What is Coronavirus 229E (Human Coronavirus 229E)?

From the Guidelines

Coronavirus 229E is a neurotropic virus that can infect fetal and adult neurons, and has been associated with neuropsychiatric symptoms, highlighting the need for careful management and consideration of potential long-term effects. The virus is one of the four common human coronaviruses that typically cause mild to moderate upper respiratory infections, similar to the common cold, primarily affecting the nasal passages and throat, causing symptoms such as runny nose, cough, sore throat, headache, and occasionally fever 1. Most infections are self-limiting and resolve within 7-10 days without specific treatment. Management focuses on supportive care including rest, adequate hydration, and over-the-counter medications like acetaminophen (325-650mg every 4-6 hours as needed) or ibuprofen (200-400mg every 6-8 hours with food) for fever and discomfort.

Key Considerations

• Nasal decongestants and cough suppressants may also provide symptomatic relief
• Unlike SARS-CoV-2, Coronavirus 229E rarely causes severe illness, though it may pose greater risk to immunocompromised individuals, the elderly, and those with underlying respiratory conditions
• The virus spreads through respiratory droplets and contaminated surfaces, so prevention involves regular handwashing, avoiding close contact with infected individuals, and disinfecting frequently touched surfaces
• No specific antiviral treatments or vaccines are currently available for Coronavirus 229E infections
• Recent studies have shown that coronaviruses, including 229E, can infect human post-mortem brains and have been associated with neuropsychiatric symptoms, such as new onset psychosis 1

Prevention and Management

• Regular handwashing and avoiding close contact with infected individuals can help prevent the spread of the virus
• Disinfecting frequently touched surfaces can also help reduce the risk of transmission
• Supportive care, including rest, adequate hydration, and over-the-counter medications, can help manage symptoms and reduce the risk of complications
• Given the potential for long-term effects, including neuropsychiatric symptoms, it is essential to closely monitor individuals infected with Coronavirus 229E and provide ongoing support and care as needed 1.

From the Research

Coronavirus 229E Overview

• Coronavirus 229E (HCoV-229E) is a common respiratory virus that causes various respiratory diseases, including pneumonia 2.
• It is one of the four human coronaviruses (HCoV) strains, along with OC43, NL63, and HKU1, that are known to cause respiratory infections 2.

Epidemiology and Clinical Characteristics

• A study of hospitalized children with acute respiratory tract infection in Guangzhou, China, found that 0.6% of patients were positive for HCoV-229E 2.
• The peak seasons of infection varied depending on the HCoV strain, and patients aged 7-12 months had the highest prevalence of HCoV and OC43 2.
• Patients infected with a single strain of HCoV-229E were less likely to present fever and more likely to present pulmonary rales than those co-infected with more than one HCoV strain or other respiratory pathogens 2.

Infection and Immune Response

• Human alveolar macrophages (AMs) are susceptible to HCoV-229E infection, and the virus can readily infect these cells 3.
• The innate immune response of AMs to HCoV-229E infection involves the secretion of cytokines such as tumour necrosis factor alpha (TNF-α), regulated on activation normal T-cell expressed and secreted (RANTES/CCL5), and macrophage inflammatory protein 1β (MIP-1β/CCL4) 3.
• Surfactant protein A (SP-A) and SP-D, which are part of the innate immune system in the distal lung, can bind to HCoV-229E and inhibit infection of epithelial cells 3.

Treatment and Management

• There is currently no specific treatment for HCoV-229E infection, and management is typically focused on relieving symptoms and supporting respiratory function 4, 5, 6.
• Studies have investigated the use of antiviral agents such as oseltamivir in the treatment of COVID-19, but its efficacy against HCoV-229E is not well established 5.