35
Views
1
CrossRef citations to date
0
Altmetric
Review

Developments in treatment for middle east respiratory syndrome coronavirus (MERS-CoV)

Pages 295-307 | Received 10 Feb 2024, Accepted 14 Jun 2024, Published online: 21 Jun 2024

References

  • European Centre for Disease Prevention and Control. MERS-CoV worldwide overview 2024. [cited 2024 Apr 6]. Available from: https://www.ecdc.europa.eu/en/middle-east-respiratory-syndrome-coronavirus-mers-cov-situation-update
  • Al-Tawfiq JA, Auwaerter PG. Healthcare-associated infections: the hallmark of Middle East respiratory syndrome coronavirus with review of the literature. J Hosp Infect. 2019;101(1):20–29. doi: 10.1016/j.jhin.2018.05.021
  • Elhazmi A, Al-Tawfiq JA, Sallam H, et al. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Middle East Respiratory Syndrome Coronavirus (MERS-CoV) coinfection: a unique case series. Travel Med Infect Dis. 2021:41. doi: 10.1016/j.tmaid.2021.102026
  • Khan A, Bin NS, Mzahim B, et al. MERS-CoV in the COVID-19 era: update from Saudi Arabia, 2019– 2020. East Mediterr Heal J. 2021;27(11):1109–1113. doi: 10.26719/emhj.21.049
  • Aljarallah KM, Alrukban MO, Alghamdi YS, et al. Hospital visitors’ awareness and adaptation of preventive measures for middle east respiratory syndrome coronavirus. Disaster Med Public Health Prep. 2022;16(3):961–966. doi: 10.1017/dmp.2020.435
  • AlBahrani S, Al Otaibi TO, AlAlalqahtani J, et al. The impact of non-pharmacologic interventions on respiratory syncytial virus hospitalization during the COVID-19 pandemic: a retrospective study from Saudi Arabia. J Infect Public Health. 2023:17. doi: 10.1016/j.jiph.2023.11.010
  • Olsen SJ, Azziz-Baumgartner E, Budd AP, et al. Decreased influenza activity during the COVID-19 pandemic—United States, Australia, Chile, and South Africa, 2020. Am J Transplant. 2020;20(12):3681–3685. doi: 10.1111/ajt.16381
  • Soo RJJ, Chiew CJ, Ma S, et al. Decreased influenza incidence under COVID-19 control measures, Singapore. Emerg Infect Dis. 2020;26:1933–1935. doi: 10.3201/eid2608.201229
  • Al-Tawfiq JA, Memish ZA. Drivers of MERS-CoV transmission: what do we know? Expert Rev Respir Med. 2016;10:331–338. doi: 10.1586/17476348.2016.1150784
  • Omrani AS, Matin MA, Haddad Q, et al. A family cluster of middle east respiratory syndrome coronavirus infections related to a likely unrecognized asymptomatic or mild case. Int J Infect Dis. 2013;17:e668–72. doi: 10.1016/j.ijid.2013.07.001
  • Memish ZA, Zumla AI, Al-Hakeem RF, et al. Family cluster of Middle East respiratory syndrome coronavirus infections. N Engl J Med. 2013;368:2487–2494. doi: 10.1056/NEJMoa1303729
  • Memish ZA, Cotten M, Watson SJ, et al. Community case clusters of middle east respiratory syndrome coronavirus in Hafr Al-Batin, Kingdom of Saudi Arabia: a descriptive genomic study. Int J Infect Dis. 2014;23:63–68. doi: 10.1016/j.ijid.2014.03.1372
  • Drosten C, Muth D, Corman VM, et al. An observational, laboratory-based study of outbreaks of middle east respiratory syndrome coronavirus in Jeddah and Riyadh, Kingdom of Saudi Arabia, 2014. Clin Infect Dis. 2015;60:369–377. doi: 10.1093/cid/ciu812
  • Assiri A, McGeer A, Perl TM, et al. Hospital outbreak of middle east respiratory syndrome coronavirus. N Engl J Med. 2013;369:407–416. doi: 10.1056/nejmoa1306742
  • Al-Abdallat MM, Payne DC, Alqasrawi S, et al. Hospital-associated outbreak of middle east respiratory syndrome coronavirus: a serologic, epidemiologic, and clinical description. Clin Infect Dis. 2014;59:1225–1233. doi: 10.1093/cid/ciu359
  • Hijawi B, Abdallat M, Sayaydeh A, et al. Novel coronavirus infections in Jordan, April 2012: epidemiological findings from a retrospective investigation. East Mediterr Heal J. 2013;19 Suppl 1:S12–8. doi: 10.26719/2013.19.supp1.S12
  • Oboho IK, Tomczyk SM, Al-Asmari AM, et al. 2014 MERS-CoV Outbreak in Jeddah — a link to health care facilities. N Engl J Med. 2015;372(9):846–854. doi: 10.1056/NEJMoa1408636
  • Alraddadi B, Bawareth N, Omar H, et al. Patient characteristics infected with Middle East respiratory syndrome coronavirus infection in a tertiary hospital. Ann Thorac Med. 2016;11:128–131. doi: 10.4103/1817-1737.180027
  • Fagbo SF, Skakni L, Chu DKW, et al. Molecular epidemiology of hospital outbreak of middle east respiratory syndrome, Riyadh, Saudi Arabia, 2014. Emerg Infect Dis. 2015;21(11):1981–1988. doi: 10.3201/eid2111.150944
  • Almekhlafi GA, Albarrak MM, Mandourah Y, et al. Presentation and outcome of Middle East respiratory syndrome in Saudi intensive care unit patients. Crit Care. 2016;20:123. doi: 10.1186/s13054-016-1303-8
  • Saad M, Omrani AS, Baig K, et al. Clinical aspects and outcomes of 70 patients with Middle East respiratory syndrome coronavirus infection: a single-center experience in Saudi Arabia. Int J Infect Dis. 2014;29:301–306. doi: 10.1016/j.ijid.2014.09.003
  • Memish ZA, Al-Tawfiq JA, Alhakeem RF, et al. Middle East respiratory syndrome coronavirus (MERS-CoV): A cluster analysis with implications for global management of suspected cases. Travel Med Infect Dis. 2015;13:311–314. doi: 10.1016/j.tmaid.2015.06.012
  • El Bushra HE, Abdalla MN, Al Arbash H, et al. An outbreak of Middle East Respiratory Syndrome (MERS) due to coronavirus in Al-Ahssa Region, Saudi Arabia, 2015. East Mediterr Health J. 2016;22(7):467–474. doi: 10.26719/2016.22.7.467
  • Balkhy HH, Alenazi TH, Alshamrani MM, et al. Notes from the field: nosocomial outbreak of middle east respiratory syndrome in a large tertiary care hospital — Riyadh, Saudi Arabia, 2015. MMWR Morb Mortal Wkly Rep. 2016;65(6):163–164. doi: 10.15585/mmwr.mm6506a5
  • Balkhy HH, Alenazi TH, Alshamrani MM, et al. Description of a hospital outbreak of middle east respiratory syndrome in a large tertiary care hospital in Saudi Arabia. Infect Control Hosp Epidemiol. 2016;37:1147–1155. doi: 10.1017/ice.2016.132
  • Assiri AM, Biggs HM, Abedi GR, et al. Increase in middle east respiratory syndrome-coronavirus cases in Saudi Arabia linked to hospital outbreak with continued circulation of recombinant virus, July 1–August 31, 2015. Open Forum Infect Dis. 2016;3(3):ofw165. doi: 10.1093/ofid/ofw165
  • Nazer RI. Outbreak of middle east respiratory syndrome-coronavirus causes high fatality after cardiac operations. Ann Thorac Surg. 2017;104:e127–9. doi: 10.1016/j.athoracsur.2017.02.072
  • Assiri A, Abedi GR, Bin Saeed AA, et al. Multifacility outbreak of middle east respiratory syndrome in Taif, Saudi Arabia. Emerg Infect Dis. 2016;22(1):32–40. doi: 10.3201/eid2201.151370
  • Hunter JC, Nguyen D, Aden B, et al. Transmission of middle east respiratory syndrome coronavirus infections in healthcare settings, Abu Dhabi. Emerg Infect Dis. 2016;22:647–656. doi: 10.3201/eid2204.151615
  • Cauchemez S, Van Kerkhove MD, Riley S, et al. Transmission scenarios for middle east respiratory syndrome coronavirus (MERS-CoV) and how to tell them apart. Euros Urveillance. 2013;18(24). pii: 20503. doi: 10.2807/ese.18.24.20503-en
  • Cauchemez S, Fraser C, Van Kerkhove MD, et al. Middle East respiratory syndrome coronavirus: quantification of the extent of the epidemic, surveillance biases, and transmissibility. Lancet Infect Dis. 2014;14:50–56. doi: 10.1016/S1473-3099(13)70304-9
  • Chowell G, Abdirizak F, Lee S, et al. Transmission characteristics of MERS and SARS in the healthcare setting: a comparative study. BMC Med. 2015;13:210. doi: 10.1186/s12916-015-0450-0
  • Raj VS, Osterhaus ADME, Fouchier RAM, et al. MERS: Emergence of a novel human coronavirus. Curr Opin Virol. 2014;5:58–62. doi: 10.1016/j.coviro.2014.01.010
  • de Wilde AH, Raj VS, Oudshoorn D, et al. MERS-coronavirus replication induces severe in vitro cytopathology and is strongly inhibited by cyclosporin a or interferon-α treatment. J Gen Virol. 2013;94(8):1749–1760. doi: 10.1099/vir.0.052910-0
  • Du L, Yang Y, Zhou Y, et al. MERS-CoV spike protein: a key target for antivirals. Expert Opin Ther Targets. 2017;21:131–143. doi: 10.1080/14728222.2017.1271415
  • Ying T, Du L, Ju TW, et al. Exceptionally potent neutralization of Middle East respiratory syndrome coronavirus by human monoclonal antibodies. J Virol. 2014;88:7796–7805. doi: 10.1128/JVI.00912-14
  • Kindler E, Thiel V, Weber F. Interaction of SARS and MERS coronaviruses with the antiviral interferon response. Adv Virus Res. 2016;96:219–243. doi: 10.1016/bs.aivir.2016.08.006
  • Momattin H, Al-Ali AY, Al-Tawfiq JA. A systematic review of therapeutic agents for the treatment of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). Travel Med Infect Dis. 2019;30:9–18. doi: 10.1016/j.tmaid.2019.06.012.
  • Hart BJ, Dyall J, Postnikova E, et al. Interferon-β and mycophenolic acid are potent inhibitors of Middle East respiratory syndrome coronavirus in cell-based assays. J Gen Virol. 2014;95:571–577. doi: 10.1099/vir.0.061911-0
  • Falzarano D, de Wit E, Martellaro C, et al. Inhibition of novel β coronavirus replication by a combination of interferon-α2b and ribavirin. Sci Rep. 2013;3:1686. doi: 10.1038/srep01686
  • Chan JF, Chan KH, Kao RY, et al. Broad-spectrum antivirals for the emerging Middle East respiratory syndrome coronavirus. J Infect. 2013;67(6):606–616. doi: 10.1016/j.jinf.2013.09.029
  • de Wit E, Feldmann F, Cronin J, et al. Prophylactic and therapeutic remdesivir (GS-5734) treatment in the rhesus macaque model of MERS-CoV infection. Proc Natl Acad Sci U S A. 2020;117:6771–6776. doi: 10.1073/PNAS.1922083117
  • Sheahan TP, Sims AC, Graham RL, et al. Broad-spectrum antiviral GS-5734 inhibits both epidemic and zoonotic coronaviruses. Sci Transl Med. 2017:9. doi: 10.1126/scitranslmed.aal3653
  • Sheahan TP, Sims AC, Leist SR, et al. Comparative therapeutic efficacy of remdesivir and combination lopinavir, ritonavir, and interferon beta against MERS-CoV. Nat Commun. 2020;11(1):11. doi: 10.1038/s41467-019-13940-6
  • Falzarano D, de Wit E, Rasmussen AL, et al. Treatment with interferon-α2b and ribavirin improves outcome in MERS-CoV–infected rhesus macaques. Nat Med. 2013;19(10):1313–1317. doi: 10.1038/nm.3362
  • Omrani AS, Saad MM, Baig K, et al. Ribavirin and interferon alfa-2a for severe Middle East respiratory syndrome coronavirus infection: a retrospective cohort study. Lancet Infect Dis. 2014;14:1090–1095. doi: 10.1016/S1473-3099(14)70920-X
  • Shalhoub S, Farahat F, Al-Jiffri A, et al. IFN-α2a or IFN-β1a in combination with ribavirin to treat Middle East respiratory syndrome coronavirus pneumonia: a retrospective study. J Antimicrob Chemother. 2015;70:2129–2132. doi: 10.1093/jac/dkv085
  • Arabi YM, Asiri AY, Assiri AM, et al. Heterogeneity of treatment effect of interferon-β1b and lopinavir–ritonavir in patients with Middle East respiratory syndrome by cytokine levels. Sci Rep. 2022;12(1):12. doi: 10.1038/s41598-022-22742-8
  • Arabi YM, Asiri AY, Assiri AM, et al. Interferon beta-1b and Lopinavir–ritonavir for middle east respiratory syndrome. N Engl J Med. 2020;383(17):1645–1656. doi: 10.1056/nejmoa2015294
  • Arabi YM, Alothman A, Balkhy HH, et al. Treatment of Middle East Respiratory Syndrome with a combination of lopinavir-ritonavir and interferon-β1b (MIRACLE trial): study protocol for a randomized controlled trial. Trials. 2018;19:81. doi: 10.1186/s13063-017-2427-0
  • Khalid I, Alraddadi BM, Dairi Y, et al. Acute management and long-term survival among subjects with severe middle east respiratory syndrome coronavirus pneumonia and ARDS. Respir Care. 2016;61:340–348. doi: 10.4187/respcare.04325
  • Al Ghamdi M, Alghamdi KM, Ghandoora Y, et al. Treatment outcomes for patients with Middle Eastern Respiratory Syndrome Coronavirus (MERS CoV) infection at a coronavirus referral center in the Kingdom of Saudi Arabia. BMC Infect Dis. 2016;16:174. doi: 10.1186/s12879-016-1492-4
  • Khalid M, Khan B, Al Rabiah FA, et al. Middle Eastern Respiratory Syndrome Corona Virus (MERS CoV): Case reports from a tertiary care hospital in Saudi Arabia. Ann Saudi Med. 2014;34(5):396–400. doi: 10.5144/0256-4947.2014.396
  • Arabi YM, Asiri AY, Assiri AM, et al. Treatment of Middle East respiratory syndrome with a combination of lopinavir/ritonavir and interferon-β1b (MIRACLE trial): statistical analysis plan for a recursive two-stage group sequential randomized controlled trial. Trials. 2020;21(1):21. doi: 10.1186/s13063-019-3846-x
  • Kain T, Lindsay PJ, Adhikari NKJ, et al. Pharmacologic treatments and supportive care for middle east respiratory syndrome. Emerg Infect Dis. 2020;26:1102–1112. doi: 10.3201/EID2606.200037
  • Al-Tawfiq JA, Arabi Y. Convalescent plasma therapy for coronavirus infection: experience from MERS and application in COVID-19. Hum Vaccines Immunother. 2020;16:2973–2979. doi: 10.1080/21645515.2020.1793712
  • Ko JH, Seok H, Cho SY, et al. Challenges of convalescent plasma infusion therapy in Middle East respiratory coronavirus infection: a single centre experience. Antivir Ther. 2018;23:617–622. doi: 10.3851/IMP3243
  • Arabi Y, Balkhy H, Hajeer AH, et al. Feasibility, safety, clinical, and laboratory effects of convalescent plasma therapy for patients with Middle East respiratory syndrome coronavirus infection: a study protocol. Springerplus. 2015;4(1):709. doi: 10.1186/s40064-015-1490-9
  • Arabi YM, Hajeer AH, Luke T, et al. Feasibility of using convalescent plasma immunotherapy for MERS-CoV infection, Saudi Arabia. Emerg Infect Dis. 2016;22:1554–1561. doi: 10.3201/eid2209.151164
  • Alshukairi AN, Khalid I, Ahmed WA, et al. Antibody response and disease severity in healthcare worker MERS survivors. Emerg Infect Dis. 2016;22. doi: 10.3201/eid2206.160010
  • Drosten C, Meyer B, Müller MA, et al. Transmission of MERS-Coronavirus in household contacts. N Engl J Med. 2014;371(9):828–835. doi: 10.1056/nejmoa1405858
  • Alrashid M, Taleb A, Hajeer A, et al. Prevalence of antibodies against the Middle East Respiratory Syndrome coronavirus, influenza a and B viruses among blood donors, Saudi Arabia. Ann Thorac Med. 2017;12(3):217–218. doi: 10.4103/atm.ATM_143_17
  • Corman VM, Albarrak AM, Omrani AS, et al. Viral shedding and antibody response in 37 patients with middle east respiratory syndrome coronavirus infection. Clin Infect Dis. 2015;62:477–483. doi: 10.1093/cid/civ951
  • Park WB, Perera RAPM, Choe PG, et al. Kinetics of serologic responses to mers coronavirus infection in humans, South Korea. Emerg Infect Dis. 2015;21:2186–2189. doi: 10.3201/eid2112.151421
  • Tang X-C, Agnihothram SS, Jiao Y, et al. Identification of human neutralizing antibodies against MERS-CoV and their role in virus adaptive evolution. Proc Natl Acad Sci U S A. 2014;111:E2018–26. doi: 10.1073/pnas.1402074111
  • Zhao J, Perera RAPM, Kayali G, et al. Passive immunotherapy with dromedary immune serum in an experimental animal model for Middle East respiratory syndrome coronavirus infection. J Virol. 2015;89:6117–6120. doi: 10.1128/JVI.00446-15
  • Corti D, Zhao J, Pedotti MS, et al. Prophylactic and postexposure efficacy of a potent human monoclonal antibody against MERS coronavirus. Proc Natl Acad Sci U S A. 2015;112(33):10473–10478. doi: 10.1073/pnas.1510199112
  • Jiang L, Wang N, Zuo T, et al. Potent neutralization of MERS-CoV by human neutralizing monoclonal antibodies to the viral spike glycoprotein. Sci Transl Med. 2014;6:234ra59. doi: 10.1126/scitranslmed.3008140
  • Johnson RF, Bagci U, Keith L, et al. 3B11-N, a monoclonal antibody against MERS-CoV, reduces lung pathology in rhesus monkeys following intratracheal inoculation of MERS-CoV Jordan-n3/2012. Virology. 2016;490:49–58. doi: 10.1016/j.virol.2016.01.004
  • Liu D, Shameem M. Antiviral monoclonal antibody cocktails as a modern weapon in combating pandemics. Ther Deliv. 2022;13:67–69. doi: 10.4155/tde-2021-0079
  • Boonkrai C, Cotrone TS, Chaisuriyong W, et al. Efficacy of the combination of monoclonal antibodies against the SARS-CoV-2 Beta and Delta variants. PLOS ONE. 2023;18:e0284173. doi: 10.1371/journal.pone.0284173
  • Boonkrai C, Cotrone TS, Chaisuriyong W, et al. Efficacy of the combination of monoclonal antibodies against the SARS-CoV-2 Beta and Delta variants. PLOS ONE. 2023;18:e0284173–e0284173. doi: 10.1371/journal.pone.0284173
  • Rouet R, Henry JY, Johansen MD, et al. Broadly neutralizing SARS-CoV-2 antibodies through epitope-based selection from convalescent patients. Nat Commun. 2023;14(1):14. doi: 10.1038/s41467-023-36295-5
  • Ansariniya H, Seifati SM, Zaker E, et al. Comparison of immune response between SARS, MERS, and COVID-19 infection, perspective on vaccine design and development. Biomed Res Int. 2021;2021. doi: 10.1155/2021/8870425
  • Zhang YY, Li BR, Ning BT. The comparative immunological characteristics of SARS-CoV, MERS-CoV, and SARS-CoV-2 coronavirus infections. Front Immunol. 2020:11. doi: 10.3389/fimmu.2020.02033
  • Olbei M, Hautefort I, Modos D, et al. SARS-CoV-2 causes a different cytokine response compared to other cytokine storm-causing respiratory viruses in severely ill patients. Front Immunol. 2021:12. doi: 10.3389/fimmu.2021.629193
  • Irani S. Immune responses in SARS-CoV-2, SARS-CoV, and MERS-CoV infections: a comparative review. Int J Prev Med. 2022;13:45. doi: 10.4103/ijpvm.IJPVM_429_20
  • Alfaraj SH, Al-Tawfiq JA, Assiri AY, et al. Clinical predictors of mortality of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection: a cohort study. Travel Med Infect Dis. 2019;29:48–50. doi: 10.1016/j.tmaid.2019.03.004
  • Arabi YM, Mandourah Y, Al-Hameed F, et al. Corticosteroid therapy for critically ill patients with middle east respiratory syndrome. Am J Respir Crit Care Med. 2018;197:757–767. doi: 10.1164/rccm.201706-1172OC
  • Arabi YM, Deeb AM, Al-Hameed F, et al. Macrolides in critically ill patients with Middle East Respiratory Syndrome. Int J Infect Dis. 2019;81:184–190. doi: 10.1016/j.ijid.2019.01.041
  • Hong KH, Choi JP, Hong SH, et al. Predictors of mortality in Middle East respiratory syndrome (MERS). Thorax. 2018;73:286–289. doi: 10.1136/thoraxjnl-2016-209313
  • Al-Hameed F, Wahla AS, Siddiqui S, et al. Characteristics and outcomes of middle east respiratory syndrome coronavirus patients admitted to an intensive care unit in Jeddah, Saudi Arabia. J Intensive Care Med. 2016;31:344–348. doi: 10.1177/0885066615579858
  • Bermingham A, Chand MA, Brown CS, et al. Severe respiratory illness caused by a novel coronavirus, in a patient transferred to the United Kingdom from the Middle East, September 2012. Euro Surveill. 2012;17(40):20290. doi: 10.2807/ese.17.40.20290-en
  • Guery B, Poissy J, el Mansouf L, et al. Clinical features and viral diagnosis of two cases of infection with Middle East Respiratory Syndrome coronavirus: a report of nosocomial transmission. Lancet. 2013;381:2265–2272. doi: 10.1016/S0140-6736(13)60982-4
  • The Health Protection Agency (Hpa) C. Health protection agency (HPA) UK novel coronavirus investigation team. Evidence of person-to-person transmission within a family cluster of novel coronavirus infections, United Kingdom, February 2013. Euro Surveill. 2013;18(11):20427. doi: 10.2807/ese.18.11.20427-en
  • Alshahrani MS, Sindi A, Alshamsi F, et al. Extracorporeal membrane oxygenation for severe Middle East respiratory syndrome coronavirus. Ann Intensive Care. 2018;8:3. doi: 10.1186/s13613-017-0350-x
  • Shalhoub S, Al-Hameed F, Mandourah Y, et al. Critically ill healthcare workers with the middle east respiratory syndrome (MERS): a multicenter study. PLoS One. 2018:13. doi: 10.1371/journal.pone.0206831
  • Franquet T, Jeong YJ, Lam HYS, et al. Imaging findings in coronavirus infections: SARS-C oV, MERS-CoV, and SARS-CoV-2. Br J Radiol. 2020;93(1112):93. doi: 10.1259/bjr.20200515
  • Alraddadi BM, Qushmaq I, Al-Hameed FM, et al. Noninvasive ventilation in critically ill patients with the Middle East respiratory syndrome. Influenza Other Respi Viruses. 2019;13(4):382–390. doi: 10.1111/irv.12635
  • Modjarrad K, Roberts CC, Mills KT, et al. Safety and immunogenicity of an anti-Middle East respiratory syndrome coronavirus DNA vaccine: a phase 1, open-label, single-arm, dose-escalation trial. Lancet Infect Dis. 2019;19:1013–1022. doi: 10.1016/S1473-3099(19)30266-X
  • Folegatti PM, Bittaye M, Flaxman A, et al. Safety and immunogenicity of a candidate Middle East respiratory syndrome coronavirus viral-vectored vaccine: a dose-escalation, open-label, non-randomised, uncontrolled, phase 1 trial. Lancet Infect Dis. 2020;20:816–826. doi: 10.1016/S1473-3099(20)30160-2
  • Bosaeed M, Balkhy HH, Almaziad S, et al. Safety and immunogenicity of ChAdOx1 MERS vaccine candidate in healthy Middle Eastern adults (MERS002): an open-label, non-randomised, dose-escalation, phase 1b trial. Lancet Microbe. 2022;3(1):e11–20. doi: 10.1016/S2666-5247(21)00193-2
  • Alhetheel A, Albarrag A, Shakoor Z, et al. Assessment of Th1/Th2 cytokines among patients with Middle East respiratory syndrome coronavirus infection. Int Immunol. 2020;32:799–804. doi: 10.1093/intimm/dxaa047
  • Al-Tawfiq JA, Memish ZA. Middle East respiratory syndrome coronavirus: Epidemiology and disease control measures. Infect Drug Resist. 2014;7:281–287. doi: 10.2147/IDR.S51283
  • Al-Tawfiq JA, Memish ZA. Emerging respiratory viral infections: MERS-CoV and influenza. Lancet Respir Med. 2014;2:23–25. doi: 10.1016/S2213-2600(13)70255-8
  • Cevik M, Tate M, Lloyd O, et al. SARS-CoV-2, SARS-CoV, and MERS-CoV viral load dynamics, duration of viral shedding, and infectiousness: a systematic review and meta-analysis. Lancet Microbe. 2021 Jan;2(1):e13–e22. doi: 10.1016/S2666-5247(20)30172-5
  • Min CK, Cheon S, Ha NY, et al. Comparative and kinetic analysis of viral shedding and immunological responses in MERS patients representing a broad spectrum of disease severity. Sci Rep. 2016;6(1):25359. doi: 10.1038/srep25359

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.