title: Middle Eastern Respiratory Syndrome Corona Virus (MERS CoV): case reports from a tertiary care hospital in Saudi Arabia.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Dr. Mohammad Khalid, Department of Medicine, King Faisal Specialist Hospital & Research Center PO Box 3354 Riyadh 11211 Saudi Arabia, mkhalid@kfshrc.edu.sa.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Khalid
authors.forename: Basha
authors.initials: B
authors.lastname: Khan
authors.forename: Fahad
authors.initials: F
authors.lastname: Al Rabiah
authors.forename: Ruwaida
authors.initials: R
authors.lastname: Alismaili
authors.forename: Sarfraz
authors.initials: S
authors.lastname: Saleemi
authors.forename: Agha Muhammad
authors.initials: AM
authors.lastname: Rehan-Khaliq
authors.forename: Ihab
authors.initials: I
authors.lastname: Weheba
authors.forename: Hail
authors.initials: H
authors.lastname: Al Abdely
authors.forename: Magid
authors.initials: M
authors.lastname: Halim
authors.forename: Quaid Johar
authors.initials: QJ
authors.lastname: Nadri
authors.forename: Abdullah Mohsin
authors.initials: AM
authors.lastname: Al Dalaan
authors.forename: Mohamed
authors.initials: M
authors.lastname: Zeitouni
authors.forename: Taimur
authors.initials: T
authors.lastname: Butt
authors.forename: Eid
authors.initials: E
authors.lastname: Al Mutairy
mesh_terms: D000293:Adolescent; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use*; D058345:Asymptomatic Infections; D018352:Coronavirus Infections / Q000175:diagnosis / Q000188:drug therapy*; D057210:Delayed Diagnosis; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D065207:Middle East Respiratory Syndrome Coronavirus; D011014:Pneumonia / Q000821:virology; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000627:therapeutic use; D012131:Respiratory Insufficiency / Q000821:virology; D012254:Ribavirin / Q000627:therapeutic use*; D012529:Saudi Arabia / Q000453:epidemiology; D062606:Tertiary Care Centers; D061665:Time-to-Treatment
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b
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