Middle East Respiratory Syndrome Coronavirus: Another Zoonotic Betacoronavirus Causing SARS-Like Disease

Abstract

SUMMARY The source of the severe acute respiratory syndrome (SARS) epidemic was traced to wildlife market civets and ultimately to bats. Subsequent hunting for novel coronaviruses (CoVs) led to the discovery of two additional human and over 40 animal CoVs, including the prototype lineage C betacoronaviruses, Tylonycteris bat CoV HKU4 and Pipistrellus bat CoV HKU5; these are phylogenetically closely related to the Middle East respiratory syndrome (MERS) CoV, which has affected more than 1,000 patients with over 35% fatality since its emergence in 2012. All primary cases of MERS are epidemiologically linked to the Middle East. Some of these patients had contacted camels which shed virus and/or had positive serology. Most secondary cases are related to health care-associated clusters. The disease is especially severe in elderly men with comorbidities. Clinical severity may be related to MERS-CoV's ability to infect a broad range of cells with DPP4 expression, evade the host innate immune response, and induce cytokine dysregulation. Reverse transcription-PCR on respiratory and/or extrapulmonary specimens rapidly establishes diagnosis. Supportive treatment with extracorporeal membrane oxygenation and dialysis is often required in patients with organ failure. Antivirals with potent in vitro activities include neutralizing monoclonal antibodies, antiviral peptides, interferons, mycophenolic acid, and lopinavir. They should be evaluated in suitable animal models before clinical trials. Developing an effective camel MERS-CoV vaccine and implementing appropriate infection control measures may control the continuing epidemic.

Clinical effects of nursing intervention on severe patients in the respiratory department

“…Patients with severe respiratory system diseases manifest acute attacks and severe conditions, resulting in long treatments and high occurrence rates of secondary infections, which further prolong the treatment time of patients [5]. Consequently, patients develop unhealthy emotions, including anxiety, fear, and pessimism, all of which influence the treatment [6].…”

Middle East Respiratory Syndrome-Coronavirus (MERSCoV) Infection

“…Filogenetik harita içinde, beta-CoV arasında A, B, C, D kökenleri bulunmakta ve MERS-CoV, insanda hastalık yapan diğer beta-CoV'dan (SARS-CoV, OC43, HKU1) uzak, yarasalarda bulunan CoV'lara daha yakın olarak yer almaktadır. Beta-CoV içinde, C kökenleri arasında insanda hastalık yapan koronavirüs-tür (5,(9)(10)(11) . Dünyanın birçok farklı bölgesinde yaşayan yarasalarda genetik olarak yakın CoV saptanmışsa da, Arap Yarımadası'nda MERS-CoV'un ara konağının tek hörgüçlü deve (hecin) olduğu gösterilmiştir (12) .…”

“…Komorbiditeler ağır hastalık ve mortalite ile bağıntılıdır (11,31,35,50,51,56) . Ağır hastaların %96'sında en az bir komorbidite saptanmıştır (11) . Bunlar sıklık sırasıyla DM (%68), kronik böb-rek hastalığı (%49), hipertansiyon (%34), kronik kalp hastalığı (%28), kronik akciğer hastalığı (%26), sigara kullanımı (%23) ve obezitedir (%17).…”

An overview of early investigational drugs for the treatment of human papilloma virus infection and associated dysplasia

“…Moreover, lopinavir has also been shown to have activity against severe acute respiratory syndrome (SARS) and, more recently, middle eastern respiratory syndrome (MERS) coronaviruses [67][68][69] .…”