Endemic Human Coronaviruses in Hospitalized Adults with Community-Acquired Pneumonia: Results from the Louisville Pneumonia Study

Introduction: There are four endemic serotypes of human coronavirus (HCoV) that may cause community-acquired pneumonia (CAP) in humans. The clinical syndrome of CAP due to HCoVs is not well characterized. The objectives of this study were to evaluate incidence, epidemiology, and outcomes of CAP in adults due to HCoV and to compare them with CAP due to influenza. Methods: The Louisville Pneumonia Study (LPS) is a prospective observational study of hospitalized adult patients with CAP in the city of Louisville. Patients enrolled in the LPS in whom a respiratory viral panel polymerase chain reaction (PCR) was obtained were evaluated. Incidence, epidemiology, and outcomes were compared for patients with a positive PCR for HCoV versus patients with a positive PCR for influenza. Results: From 1,974 CAP patients with a PCR performed, HCoV was identified in 65 patients (3.3%), corresponding to the following serotypes: HCoV-229E in 12 patients, HCoV-OC43 in 38 patients, HCoV-NL63 in 6 patients and HCoV-HKU1 in 9 patients. No differences were observed in clinical presentation and early outcomes for patients with CAP due to HCoV compared to 244 patients with CAP due to influenza. One-year mortality after hospitalization was 32% for patients with CAP due to HCoV versus 13% for patients with CAP due to influenza. Conclusions: When compared to patients with CAP due to influenza, the clinical presentation of patients with CAP due to HCoV is similar, but these patients have significantly worse outcomes one year after hospitalization