The Most Effective Therapeutic Regimen for Patients with Severe Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Infection

The Middle East Respiratory Syndrome coronavirus (MERS-CoV) was first detected in June 2012 in Saudi Arabia. Since then the virus is predominantly detected in the Arabian Peninsula. Other countries were also involved, but the majority of their affected cases were linked to travel to the Arabian Peninsula or caused by a contact with travelers. In Kuwait, one of the Arabian Peninsula countries,despite active surveillance and vigilance, only three cases have been discovered so far. In this report we describe our experience and findings highlighting the virological response to the different treatment regimens adopted in managing both patients.

 Method: Clinical samples were screened for MERS-CoV by real-time RT-PCR targeting the upstream of the E gene (upE). Positive results were confirmed by real-time RT-PCR targeting the open reading frame 1a gene (ORF 1a). Viral RNA was extracted from the samples using MagNA Pure LC Total Nucliec Acid Isolation Kit (Roche). ModularDx Kits Corona SA1 up E-gene and Corona Orf1a (TibMolBiol) were utilized in a LightCycler 2.0 real-time PCR system (Roche) for the investigations. Viral load was determined by extrapolation from the standard curves constructed with different dilutions of positive controls included in each kit [2]. Except for the first sample from both patients 1 and 2 which were bronchoalveolar lavage (BAL) fluid, tracheal aspirations were the only samples processed for viral load estimation.  Read more...............