current data clearly show that HCoV-NL63 is clinically more important that previously suspected.

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Financial & competing interests disclosure
The author receives funding from the National Research Foundation (South Africa) and the University of the Western Cape Senate Research Fund. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
No writing assistance was utilized in the production of this manuscript.

Cite this: Human Coronavirus NL63 - Medscape - Feb 01, 2011.

Table 1. Incidence of HCoV-NL63 in clinical samples.
Country	Method used for detection	Incidence (%; sample size)	Ref.
Australia	RT-PCR	3.30 (234)	[31]
Belgium	RT-PCR	2.30 (309)	[29]
Canada	RT-PCR	3.60 (525)	[18]
France	RT-PCR	9.30 (300)	[25]
Germany	Real-time RT-PCR	5.20 (949)	[28,30]
China	RT-PCR	2.60 (587)	[19]
Italy	RT-PCR	1.86 (150)	[27]
Japan	RT-PCR	1.20 (419)	[24]
Japan	RT-PCR	2.50 (118)	[22]
South Korea	RT-PCR	1.60 (515)	[20]
Taiwan	Quantitative RT-PCR	1.30 (539)	[43]
Thailand	RT-PCR	0.42 (1890)	[44]
South Africa	RT-PCR	8.30 (238)	[26]
Switzerland	RT-PCR	7.00 (82)	[23]
Sweden	RT-PCR	6.00 (212)	[32]
USA	RT-PCR	2.20 (1683)	[21]
South Korea	Multiplex RT-PCR	16.5 (182)	[17]
Germany	Real-time RT-PCR	3.90 (1756)	[5]
Norway	Multiplex real-time PCR	4.50 (536)	[33]

RT-PCR: Reverse transcription PCR.
Modified from [74].

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Executive Summary

Prevalence & seasonal incidence

Human coronavirus (HCoV)-NL63 has a worldwide distribution.
HCoV-NL63 infections peak in winter and have an interepidemic period of 2 years.

Respiratory clinical findings

HCoV-NL63 infects both the upper and lower respiratory tracts.
Infection with HCoV-NL63 is often associated with more severe lower respiratory tract infections and subsequent hospitalization.
Lower respiratory tract symptoms include croup and bronchiolitis.

Nonrespiratory clinical findings

The majority of studies did not find an association between HCoV-NL63 infection and Kawasaki disease.
HCoV-NL63 has been detected in a small number of diarrhea stool samples.

Coinfections with other respiratory viruses

Coinfections with other well known respiratory viruses are very common.
HCoV-NL63 viral load is higher in patients infected with HCoV-NL63 alone.
Patients with coinfections are more likely to be hospitalized.

Future perspective

More comprehensive population-based studies are needed to determine the involvement of HCoV-NL63 in the infection of systems other than the respiratory tract.
The development of the HCoV-NL63 infectious clone will greatly aid in understanding this virus.
An animal model is required for virus study and vaccine development.

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Human Coronavirus NL63

Conclusion

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