Coronavirus Infections in the Central Nervous System and Respiratory Tract Show Distinct Features in Hospitalized Children

Intervirology. 2016;59(3):163-169. doi: 10.1159/000453066. Epub 2017 Jan 20.


Background/aims: Coronavirus (CoV) infections induce respiratory tract illnesses and central nervous system (CNS) diseases. We aimed to explore the cytokine expression profiles in hospitalized children with CoV-CNS and CoV-respiratory tract infections.

Methods: A total of 183 and 236 hospitalized children with acute encephalitis-like syndrome and respiratory tract infection, respectively, were screened for anti-CoV IgM antibodies. The expression profiles of multiple cytokines were determined in CoV-positive patients.

Results: Anti-CoV IgM antibodies were detected in 22/183 (12.02%) and 26/236 (11.02%) patients with acute encephalitis-like syndrome and respiratory tract infection, respectively. Cytokine analysis revealed that the level of serum granulocyte colony-stimulating factor (G-CSF) was significantly higher in both CoV-CNS and CoV-respiratory tract infection compared with healthy controls. Additionally, the serum level of granulocyte macrophage colony-stimulating factor (GM-CSF) was significantly higher in CoV-CNS infection than in CoV-respiratory tract infection. In patients with CoV-CNS infection, the levels of IL-6, IL-8, MCP-1, and GM-CSF were significantly higher in their cerebrospinal fluid samples than in matched serum samples.

Conclusion: To the best of our knowledge, this is the first report showing a high incidence of CoV infection in hospitalized children, especially with CNS illness. The characteristic cytokine expression profiles in CoV infection indicate the importance of host immune response in disease progression.

MeSH terms

  • Adolescent
  • Central Nervous System Viral Diseases / diagnosis
  • Central Nervous System Viral Diseases / epidemiology*
  • Central Nervous System Viral Diseases / immunology
  • Chemokine CCL2 / blood
  • Chemokine CCL2 / cerebrospinal fluid
  • Child
  • Child, Hospitalized
  • Child, Preschool
  • China / epidemiology
  • Coronavirus / immunology
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / immunology
  • Cytokines / blood*
  • Cytokines / cerebrospinal fluid*
  • Cytokines / immunology
  • Disease Progression
  • Female
  • Granulocyte Colony-Stimulating Factor / blood
  • Granulocyte Colony-Stimulating Factor / cerebrospinal fluid
  • Granulocyte-Macrophage Colony-Stimulating Factor / blood
  • Granulocyte-Macrophage Colony-Stimulating Factor / cerebrospinal fluid
  • Humans
  • Immunoglobulin M / blood
  • Immunoglobulin M / cerebrospinal fluid
  • Infant
  • Interleukin-6 / blood
  • Interleukin-6 / cerebrospinal fluid
  • Interleukin-8 / blood
  • Interleukin-8 / cerebrospinal fluid
  • Male
  • Respiratory Tract Infections / diagnosis
  • Respiratory Tract Infections / epidemiology*
  • Respiratory Tract Infections / immunology


  • CCL2 protein, human
  • Chemokine CCL2
  • Cytokines
  • IL6 protein, human
  • Immunoglobulin M
  • Interleukin-6
  • Interleukin-8
  • Granulocyte Colony-Stimulating Factor
  • Granulocyte-Macrophage Colony-Stimulating Factor