Ribavirin and interferon alfa-2a for severe Middle East respiratory syndrome coronavirus infection: a retrospective cohort study
Identifieur interne : 001E39 ( Main/Curation ); précédent : 001E38; suivant : 001E40Ribavirin and interferon alfa-2a for severe Middle East respiratory syndrome coronavirus infection: a retrospective cohort study
Auteurs : Ali S. Omrani [Arabie saoudite] ; Mustafa M. Saad [Arabie saoudite] ; Kamran Baig [Arabie saoudite] ; Abdelkarim Bahloul [Arabie saoudite] ; Mohammed Abdul-Matin [Arabie saoudite] ; Amal Y. Alaidaroos [Arabie saoudite] ; Ghaleb A. Almakhlafi [Arabie saoudite] ; Mohammed M. Albarrak [Arabie saoudite] ; Ziad A. Memish [Arabie saoudite] ; Ali M. Albarrak [Arabie saoudite]Source :
- Lancet. Infectious diseases : (print) [ 1473-3099 ] ; 2014.
Descripteurs français
- KwdFr :
- Adolescent, Adulte, Adulte d'âge moyen, Analyse de survie, Antiviraux (usage thérapeutique), Arabie saoudite, Coronavirus du syndrome respiratoire du Moyen-Orient (), Femelle, Humains, Infections à coronavirus (traitement médicamenteux), Interféron alpha (usage thérapeutique), Jeune adulte, Mâle, Protéines recombinantes (usage thérapeutique), Ribavirine (usage thérapeutique), Résultat thérapeutique, Sujet âgé, Sujet âgé de 80 ans ou plus, Études de cohortes, Études rétrospectives.
- MESH :
- traitement médicamenteux : Infections à coronavirus.
- usage thérapeutique : Antiviraux, Interféron alpha, Protéines recombinantes, Ribavirine.
- Pascal (Inist)
- Adolescent, Adulte, Adulte d'âge moyen, Analyse de survie, Arabie saoudite, Coronavirus du syndrome respiratoire du Moyen-Orient, Femelle, Humains, Jeune adulte, Mâle, Ribavirine, Interféron alpha 2a, Etude cohorte, Coronavirus, Antiviral, Anticancéreux, Forme grave, Résultat thérapeutique, Sujet âgé, Sujet âgé de 80 ans ou plus, Syndrome respiratoire du Moyen-Orient, Études de cohortes, Études rétrospectives.
English descriptors
- KwdEn :
- Adolescent, Adult, Aged, Aged, 80 and over, Antineoplastic agent, Antiviral, Antiviral Agents (therapeutic use), Cohort Studies, Cohort study, Coronavirus, Coronavirus Infections (drug therapy), Female, Humans, Interferon alpha 2a, Interferon alpha-2, Interferon-alpha (therapeutic use), Male, Middle Aged, Middle East Respiratory Syndrome Coronavirus (drug effects), Middle East respiratory syndrome, Recombinant Proteins (therapeutic use), Retrospective Studies, Ribavirin, Ribavirin (therapeutic use), Saudi Arabia, Survival Analysis, Treatment Outcome, Young Adult.
- MESH :
- chemical , therapeutic use : Antiviral Agents, Interferon-alpha, Recombinant Proteins, Ribavirin.
- drug effects : Middle East Respiratory Syndrome Coronavirus.
- drug therapy : Coronavirus Infections.
- Adolescent, Adult, Aged, Aged, 80 and over, Cohort Studies, Female, Humans, Interferon alpha-2, Male, Middle Aged, Retrospective Studies, Saudi Arabia, Survival Analysis, Treatment Outcome, Young Adult.
Abstract
Background Middle East respiratory syndrome coronavirus (MERS-CoV) infection is associated with high mortality and has no approved antiviral therapy. We aimed to compare ribavirin and interferon alfa-2a treatment for patients with severe MERS-CoV infection with a supportive therapy only. Methods In this retrospective cohort study, we included adults (aged ≥16 years) with laboratory-confirmed MERS-CoV infection and pneumonia needing ventilation support, diagnosed between Oct 23, 2012, and May 1, 2014, at the Prince Sultan Military Medical City (Riyadh, Saudi Arabia). All patients received appropriate supportive care and regular clinical and laboratory monitoring, but patients diagnosed after Sept 16, 2013, were also given oral ribavirin (dose based on calculated creatinine clearance, for 8-10 days) and subcutaneous pegylated interferon alfa-2a (180 μg per week for 2 weeks). The primary endpoint was 14-day and 28-day survival from the date of MERS-CoV infection diagnosis. We used X2 and Fischer's exact test to analyse categorical variables and the t test to analyse continuous variables. Findings We analysed 20 patients who received ribavirin and interferon (treatment group; initiated a median of 3 days [range 0-8] after diagnosis) and 24 who did not (comparator group). Baseline clinical and laboratory characteristics were similar between groups, apart from baseline absolute neutrophil count, which was significantly lower in the comparator group (5 • 88 × 109/L [SD 3 • 95] vs 9 • 88 × 109/L [6 • 63]; p=0.023). 14 (70%) of 20 patients in the treatment group had survived after 14 days, compared with seven (29%) of 24 in the comparator group (p=0 • 004). After 28 days, six (30%) of 20 and four (17%) of 24, respectively, had survived (p=0 • 54). Adverse effects were similar between groups, apart from reduction in haemoglobin, which was significantly greater in the treatment group than in the comparator group (4 • 32 g/L [SD 2 • 47] vs 2 • 14 g/L [1 • 90]; p=0 • 002). Interpretation In patients with severe MERS-CoV infection, ribavirin and interferon alfa-2a therapy is associated with significantly improved survival at 14 days, but not at 28 days. Further assessment in appropriately designed randomised trials is recommended.
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<series><title level="j" type="main">Lancet. Infectious diseases : (print)</title>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term>
<term>Adult</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Antineoplastic agent</term>
<term>Antiviral</term>
<term>Antiviral Agents (therapeutic use)</term>
<term>Cohort Studies</term>
<term>Cohort study</term>
<term>Coronavirus</term>
<term>Coronavirus Infections (drug therapy)</term>
<term>Female</term>
<term>Humans</term>
<term>Interferon alpha 2a</term>
<term>Interferon alpha-2</term>
<term>Interferon-alpha (therapeutic use)</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Middle East Respiratory Syndrome Coronavirus (drug effects)</term>
<term>Middle East respiratory syndrome</term>
<term>Recombinant Proteins (therapeutic use)</term>
<term>Retrospective Studies</term>
<term>Ribavirin</term>
<term>Ribavirin (therapeutic use)</term>
<term>Saudi Arabia</term>
<term>Survival Analysis</term>
<term>Treatment Outcome</term>
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<keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent</term>
<term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Analyse de survie</term>
<term>Antiviraux (usage thérapeutique)</term>
<term>Arabie saoudite</term>
<term>Coronavirus du syndrome respiratoire du Moyen-Orient ()</term>
<term>Femelle</term>
<term>Humains</term>
<term>Infections à coronavirus (traitement médicamenteux)</term>
<term>Interféron alpha (usage thérapeutique)</term>
<term>Jeune adulte</term>
<term>Mâle</term>
<term>Protéines recombinantes (usage thérapeutique)</term>
<term>Ribavirine (usage thérapeutique)</term>
<term>Résultat thérapeutique</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Études de cohortes</term>
<term>Études rétrospectives</term>
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<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiviral Agents</term>
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<term>Interféron alpha</term>
<term>Protéines recombinantes</term>
<term>Ribavirine</term>
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<keywords scheme="MESH" xml:lang="en"><term>Adolescent</term>
<term>Adult</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Cohort Studies</term>
<term>Female</term>
<term>Humans</term>
<term>Interferon alpha-2</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Retrospective Studies</term>
<term>Saudi Arabia</term>
<term>Survival Analysis</term>
<term>Treatment Outcome</term>
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<keywords scheme="Pascal" xml:lang="fr"><term>Adolescent</term>
<term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Analyse de survie</term>
<term>Arabie saoudite</term>
<term>Coronavirus du syndrome respiratoire du Moyen-Orient</term>
<term>Femelle</term>
<term>Humains</term>
<term>Jeune adulte</term>
<term>Mâle</term>
<term>Ribavirine</term>
<term>Interféron alpha 2a</term>
<term>Etude cohorte</term>
<term>Coronavirus</term>
<term>Antiviral</term>
<term>Anticancéreux</term>
<term>Forme grave</term>
<term>Résultat thérapeutique</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Syndrome respiratoire du Moyen-Orient</term>
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<front><div type="abstract" xml:lang="en">Background Middle East respiratory syndrome coronavirus (MERS-CoV) infection is associated with high mortality and has no approved antiviral therapy. We aimed to compare ribavirin and interferon alfa-2a treatment for patients with severe MERS-CoV infection with a supportive therapy only. Methods In this retrospective cohort study, we included adults (aged ≥16 years) with laboratory-confirmed MERS-CoV infection and pneumonia needing ventilation support, diagnosed between Oct 23, 2012, and May 1, 2014, at the Prince Sultan Military Medical City (Riyadh, Saudi Arabia). All patients received appropriate supportive care and regular clinical and laboratory monitoring, but patients diagnosed after Sept 16, 2013, were also given oral ribavirin (dose based on calculated creatinine clearance, for 8-10 days) and subcutaneous pegylated interferon alfa-2a (180 μg per week for 2 weeks). The primary endpoint was 14-day and 28-day survival from the date of MERS-CoV infection diagnosis. We used X<sup>2</sup>
and Fischer's exact test to analyse categorical variables and the t test to analyse continuous variables. Findings We analysed 20 patients who received ribavirin and interferon (treatment group; initiated a median of 3 days [range 0-8] after diagnosis) and 24 who did not (comparator group). Baseline clinical and laboratory characteristics were similar between groups, apart from baseline absolute neutrophil count, which was significantly lower in the comparator group (5 • 88 × 10<sup>9</sup>
/L [SD 3 • 95] vs 9 • 88 × 10<sup>9</sup>
/L [6 • 63]; p=0.023). 14 (70%) of 20 patients in the treatment group had survived after 14 days, compared with seven (29%) of 24 in the comparator group (p=0 • 004). After 28 days, six (30%) of 20 and four (17%) of 24, respectively, had survived (p=0 • 54). Adverse effects were similar between groups, apart from reduction in haemoglobin, which was significantly greater in the treatment group than in the comparator group (4 • 32 g/L [SD 2 • 47] vs 2 • 14 g/L [1 • 90]; p=0 • 002). Interpretation In patients with severe MERS-CoV infection, ribavirin and interferon alfa-2a therapy is associated with significantly improved survival at 14 days, but not at 28 days. Further assessment in appropriately designed randomised trials is recommended.</div>
</front>
</TEI>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Ribavirin and interferon alfa-2a for severe Middle East respiratory syndrome coronavirus infection: a retrospective cohort study</title>
<author><name sortKey="Omrani, Ali S" sort="Omrani, Ali S" uniqKey="Omrani A" first="Ali S." last="Omrani">Ali S. Omrani</name>
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</author>
<author><name sortKey="Saad, Mustafa M" sort="Saad, Mustafa M" uniqKey="Saad M" first="Mustafa M." last="Saad">Mustafa M. Saad</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Division of Infectious Diseases, Prince Sultan Military Medical City</s1>
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<author><name sortKey="Baig, Kamran" sort="Baig, Kamran" uniqKey="Baig K" first="Kamran" last="Baig">Kamran Baig</name>
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</affiliation>
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<author><name sortKey="Bahloul, Abdelkarim" sort="Bahloul, Abdelkarim" uniqKey="Bahloul A" first="Abdelkarim" last="Bahloul">Abdelkarim Bahloul</name>
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</author>
<author><name sortKey="Abdul Matin, Mohammed" sort="Abdul Matin, Mohammed" uniqKey="Abdul Matin M" first="Mohammed" last="Abdul-Matin">Mohammed Abdul-Matin</name>
<affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Medicine, Prince Sultan Military Medical City</s1>
<s2>Riyadh</s2>
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<author><name sortKey="Alaidaroos, Amal Y" sort="Alaidaroos, Amal Y" uniqKey="Alaidaroos A" first="Amal Y." last="Alaidaroos">Amal Y. Alaidaroos</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Division of Infectious Diseases, Prince Sultan Military Medical City</s1>
<s2>Riyadh</s2>
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<s2>Riyadh</s2>
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<sZ>6 aut.</sZ>
</inist:fA14>
<country>Arabie saoudite</country>
<wicri:noRegion>Riyadh</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Almakhlafi, Ghaleb A" sort="Almakhlafi, Ghaleb A" uniqKey="Almakhlafi G" first="Ghaleb A." last="Almakhlafi">Ghaleb A. Almakhlafi</name>
<affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Department of Critical Care, Prince Sultan Military Medical City</s1>
<s2>Riyadh</s2>
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<wicri:noRegion>Riyadh</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Albarrak, Mohammed M" sort="Albarrak, Mohammed M" uniqKey="Albarrak M" first="Mohammed M." last="Albarrak">Mohammed M. Albarrak</name>
<affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Department of Critical Care, Prince Sultan Military Medical City</s1>
<s2>Riyadh</s2>
<s3>SAU</s3>
<sZ>7 aut.</sZ>
<sZ>8 aut.</sZ>
</inist:fA14>
<country>Arabie saoudite</country>
<wicri:noRegion>Riyadh</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Memish, Ziad A" sort="Memish, Ziad A" uniqKey="Memish Z" first="Ziad A." last="Memish">Ziad A. Memish</name>
<affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Al-Faisal University and Ministry of Health</s1>
<s2>Riyadh</s2>
<s3>SAU</s3>
<sZ>9 aut.</sZ>
</inist:fA14>
<country>Arabie saoudite</country>
<wicri:noRegion>Al-Faisal University and Ministry of Health</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Albarrak, Ali M" sort="Albarrak, Ali M" uniqKey="Albarrak A" first="Ali M." last="Albarrak">Ali M. Albarrak</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Division of Infectious Diseases, Prince Sultan Military Medical City</s1>
<s2>Riyadh</s2>
<s3>SAU</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>4 aut.</sZ>
<sZ>6 aut.</sZ>
<sZ>10 aut.</sZ>
</inist:fA14>
<country>Arabie saoudite</country>
<wicri:noRegion>Riyadh</wicri:noRegion>
</affiliation>
</author>
</analytic>
<series><title level="j" type="main">Lancet. Infectious diseases : (print)</title>
<title level="j" type="abbreviated">Lancet. Infect. dis. : (print)</title>
<idno type="ISSN">1473-3099</idno>
<imprint><date when="2014">2014</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt><title level="j" type="main">Lancet. Infectious diseases : (print)</title>
<title level="j" type="abbreviated">Lancet. Infect. dis. : (print)</title>
<idno type="ISSN">1473-3099</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antineoplastic agent</term>
<term>Antiviral</term>
<term>Cohort study</term>
<term>Coronavirus</term>
<term>Interferon alpha 2a</term>
<term>Middle East respiratory syndrome</term>
<term>Ribavirin</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Ribavirine</term>
<term>Interféron alpha 2a</term>
<term>Etude cohorte</term>
<term>Coronavirus</term>
<term>Antiviral</term>
<term>Anticancéreux</term>
<term>Forme grave</term>
<term>Syndrome respiratoire du Moyen-Orient</term>
</keywords>
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<front><div type="abstract" xml:lang="en">Background Middle East respiratory syndrome coronavirus (MERS-CoV) infection is associated with high mortality and has no approved antiviral therapy. We aimed to compare ribavirin and interferon alfa-2a treatment for patients with severe MERS-CoV infection with a supportive therapy only. Methods In this retrospective cohort study, we included adults (aged ≥16 years) with laboratory-confirmed MERS-CoV infection and pneumonia needing ventilation support, diagnosed between Oct 23, 2012, and May 1, 2014, at the Prince Sultan Military Medical City (Riyadh, Saudi Arabia). All patients received appropriate supportive care and regular clinical and laboratory monitoring, but patients diagnosed after Sept 16, 2013, were also given oral ribavirin (dose based on calculated creatinine clearance, for 8-10 days) and subcutaneous pegylated interferon alfa-2a (180 μg per week for 2 weeks). The primary endpoint was 14-day and 28-day survival from the date of MERS-CoV infection diagnosis. We used X<sup>2</sup>
and Fischer's exact test to analyse categorical variables and the t test to analyse continuous variables. Findings We analysed 20 patients who received ribavirin and interferon (treatment group; initiated a median of 3 days [range 0-8] after diagnosis) and 24 who did not (comparator group). Baseline clinical and laboratory characteristics were similar between groups, apart from baseline absolute neutrophil count, which was significantly lower in the comparator group (5 • 88 × 10<sup>9</sup>
/L [SD 3 • 95] vs 9 • 88 × 10<sup>9</sup>
/L [6 • 63]; p=0.023). 14 (70%) of 20 patients in the treatment group had survived after 14 days, compared with seven (29%) of 24 in the comparator group (p=0 • 004). After 28 days, six (30%) of 20 and four (17%) of 24, respectively, had survived (p=0 • 54). Adverse effects were similar between groups, apart from reduction in haemoglobin, which was significantly greater in the treatment group than in the comparator group (4 • 32 g/L [SD 2 • 47] vs 2 • 14 g/L [1 • 90]; p=0 • 002). Interpretation In patients with severe MERS-CoV infection, ribavirin and interferon alfa-2a therapy is associated with significantly improved survival at 14 days, but not at 28 days. Further assessment in appropriately designed randomised trials is recommended.</div>
</front>
</TEI>
</INIST>
<PMC><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Ribavirin and interferon alfa-2a for severe Middle East respiratory syndrome coronavirus infection: a retrospective cohort study</title>
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<author><name sortKey="Saad, Mustafa M" sort="Saad, Mustafa M" uniqKey="Saad M" first="Mustafa M" last="Saad">Mustafa M. Saad</name>
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</affiliation>
</author>
<author><name sortKey="Baig, Kamran" sort="Baig, Kamran" uniqKey="Baig K" first="Kamran" last="Baig">Kamran Baig</name>
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<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea>Department of Infection Prevention and Control, Prince Sultan Military Medical City, Riyadh</wicri:regionArea>
<wicri:noRegion>Riyadh</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Bahloul, Abdelkarim" sort="Bahloul, Abdelkarim" uniqKey="Bahloul A" first="Abdelkarim" last="Bahloul">Abdelkarim Bahloul</name>
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<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea>Division of Infectious Diseases, Prince Sultan Military Medical City, Riyadh</wicri:regionArea>
<wicri:noRegion>Riyadh</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Abdul Matin, Mohammed" sort="Abdul Matin, Mohammed" uniqKey="Abdul Matin M" first="Mohammed" last="Abdul-Matin">Mohammed Abdul-Matin</name>
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<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea>Department of Medicine, Prince Sultan Military Medical City, Riyadh</wicri:regionArea>
<wicri:noRegion>Riyadh</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Alaidaroos, Amal Y" sort="Alaidaroos, Amal Y" uniqKey="Alaidaroos A" first="Amal Y" last="Alaidaroos">Amal Y. Alaidaroos</name>
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<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea>Division of Infectious Diseases, Prince Sultan Military Medical City, Riyadh</wicri:regionArea>
<wicri:noRegion>Riyadh</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="aff2">Department of Infection Prevention and Control, Prince Sultan Military Medical City, Riyadh, Saudi Arabia</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea>Department of Infection Prevention and Control, Prince Sultan Military Medical City, Riyadh</wicri:regionArea>
<wicri:noRegion>Riyadh</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Almakhlafi, Ghaleb A" sort="Almakhlafi, Ghaleb A" uniqKey="Almakhlafi G" first="Ghaleb A" last="Almakhlafi">Ghaleb A. Almakhlafi</name>
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<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea>Department of Critical Care, Prince Sultan Military Medical City, Riyadh</wicri:regionArea>
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</author>
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<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea>Department of Critical Care, Prince Sultan Military Medical City, Riyadh</wicri:regionArea>
<wicri:noRegion>Riyadh</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Memish, Ziad A" sort="Memish, Ziad A" uniqKey="Memish Z" first="Ziad A" last="Memish">Ziad A. Memish</name>
<affiliation wicri:level="1"><nlm:aff id="aff5">Al-Faisal University and Ministry of Health, Riyadh, Saudi Arabia</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea>Al-Faisal University and Ministry of Health, Riyadh</wicri:regionArea>
<wicri:noRegion>Riyadh</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Albarrak, Ali M" sort="Albarrak, Ali M" uniqKey="Albarrak A" first="Ali M" last="Albarrak">Ali M. Albarrak</name>
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<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea>Division of Infectious Diseases, Prince Sultan Military Medical City, Riyadh</wicri:regionArea>
<wicri:noRegion>Riyadh</wicri:noRegion>
</affiliation>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Ribavirin and interferon alfa-2a for severe Middle East respiratory syndrome coronavirus infection: a retrospective cohort study</title>
<author><name sortKey="Omrani, Ali S" sort="Omrani, Ali S" uniqKey="Omrani A" first="Ali S" last="Omrani">Ali S. Omrani</name>
<affiliation wicri:level="1"><nlm:aff id="aff1">Division of Infectious Diseases, Prince Sultan Military Medical City, Riyadh, Saudi Arabia</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea>Division of Infectious Diseases, Prince Sultan Military Medical City, Riyadh</wicri:regionArea>
<wicri:noRegion>Riyadh</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Saad, Mustafa M" sort="Saad, Mustafa M" uniqKey="Saad M" first="Mustafa M" last="Saad">Mustafa M. Saad</name>
<affiliation wicri:level="1"><nlm:aff id="aff1">Division of Infectious Diseases, Prince Sultan Military Medical City, Riyadh, Saudi Arabia</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea>Division of Infectious Diseases, Prince Sultan Military Medical City, Riyadh</wicri:regionArea>
<wicri:noRegion>Riyadh</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Baig, Kamran" sort="Baig, Kamran" uniqKey="Baig K" first="Kamran" last="Baig">Kamran Baig</name>
<affiliation wicri:level="1"><nlm:aff id="aff2">Department of Infection Prevention and Control, Prince Sultan Military Medical City, Riyadh, Saudi Arabia</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea>Department of Infection Prevention and Control, Prince Sultan Military Medical City, Riyadh</wicri:regionArea>
<wicri:noRegion>Riyadh</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Bahloul, Abdelkarim" sort="Bahloul, Abdelkarim" uniqKey="Bahloul A" first="Abdelkarim" last="Bahloul">Abdelkarim Bahloul</name>
<affiliation wicri:level="1"><nlm:aff id="aff1">Division of Infectious Diseases, Prince Sultan Military Medical City, Riyadh, Saudi Arabia</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea>Division of Infectious Diseases, Prince Sultan Military Medical City, Riyadh</wicri:regionArea>
<wicri:noRegion>Riyadh</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Abdul Matin, Mohammed" sort="Abdul Matin, Mohammed" uniqKey="Abdul Matin M" first="Mohammed" last="Abdul-Matin">Mohammed Abdul-Matin</name>
<affiliation wicri:level="1"><nlm:aff id="aff3">Department of Medicine, Prince Sultan Military Medical City, Riyadh, Saudi Arabia</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea>Department of Medicine, Prince Sultan Military Medical City, Riyadh</wicri:regionArea>
<wicri:noRegion>Riyadh</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Alaidaroos, Amal Y" sort="Alaidaroos, Amal Y" uniqKey="Alaidaroos A" first="Amal Y" last="Alaidaroos">Amal Y. Alaidaroos</name>
<affiliation wicri:level="1"><nlm:aff id="aff1">Division of Infectious Diseases, Prince Sultan Military Medical City, Riyadh, Saudi Arabia</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea>Division of Infectious Diseases, Prince Sultan Military Medical City, Riyadh</wicri:regionArea>
<wicri:noRegion>Riyadh</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="aff2">Department of Infection Prevention and Control, Prince Sultan Military Medical City, Riyadh, Saudi Arabia</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea>Department of Infection Prevention and Control, Prince Sultan Military Medical City, Riyadh</wicri:regionArea>
<wicri:noRegion>Riyadh</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Almakhlafi, Ghaleb A" sort="Almakhlafi, Ghaleb A" uniqKey="Almakhlafi G" first="Ghaleb A" last="Almakhlafi">Ghaleb A. Almakhlafi</name>
<affiliation wicri:level="1"><nlm:aff id="aff4">Department of Critical Care, Prince Sultan Military Medical City, Riyadh, Saudi Arabia</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea>Department of Critical Care, Prince Sultan Military Medical City, Riyadh</wicri:regionArea>
<wicri:noRegion>Riyadh</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Albarrak, Mohammed M" sort="Albarrak, Mohammed M" uniqKey="Albarrak M" first="Mohammed M" last="Albarrak">Mohammed M. Albarrak</name>
<affiliation wicri:level="1"><nlm:aff id="aff4">Department of Critical Care, Prince Sultan Military Medical City, Riyadh, Saudi Arabia</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea>Department of Critical Care, Prince Sultan Military Medical City, Riyadh</wicri:regionArea>
<wicri:noRegion>Riyadh</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Memish, Ziad A" sort="Memish, Ziad A" uniqKey="Memish Z" first="Ziad A" last="Memish">Ziad A. Memish</name>
<affiliation wicri:level="1"><nlm:aff id="aff5">Al-Faisal University and Ministry of Health, Riyadh, Saudi Arabia</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea>Al-Faisal University and Ministry of Health, Riyadh</wicri:regionArea>
<wicri:noRegion>Riyadh</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Albarrak, Ali M" sort="Albarrak, Ali M" uniqKey="Albarrak A" first="Ali M" last="Albarrak">Ali M. Albarrak</name>
<affiliation wicri:level="1"><nlm:aff id="aff1">Division of Infectious Diseases, Prince Sultan Military Medical City, Riyadh, Saudi Arabia</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea>Division of Infectious Diseases, Prince Sultan Military Medical City, Riyadh</wicri:regionArea>
<wicri:noRegion>Riyadh</wicri:noRegion>
</affiliation>
</author>
</analytic>
<series><title level="j">The Lancet. Infectious Diseases</title>
<idno type="ISSN">1473-3099</idno>
<idno type="eISSN">1474-4457</idno>
<imprint><date when="2014">2014</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term>
<term>Adult</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Antiviral Agents (therapeutic use)</term>
<term>Cohort Studies</term>
<term>Coronavirus Infections (drug therapy)</term>
<term>Female</term>
<term>Humans</term>
<term>Interferon alpha-2</term>
<term>Interferon-alpha (therapeutic use)</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Middle East Respiratory Syndrome Coronavirus (drug effects)</term>
<term>Recombinant Proteins (therapeutic use)</term>
<term>Retrospective Studies</term>
<term>Ribavirin (therapeutic use)</term>
<term>Saudi Arabia</term>
<term>Survival Analysis</term>
<term>Treatment Outcome</term>
<term>Young Adult</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent</term>
<term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Analyse de survie</term>
<term>Antiviraux (usage thérapeutique)</term>
<term>Arabie saoudite</term>
<term>Coronavirus du syndrome respiratoire du Moyen-Orient ()</term>
<term>Femelle</term>
<term>Humains</term>
<term>Infections à coronavirus (traitement médicamenteux)</term>
<term>Interféron alpha (usage thérapeutique)</term>
<term>Jeune adulte</term>
<term>Mâle</term>
<term>Protéines recombinantes (usage thérapeutique)</term>
<term>Ribavirine (usage thérapeutique)</term>
<term>Résultat thérapeutique</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Études de cohortes</term>
<term>Études rétrospectives</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiviral Agents</term>
<term>Interferon-alpha</term>
<term>Recombinant Proteins</term>
<term>Ribavirin</term>
</keywords>
<keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Middle East Respiratory Syndrome Coronavirus</term>
</keywords>
<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Coronavirus Infections</term>
</keywords>
<keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Infections à coronavirus</term>
</keywords>
<keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Antiviraux</term>
<term>Interféron alpha</term>
<term>Protéines recombinantes</term>
<term>Ribavirine</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adolescent</term>
<term>Adult</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Cohort Studies</term>
<term>Female</term>
<term>Humans</term>
<term>Interferon alpha-2</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Retrospective Studies</term>
<term>Saudi Arabia</term>
<term>Survival Analysis</term>
<term>Treatment Outcome</term>
<term>Young Adult</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term>
<term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Analyse de survie</term>
<term>Arabie saoudite</term>
<term>Coronavirus du syndrome respiratoire du Moyen-Orient</term>
<term>Femelle</term>
<term>Humains</term>
<term>Jeune adulte</term>
<term>Mâle</term>
<term>Résultat thérapeutique</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Études de cohortes</term>
<term>Études rétrospectives</term>
</keywords>
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<front><div type="abstract" xml:lang="en"><title>Summary</title>
<sec><title>Background</title>
<p>Middle East respiratory syndrome coronavirus (MERS-CoV) infection is associated with high mortality and has no approved antiviral therapy. We aimed to compare ribavirin and interferon alfa-2a treatment for patients with severe MERS-CoV infection with a supportive therapy only.</p>
</sec>
<sec><title>Methods</title>
<p>In this retrospective cohort study, we included adults (aged ≥16 years) with laboratory-confirmed MERS-CoV infection and pneumonia needing ventilation support, diagnosed between Oct 23, 2012, and May 1, 2014, at the Prince Sultan Military Medical City (Riyadh, Saudi Arabia). All patients received appropriate supportive care and regular clinical and laboratory monitoring, but patients diagnosed after Sept 16, 2013, were also given oral ribavirin (dose based on calculated creatinine clearance, for 8–10 days) and subcutaneous pegylated interferon alfa-2a (180 μg per week for 2 weeks). The primary endpoint was 14-day and 28-day survival from the date of MERS-CoV infection diagnosis. We used χ<sup>2</sup>
and Fischer's exact test to analyse categorical variables and the <italic>t</italic>
test to analyse continuous variables.</p>
</sec>
<sec><title>Findings</title>
<p>We analysed 20 patients who received ribavirin and interferon (treatment group; initiated a median of 3 days [range 0–8] after diagnosis) and 24 who did not (comparator group). Baseline clinical and laboratory characteristics were similar between groups, apart from baseline absolute neutrophil count, which was significantly lower in the comparator group (5·88 × 10<sup>9</sup>
/L [SD 3·95] <italic>vs</italic>
9·88 × 10<sup>9</sup>
/L [6·63]; p=0·023). 14 (70%) of 20 patients in the treatment group had survived after 14 days, compared with seven (29%) of 24 in the comparator group (p=0·004). After 28 days, six (30%) of 20 and four (17%) of 24, respectively, had survived (p=0·054). Adverse effects were similar between groups, apart from reduction in haemoglobin, which was significantly greater in the treatment group than in the comparator group (4·32 g/L [SD 2·47] <italic>vs</italic>
2·14 g/L [1·90]; p=0·002).</p>
</sec>
<sec><title>Interpretation</title>
<p>In patients with severe MERS-CoV infection, ribavirin and interferon alfa-2a therapy is associated with significantly improved survival at 14 days, but not at 28 days. Further assessment in appropriately designed randomised trials is recommended.</p>
</sec>
<sec><title>Funding</title>
<p>None.</p>
</sec>
</div>
</front>
<back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Zaki, Am" uniqKey="Zaki A">AM Zaki</name>
</author>
<author><name sortKey="Van Boheemen, S" uniqKey="Van Boheemen S">S van Boheemen</name>
</author>
<author><name sortKey="Bestebroer, Tm" uniqKey="Bestebroer T">TM Bestebroer</name>
</author>
<author><name sortKey="Osterhaus, Adme" uniqKey="Osterhaus A">ADME Osterhaus</name>
</author>
<author><name sortKey="Fouchier, Ram" uniqKey="Fouchier R">RAM Fouchier</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="Assiri, A" uniqKey="Assiri A">A Assiri</name>
</author>
<author><name sortKey="Al Tawfiq, Ja" uniqKey="Al Tawfiq J">JA Al-Tawfiq</name>
</author>
<author><name sortKey="Al Rabeeah, Aa" uniqKey="Al Rabeeah A">AA Al-Rabeeah</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Omrani, As" uniqKey="Omrani A">AS Omrani</name>
</author>
<author><name sortKey="Matin, Ma" uniqKey="Matin M">MA Matin</name>
</author>
<author><name sortKey="Haddad, Q" uniqKey="Haddad Q">Q Haddad</name>
</author>
<author><name sortKey="Al Nakhli, D" uniqKey="Al Nakhli D">D Al-Nakhli</name>
</author>
<author><name sortKey="Memish, Za" uniqKey="Memish Z">ZA Memish</name>
</author>
<author><name sortKey="Albarrak, Am" uniqKey="Albarrak A">AM Albarrak</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Assiri, A" uniqKey="Assiri A">A Assiri</name>
</author>
<author><name sortKey="Mcgeer, A" uniqKey="Mcgeer A">A McGeer</name>
</author>
<author><name sortKey="Perl, Tm" uniqKey="Perl T">TM Perl</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Arabi, Ym" uniqKey="Arabi Y">YM Arabi</name>
</author>
<author><name sortKey="Arifi, Aa" uniqKey="Arifi A">AA Arifi</name>
</author>
<author><name sortKey="Balkhy, Hh" uniqKey="Balkhy H">HH Balkhy</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="Peiris, Jsm" uniqKey="Peiris J">JSM Peiris</name>
</author>
<author><name sortKey="Yuen, Ky" uniqKey="Yuen K">KY Yuen</name>
</author>
<author><name sortKey="Osterhaus, Adme" uniqKey="Osterhaus A">ADME Osterhaus</name>
</author>
<author><name sortKey="Stohr, K" uniqKey="Stohr K">K Stöhr</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Stockman, Lj" uniqKey="Stockman L">LJ Stockman</name>
</author>
<author><name sortKey="Bellamy, R" uniqKey="Bellamy R">R Bellamy</name>
</author>
<author><name sortKey="Garner, P" uniqKey="Garner P">P Garner</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Mccloskey, B" uniqKey="Mccloskey B">B McCloskey</name>
</author>
<author><name sortKey="Zumla, A" uniqKey="Zumla A">A Zumla</name>
</author>
<author><name sortKey="Stephens, G" uniqKey="Stephens G">G Stephens</name>
</author>
<author><name sortKey="Heymann, Dl" uniqKey="Heymann D">DL Heymann</name>
</author>
<author><name sortKey="Memish, Za" uniqKey="Memish Z">ZA Memish</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Momattin, H" uniqKey="Momattin H">H Momattin</name>
</author>
<author><name sortKey="Mohammed, K" uniqKey="Mohammed K">K Mohammed</name>
</author>
<author><name sortKey="Zumla, A" uniqKey="Zumla A">A Zumla</name>
</author>
<author><name sortKey="Memish, Za" uniqKey="Memish Z">ZA Memish</name>
</author>
<author><name sortKey="Al Tawfiq, Ja" uniqKey="Al Tawfiq J">JA Al-Tawfiq</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Falzarano, D" uniqKey="Falzarano D">D Falzarano</name>
</author>
<author><name sortKey="De Wit, E" uniqKey="De Wit E">E de Wit</name>
</author>
<author><name sortKey="Martellaro, C" uniqKey="Martellaro C">C Martellaro</name>
</author>
<author><name sortKey="Callison, J" uniqKey="Callison J">J Callison</name>
</author>
<author><name sortKey="Munster, Vj" uniqKey="Munster V">VJ Munster</name>
</author>
<author><name sortKey="Feldmann, H" uniqKey="Feldmann H">H Feldmann</name>
</author>
</analytic>
</biblStruct>
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</author>
<author><name sortKey="De Wit, E" uniqKey="De Wit E">E de Wit</name>
</author>
<author><name sortKey="Rasmussen, Al" uniqKey="Rasmussen A">AL Rasmussen</name>
</author>
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</author>
<author><name sortKey="Muller, Ma" uniqKey="Muller M">MA Muller</name>
</author>
<author><name sortKey="Costabel, U" uniqKey="Costabel U">U Costabel</name>
</author>
</analytic>
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</author>
<author><name sortKey="Levy, M" uniqKey="Levy M">M Levy</name>
</author>
<author><name sortKey="Rhodes, A" uniqKey="Rhodes A">A Rhodes</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Al Tawfiq, Ja" uniqKey="Al Tawfiq J">JA Al-Tawfiq</name>
</author>
<author><name sortKey="Momattin, H" uniqKey="Momattin H">H Momattin</name>
</author>
<author><name sortKey="Dib, J" uniqKey="Dib J">J Dib</name>
</author>
<author><name sortKey="Memish, Za" uniqKey="Memish Z">ZA Memish</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="De Wilde, Ah" uniqKey="De Wilde A">AH de Wilde</name>
</author>
<author><name sortKey="Raj, Vs" uniqKey="Raj V">VS Raj</name>
</author>
<author><name sortKey="Oudshoorn, D" uniqKey="Oudshoorn D">D Oudshoorn</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Hart, Bj" uniqKey="Hart B">BJ Hart</name>
</author>
<author><name sortKey="Dyall, J" uniqKey="Dyall J">J Dyall</name>
</author>
<author><name sortKey="Postnikova, E" uniqKey="Postnikova E">E Postnikova</name>
</author>
</analytic>
</biblStruct>
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</author>
<author><name sortKey="Chan, Kh" uniqKey="Chan K">KH Chan</name>
</author>
<author><name sortKey="Kao, Ry" uniqKey="Kao R">RY Kao</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Dyall, J" uniqKey="Dyall J">J Dyall</name>
</author>
<author><name sortKey="Coleman, Cm" uniqKey="Coleman C">CM Coleman</name>
</author>
<author><name sortKey="Hart, Bj" uniqKey="Hart B">BJ Hart</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Al Tawfiq, Ja" uniqKey="Al Tawfiq J">JA Al-Tawfiq</name>
</author>
<author><name sortKey="Hinedi, K" uniqKey="Hinedi K">K Hinedi</name>
</author>
<author><name sortKey="Ghandour, J" uniqKey="Ghandour J">J Ghandour</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Knowles, Sr" uniqKey="Knowles S">SR Knowles</name>
</author>
<author><name sortKey="Phillips, Ej" uniqKey="Phillips E">EJ Phillips</name>
</author>
<author><name sortKey="Dresser, L" uniqKey="Dresser L">L Dresser</name>
</author>
<author><name sortKey="Matukas, L" uniqKey="Matukas L">L Matukas</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Sung, Jj" uniqKey="Sung J">JJ Sung</name>
</author>
<author><name sortKey="Wu, A" uniqKey="Wu A">A Wu</name>
</author>
<author><name sortKey="Joynt, Gm" uniqKey="Joynt G">GM Joynt</name>
</author>
</analytic>
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