Middle Eastern Respiratory Syndrome Corona Virus (MERS CoV): case reports from a tertiary care hospital in Saudi Arabia

Ann Saudi Med. 2014 Sep-Oct;34(5):396-400. doi: 10.5144/0256-4947.2014.396.

Abstract

Background and objectives: Middle Eastern respiratory syndrome caused by novel coronavirus (MERS CoV) has been a major public health challenge since it was first described in 2012 in Saudi Arabia. So far, there is no effective treatment for this serious illness, which features a high mortality rate. We report an initial experience of the use of ribavirin and interferon (IFN)-a2b in the management of MERS CoV at a tertiary care hospital.

Design and settings: A case series of 6 patients admitted with a confirmed diagnosis of MERS CoV were treated with ribavirin and IFN-a2b in addition to supportive management. The patients' demographics, clinical parameters, and outcomes were recorded. Fifty-four close contacts of these patients were screened for MERS CoV.

Methods: Six patients with MERS CoV infection were included in this study. Four cases featured symptomatic disease, including pneumonia and respiratory failure, while 2 were asymptomatic close contacts of the MERS CoV patients. The MERS CoV infection was confirmed by reverse transcription-polymerase chain reaction detection of the consensus viral RNA targets upstream of the E gene (UPE) and open reading frame (ORF1b) on a sputum sample. The patients' demographics, comorbid conditions, time to diagnosis and initiation of treatment, and clinical outcomes were recorded.

Results: Three out of 6 patients who had comorbid conditions died during the study period, while 3 had suc.cessful outcomes. The diagnosis and treatment was delayed by an average of 15 days in those patients who died. Only 2 close contacts out of the 54 screened (3.7%) were positive for MERS CoV.

Conclusion: Treatment with ribavirin and IFN-a2b may be effective in patients infected with MERS CoV. There appears to be a low infectivity rate among close contacts of MERS CoV patients.

MeSH terms

  • Adolescent
  • Aged
  • Aged, 80 and over
  • Antiviral Agents / therapeutic use*
  • Asymptomatic Infections
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / drug therapy*
  • Delayed Diagnosis
  • Drug Therapy, Combination
  • Female
  • Humans
  • Interferon alpha-2
  • Interferon-alpha / therapeutic use*
  • Male
  • Middle Aged
  • Middle East Respiratory Syndrome Coronavirus*
  • Pneumonia / virology
  • Polyethylene Glycols / therapeutic use*
  • Recombinant Proteins / therapeutic use
  • Respiratory Insufficiency / virology
  • Ribavirin / therapeutic use*
  • Saudi Arabia / epidemiology
  • Tertiary Care Centers
  • Time-to-Treatment

Substances

  • Antiviral Agents
  • Interferon alpha-2
  • Interferon-alpha
  • Recombinant Proteins
  • Polyethylene Glycols
  • Ribavirin
  • peginterferon alfa-2b