IFN-α2a or IFN-β1a in combination with ribavirin to treat Middle East respiratory syndrome coronavirus pneumonia: a retrospective study

Shalhoub, Sarah; Farahat, Fayssal; Al-Jiffri, Abdullah; Simhairi, Raed; Shamma, Omar; Siddiqi, Nikhat J.; Mushtaq, Adnan

doi:10.1093/jac/dkv085

Cited by 198 publications

(280 citation statements)

References 14 publications

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“…Whether interferon ␤ could be a better replacement for peginterferon 2␣ also remains to be seen. 23 These treatment combinations need to be evaluated in a prospective randomized manner. The use of corticosteroids in viral pneumonia and ARDS is controversial.…”

Section: Discussionmentioning

confidence: 99%

Acute Management and Long-Term Survival Among Subjects With Severe Middle East Respiratory Syndrome Coronavirus Pneumonia and ARDS

et al. 2015

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outbreak were included. Their characteristics, ICU course, management, and outcome were evaluated. RESULTS: Fourteen subjects, including 3 health-care workers, met study criteria. Besides 2 health-care workers, all subjects had comorbidities. Predominant symptoms were fever, cough, and dyspnea. The worst median P aO 2 /F IO 2 ratio of 118 post-intubation was seen on the third day, and median APACHE II score was 27. All subjects received lung-protective ventilation and 1 mg/kg/d methylprednisolone infusion for ARDS. Eleven subjects received ribavirin and peginterferon ␣-2a. Subjects had a critical ICU course and required neuromuscular blockade (n ‫؍‬ 11; 79%), required rescue therapy for respiratory failure (n ‫؍‬ 8; 57%), developed shock (n ‫؍‬ 10; 71%), and required renal replacement therapy (n ‫؍‬ 8; 57%). Declining C-reactive protein levels correlated with clinical improvement despite continued positive real-time polymerase chain reaction results. Nine subjects died in ICU. Five subjects, including 3 health-care workers, were discharged from hospital and were alive after 1 y. CONCLUSIONS: Middle East Respiratory Syndrome coronavirus pneumonia with ARDS has high mortality in subjects with comorbidities. The mainstay of treatment is meticulous ARDS management. Those who survived the acute infection and its complications remained well after 1 y in our study. The role of ribavirin and interferon warrants urgent further evaluation.

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Section: Discussionmentioning

confidence: 99%

Acute Management and Long-Term Survival Among Subjects With Severe Middle East Respiratory Syndrome Coronavirus Pneumonia and ARDS

et al. 2015

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“…MERS-CoV infects more males than females 1,3,6,7 and is accompanied by a cluster of flu-like syndrome [8][9][10] and life threatening severe illnesses varying from acute respiratory distress syndrome, pneumonia, myocarditis and organ failure. [3][4][5][6][7] Death occurs in 30% 1 to 60% 7 of the cases with an overall average of ~35% according to the estimated from the WHO notified cases.…”

mentioning

confidence: 99%

Prevalence of comorbidities in the Middle East respiratory syndrome coronavirus (MERS-CoV): a systematic review and meta-analysis

Badawi

Ryoo

2016

International Journal of Infectious Diseases

670

570

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The Middle East respiratory syndrome coronavirus (MERS-CoV) is associated with life-threatening severe illnesses and a mortality rate of approximately 35%, particularly in patients with underlying comorbidities. A systematic analysis of 637 MERS-CoV cases suggests that diabetes and hypertension are equally prevalent in approximately 50% of the patients. Cardiac diseases are present in 30% and obesity in 16% of the cases. These conditions down-regulate the synthesis of proinflammatory cytokines and impair the host's innate and humoral immune systems. In conclusion, protection against MERS-CoV and other respiratory infections can be improved if public health vaccination strategies are tailored to target persons with chronic disorders.

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“…The clinical spectrum of disease ranges in severity from asymptomatic infection to severe pneumonia requiring mechanical ventilation [32]. Patients particularly at risk of severe disease include those with chronic kidney disease requiring hemodialysis, those with diabetes mellitus, or those aged > 50 years [38]. MERS-CoV cases are confirmed by detection of viral RNA in clinical samples or by demonstration of seroconversion [39].…”

Section: Viral Infectionsmentioning

confidence: 99%

Pulmonary Diseases in Refugees and Migrants in Europe

et al. 2018

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More than 2 million people fleeing conflict, persecution, and poverty applied for asylum between 2015 and 2016 in the European Union. Due to this, medical practitioners in recipient countries may be facing a broader spectrum of conditions and unusual presentations not previously encountered, including a wide range of infections with pulmonary involvement. Tuberculosis is known to be more common in migrants and has been covered broadly in other publications. The scope of this review was to provide an overview of exotic infections with pulmonary involvement that could be encountered in refugees and migrants and to briefly describe their epidemiology, diagnosis, and management. As refugees and migrants travel from numerous countries and continents, it is important to be aware of the various organisms that might cause disease according to the country of origin. Some of these diseases are very rare and geographically restricted to certain regions, while others have a more cosmopolitan distribution. Also, the spectrum of severity of these infections can vary from very benign to severe and even life-threatening. We will also describe infectious and noninfectious complications that can be associated with HIV infection as some migrants might originate from high HIV prevalence countries in sub-Saharan Africa. As the diagnosis and treatment of these diseases can be challenging in certain situations, patients with suspected infection might require referral to specialized centers with experience in their management. Additionally, a brief description of noncommunicable pulmonary diseases will be provided.

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IFN-α2a or IFN-β1a in combination with ribavirin to treat Middle East respiratory syndrome coronavirus pneumonia: a retrospective study

Abstract: Plasma MERS-CoV RT-PCR may serve as an effective tool to predict MERS-CoV-associated mortality. Older age and comorbid conditions may have contributed to the lack of efficacy of IFN-α2a or IFN-β1a with ribavirin in treating MERS-CoV. Absence of fever should not exclude MERS-CoV.

Cited by 198 publications

References 14 publications

Acute Management and Long-Term Survival Among Subjects With Severe Middle East Respiratory Syndrome Coronavirus Pneumonia and ARDS

Acute Management and Long-Term Survival Among Subjects With Severe Middle East Respiratory Syndrome Coronavirus Pneumonia and ARDS

Prevalence of comorbidities in the Middle East respiratory syndrome coronavirus (MERS-CoV): a systematic review and meta-analysis

Pulmonary Diseases in Refugees and Migrants in Europe

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