Middle East Respiratory Syndrome Coronavirus Infection Dynamics and Antibody Responses among Clinically Diverse Patients, Saudi Arabia
Identifieur interne : 002148 ( Ncbi/Merge ); précédent : 002147; suivant : 002149Middle East Respiratory Syndrome Coronavirus Infection Dynamics and Antibody Responses among Clinically Diverse Patients, Saudi Arabia
Auteurs : Hail M. Al-Abdely ; Claire M. Midgley ; Abdulrahim M. Alkhamis ; Glen R. Abedi ; Xiaoyan Lu ; Alison M. Binder ; Khalid H. Alanazi ; Azaibi Tamin ; Weam M. Banjar ; Sandra Lester ; Osman Abdalla ; Rebecca M. Dahl ; Mutaz Mohammed ; Suvang Trivedi ; Homoud S. Algarni ; Senthilkumar K. Sakthivel ; Abdullah Algwizani ; Fahad Bafaqeeh ; Abdullah Alzahrani ; Ali Abraheem Alsharef ; Raafat F. Alhakeem ; Hani A. Aziz Jokhdar ; Sameeh S. Ghazal ; Natalie J. Thornburg ; Dean D. Erdman ; Abdullah M. Assiri ; John T. Watson ; Susan I. GerberSource :
- Emerging Infectious Diseases [ 1080-6040 ] ; 2019.
Descripteurs français
- KwdFr :
- ARN viral, Adulte, Adulte d'âge moyen, Anticorps antiviraux (immunologie), Anticorps antiviraux (sang), Anticorps neutralisants, Arabie saoudite (épidémiologie), Charge virale, Coronavirus du syndrome respiratoire du Moyen-Orient (), Coronavirus du syndrome respiratoire du Moyen-Orient (physiologie), Femelle, Gènes viraux, Humains, Infections à coronavirus (diagnostic), Infections à coronavirus (immunologie), Infections à coronavirus (virologie), Infections à coronavirus (épidémiologie), Interactions hôte-pathogène (immunologie), Mâle, Sujet âgé, Surveillance de la santé publique, Évaluation des symptômes.
- MESH :
- diagnostic : Infections à coronavirus.
- immunologie : Anticorps antiviraux, Infections à coronavirus, Interactions hôte-pathogène.
- physiologie : Coronavirus du syndrome respiratoire du Moyen-Orient.
- sang : Anticorps antiviraux.
- virologie : Infections à coronavirus.
- épidémiologie : Arabie saoudite, Infections à coronavirus.
- ARN viral, Adulte, Adulte d'âge moyen, Anticorps neutralisants, Charge virale, Coronavirus du syndrome respiratoire du Moyen-Orient, Femelle, Gènes viraux, Humains, Mâle, Sujet âgé, Surveillance de la santé publique, Évaluation des symptômes.
- Wicri :
- geographic : Arabie saoudite.
English descriptors
- KwdEn :
- Adult, Aged, Antibodies, Neutralizing, Antibodies, Viral (blood), Antibodies, Viral (immunology), Coronavirus Infections (diagnosis), Coronavirus Infections (epidemiology), Coronavirus Infections (immunology), Coronavirus Infections (virology), Female, Genes, Viral, Host-Pathogen Interactions (immunology), Humans, Male, Middle Aged, Middle East Respiratory Syndrome Coronavirus (classification), Middle East Respiratory Syndrome Coronavirus (physiology), Public Health Surveillance, RNA, Viral, Saudi Arabia (epidemiology), Symptom Assessment, Viral Load.
- MESH :
- chemical , blood : Antibodies, Viral.
- chemical , immunology : Antibodies, Viral.
- chemical : Antibodies, Neutralizing, RNA, Viral.
- geographic , epidemiology : Saudi Arabia.
- classification : Middle East Respiratory Syndrome Coronavirus.
- diagnosis : Coronavirus Infections.
- epidemiology : Coronavirus Infections.
- immunology : Coronavirus Infections, Host-Pathogen Interactions.
- physiology : Middle East Respiratory Syndrome Coronavirus.
- virology : Coronavirus Infections.
- Adult, Aged, Female, Genes, Viral, Humans, Male, Middle Aged, Public Health Surveillance, Symptom Assessment, Viral Load.
Abstract
Middle East respiratory syndrome coronavirus (MERS-CoV) shedding and antibody responses are not fully understood, particularly in relation to underlying medical conditions, clinical manifestations, and mortality. We enrolled MERS-CoV–positive patients at a hospital in Saudi Arabia and periodically collected specimens from multiple sites for real-time reverse transcription PCR and serologic testing. We conducted interviews and chart abstractions to collect clinical, epidemiologic, and laboratory information. We found that diabetes mellitus among survivors was associated with prolonged MERS-CoV RNA detection in the respiratory tract. Among case-patients who died, development of robust neutralizing serum antibody responses during the second and third week of illness was not sufficient for patient recovery or virus clearance. Fever and cough among mildly ill patients typically aligned with RNA detection in the upper respiratory tract; RNA levels peaked during the first week of illness. These findings should be considered in the development of infection control policies, vaccines, and antibody therapeutics.
Url:
DOI: 10.3201/eid2504.181595
PubMed: 30882305
PubMed Central: 6433025
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PMC:6433025Le document en format XML
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<front><div type="abstract" xml:lang="en"><p>Middle East respiratory syndrome coronavirus (MERS-CoV) shedding and antibody responses are not fully understood, particularly in relation to underlying medical conditions, clinical manifestations, and mortality. We enrolled MERS-CoV–positive patients at a hospital in Saudi Arabia and periodically collected specimens from multiple sites for real-time reverse transcription PCR and serologic testing. We conducted interviews and chart abstractions to collect clinical, epidemiologic, and laboratory information. We found that diabetes mellitus among survivors was associated with prolonged MERS-CoV RNA detection in the respiratory tract. Among case-patients who died, development of robust neutralizing serum antibody responses during the second and third week of illness was not sufficient for patient recovery or virus clearance. Fever and cough among mildly ill patients typically aligned with RNA detection in the upper respiratory tract; RNA levels peaked during the first week of illness. These findings should be considered in the development of infection control policies, vaccines, and antibody therapeutics.</p>
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<author><name sortKey="Al Abdely, Hail M" sort="Al Abdely, Hail M" uniqKey="Al Abdely H" first="Hail M." last="Al-Abdely">Hail M. Al-Abdely</name>
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<author><name sortKey="Midgley, Claire M" sort="Midgley, Claire M" uniqKey="Midgley C" first="Claire M." last="Midgley">Claire M. Midgley</name>
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<author><name sortKey="Alkhamis, Abdulrahim M" sort="Alkhamis, Abdulrahim M" uniqKey="Alkhamis A" first="Abdulrahim M." last="Alkhamis">Abdulrahim M. Alkhamis</name>
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<author><name sortKey="Abedi, Glen R" sort="Abedi, Glen R" uniqKey="Abedi G" first="Glen R." last="Abedi">Glen R. Abedi</name>
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<author><name sortKey="Lu, Xiaoyan" sort="Lu, Xiaoyan" uniqKey="Lu X" first="Xiaoyan" last="Lu">Xiaoyan Lu</name>
</author>
<author><name sortKey="Binder, Alison M" sort="Binder, Alison M" uniqKey="Binder A" first="Alison M." last="Binder">Alison M. Binder</name>
</author>
<author><name sortKey="Alanazi, Khalid H" sort="Alanazi, Khalid H" uniqKey="Alanazi K" first="Khalid H." last="Alanazi">Khalid H. Alanazi</name>
</author>
<author><name sortKey="Tamin, Azaibi" sort="Tamin, Azaibi" uniqKey="Tamin A" first="Azaibi" last="Tamin">Azaibi Tamin</name>
</author>
<author><name sortKey="Banjar, Weam M" sort="Banjar, Weam M" uniqKey="Banjar W" first="Weam M." last="Banjar">Weam M. Banjar</name>
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<author><name sortKey="Lester, Sandra" sort="Lester, Sandra" uniqKey="Lester S" first="Sandra" last="Lester">Sandra Lester</name>
</author>
<author><name sortKey="Abdalla, Osman" sort="Abdalla, Osman" uniqKey="Abdalla O" first="Osman" last="Abdalla">Osman Abdalla</name>
</author>
<author><name sortKey="Dahl, Rebecca M" sort="Dahl, Rebecca M" uniqKey="Dahl R" first="Rebecca M." last="Dahl">Rebecca M. Dahl</name>
</author>
<author><name sortKey="Mohammed, Mutaz" sort="Mohammed, Mutaz" uniqKey="Mohammed M" first="Mutaz" last="Mohammed">Mutaz Mohammed</name>
</author>
<author><name sortKey="Trivedi, Suvang" sort="Trivedi, Suvang" uniqKey="Trivedi S" first="Suvang" last="Trivedi">Suvang Trivedi</name>
</author>
<author><name sortKey="Algarni, Homoud S" sort="Algarni, Homoud S" uniqKey="Algarni H" first="Homoud S." last="Algarni">Homoud S. Algarni</name>
</author>
<author><name sortKey="Sakthivel, Senthilkumar K" sort="Sakthivel, Senthilkumar K" uniqKey="Sakthivel S" first="Senthilkumar K." last="Sakthivel">Senthilkumar K. Sakthivel</name>
</author>
<author><name sortKey="Algwizani, Abdullah" sort="Algwizani, Abdullah" uniqKey="Algwizani A" first="Abdullah" last="Algwizani">Abdullah Algwizani</name>
</author>
<author><name sortKey="Bafaqeeh, Fahad" sort="Bafaqeeh, Fahad" uniqKey="Bafaqeeh F" first="Fahad" last="Bafaqeeh">Fahad Bafaqeeh</name>
</author>
<author><name sortKey="Alzahrani, Abdullah" sort="Alzahrani, Abdullah" uniqKey="Alzahrani A" first="Abdullah" last="Alzahrani">Abdullah Alzahrani</name>
</author>
<author><name sortKey="Alsharef, Ali Abraheem" sort="Alsharef, Ali Abraheem" uniqKey="Alsharef A" first="Ali Abraheem" last="Alsharef">Ali Abraheem Alsharef</name>
</author>
<author><name sortKey="Alhakeem, Raafat F" sort="Alhakeem, Raafat F" uniqKey="Alhakeem R" first="Raafat F." last="Alhakeem">Raafat F. Alhakeem</name>
</author>
<author><name sortKey="Jokhdar, Hani A Aziz" sort="Jokhdar, Hani A Aziz" uniqKey="Jokhdar H" first="Hani A. Aziz" last="Jokhdar">Hani A. Aziz Jokhdar</name>
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<author><name sortKey="Ghazal, Sameeh S" sort="Ghazal, Sameeh S" uniqKey="Ghazal S" first="Sameeh S." last="Ghazal">Sameeh S. Ghazal</name>
</author>
<author><name sortKey="Thornburg, Natalie J" sort="Thornburg, Natalie J" uniqKey="Thornburg N" first="Natalie J." last="Thornburg">Natalie J. Thornburg</name>
</author>
<author><name sortKey="Erdman, Dean D" sort="Erdman, Dean D" uniqKey="Erdman D" first="Dean D." last="Erdman">Dean D. Erdman</name>
</author>
<author><name sortKey="Assiri, Abdullah M" sort="Assiri, Abdullah M" uniqKey="Assiri A" first="Abdullah M." last="Assiri">Abdullah M. Assiri</name>
</author>
<author><name sortKey="Watson, John T" sort="Watson, John T" uniqKey="Watson J" first="John T." last="Watson">John T. Watson</name>
</author>
<author><name sortKey="Gerber, Susan I" sort="Gerber, Susan I" uniqKey="Gerber S" first="Susan I." last="Gerber">Susan I. Gerber</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Middle East Respiratory Syndrome Coronavirus Infection Dynamics and Antibody Responses among Clinically Diverse Patients, Saudi Arabia</title>
<author><name sortKey="Al Abdely, Hail M" sort="Al Abdely, Hail M" uniqKey="Al Abdely H" first="Hail M." last="Al-Abdely">Hail M. Al-Abdely</name>
</author>
<author><name sortKey="Midgley, Claire M" sort="Midgley, Claire M" uniqKey="Midgley C" first="Claire M." last="Midgley">Claire M. Midgley</name>
</author>
<author><name sortKey="Alkhamis, Abdulrahim M" sort="Alkhamis, Abdulrahim M" uniqKey="Alkhamis A" first="Abdulrahim M." last="Alkhamis">Abdulrahim M. Alkhamis</name>
</author>
<author><name sortKey="Abedi, Glen R" sort="Abedi, Glen R" uniqKey="Abedi G" first="Glen R." last="Abedi">Glen R. Abedi</name>
</author>
<author><name sortKey="Lu, Xiaoyan" sort="Lu, Xiaoyan" uniqKey="Lu X" first="Xiaoyan" last="Lu">Xiaoyan Lu</name>
</author>
<author><name sortKey="Binder, Alison M" sort="Binder, Alison M" uniqKey="Binder A" first="Alison M." last="Binder">Alison M. Binder</name>
</author>
<author><name sortKey="Alanazi, Khalid H" sort="Alanazi, Khalid H" uniqKey="Alanazi K" first="Khalid H." last="Alanazi">Khalid H. Alanazi</name>
</author>
<author><name sortKey="Tamin, Azaibi" sort="Tamin, Azaibi" uniqKey="Tamin A" first="Azaibi" last="Tamin">Azaibi Tamin</name>
</author>
<author><name sortKey="Banjar, Weam M" sort="Banjar, Weam M" uniqKey="Banjar W" first="Weam M." last="Banjar">Weam M. Banjar</name>
</author>
<author><name sortKey="Lester, Sandra" sort="Lester, Sandra" uniqKey="Lester S" first="Sandra" last="Lester">Sandra Lester</name>
</author>
<author><name sortKey="Abdalla, Osman" sort="Abdalla, Osman" uniqKey="Abdalla O" first="Osman" last="Abdalla">Osman Abdalla</name>
</author>
<author><name sortKey="Dahl, Rebecca M" sort="Dahl, Rebecca M" uniqKey="Dahl R" first="Rebecca M." last="Dahl">Rebecca M. Dahl</name>
</author>
<author><name sortKey="Mohammed, Mutaz" sort="Mohammed, Mutaz" uniqKey="Mohammed M" first="Mutaz" last="Mohammed">Mutaz Mohammed</name>
</author>
<author><name sortKey="Trivedi, Suvang" sort="Trivedi, Suvang" uniqKey="Trivedi S" first="Suvang" last="Trivedi">Suvang Trivedi</name>
</author>
<author><name sortKey="Algarni, Homoud S" sort="Algarni, Homoud S" uniqKey="Algarni H" first="Homoud S." last="Algarni">Homoud S. Algarni</name>
</author>
<author><name sortKey="Sakthivel, Senthilkumar K" sort="Sakthivel, Senthilkumar K" uniqKey="Sakthivel S" first="Senthilkumar K." last="Sakthivel">Senthilkumar K. Sakthivel</name>
</author>
<author><name sortKey="Algwizani, Abdullah" sort="Algwizani, Abdullah" uniqKey="Algwizani A" first="Abdullah" last="Algwizani">Abdullah Algwizani</name>
</author>
<author><name sortKey="Bafaqeeh, Fahad" sort="Bafaqeeh, Fahad" uniqKey="Bafaqeeh F" first="Fahad" last="Bafaqeeh">Fahad Bafaqeeh</name>
</author>
<author><name sortKey="Alzahrani, Abdullah" sort="Alzahrani, Abdullah" uniqKey="Alzahrani A" first="Abdullah" last="Alzahrani">Abdullah Alzahrani</name>
</author>
<author><name sortKey="Alsharef, Ali Abraheem" sort="Alsharef, Ali Abraheem" uniqKey="Alsharef A" first="Ali Abraheem" last="Alsharef">Ali Abraheem Alsharef</name>
</author>
<author><name sortKey="Alhakeem, Raafat F" sort="Alhakeem, Raafat F" uniqKey="Alhakeem R" first="Raafat F." last="Alhakeem">Raafat F. Alhakeem</name>
</author>
<author><name sortKey="Jokhdar, Hani A Aziz" sort="Jokhdar, Hani A Aziz" uniqKey="Jokhdar H" first="Hani A. Aziz" last="Jokhdar">Hani A. Aziz Jokhdar</name>
</author>
<author><name sortKey="Ghazal, Sameeh S" sort="Ghazal, Sameeh S" uniqKey="Ghazal S" first="Sameeh S." last="Ghazal">Sameeh S. Ghazal</name>
</author>
<author><name sortKey="Thornburg, Natalie J" sort="Thornburg, Natalie J" uniqKey="Thornburg N" first="Natalie J." last="Thornburg">Natalie J. Thornburg</name>
</author>
<author><name sortKey="Erdman, Dean D" sort="Erdman, Dean D" uniqKey="Erdman D" first="Dean D." last="Erdman">Dean D. Erdman</name>
</author>
<author><name sortKey="Assiri, Abdullah M" sort="Assiri, Abdullah M" uniqKey="Assiri A" first="Abdullah M." last="Assiri">Abdullah M. Assiri</name>
</author>
<author><name sortKey="Watson, John T" sort="Watson, John T" uniqKey="Watson J" first="John T." last="Watson">John T. Watson</name>
</author>
<author><name sortKey="Gerber, Susan I" sort="Gerber, Susan I" uniqKey="Gerber S" first="Susan I." last="Gerber">Susan I. Gerber</name>
</author>
</analytic>
<series><title level="j">Emerging Infectious Diseases</title>
<idno type="ISSN">1080-6040</idno>
<idno type="eISSN">1080-6059</idno>
<imprint><date when="2019">2019</date>
</imprint>
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<front><div type="abstract" xml:lang="en"><p>Middle East respiratory syndrome coronavirus (MERS-CoV) shedding and antibody responses are not fully understood, particularly in relation to underlying medical conditions, clinical manifestations, and mortality. We enrolled MERS-CoV–positive patients at a hospital in Saudi Arabia and periodically collected specimens from multiple sites for real-time reverse transcription PCR and serologic testing. We conducted interviews and chart abstractions to collect clinical, epidemiologic, and laboratory information. We found that diabetes mellitus among survivors was associated with prolonged MERS-CoV RNA detection in the respiratory tract. Among case-patients who died, development of robust neutralizing serum antibody responses during the second and third week of illness was not sufficient for patient recovery or virus clearance. Fever and cough among mildly ill patients typically aligned with RNA detection in the upper respiratory tract; RNA levels peaked during the first week of illness. These findings should be considered in the development of infection control policies, vaccines, and antibody therapeutics.</p>
</div>
</front>
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<pubmed><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Middle East Respiratory Syndrome Coronavirus Infection Dynamics and Antibody Responses among Clinically Diverse Patients, Saudi Arabia.</title>
<author><name sortKey="Al Abdely, Hail M" sort="Al Abdely, Hail M" uniqKey="Al Abdely H" first="Hail M" last="Al-Abdely">Hail M. Al-Abdely</name>
</author>
<author><name sortKey="Midgley, Claire M" sort="Midgley, Claire M" uniqKey="Midgley C" first="Claire M" last="Midgley">Claire M. Midgley</name>
</author>
<author><name sortKey="Alkhamis, Abdulrahim M" sort="Alkhamis, Abdulrahim M" uniqKey="Alkhamis A" first="Abdulrahim M" last="Alkhamis">Abdulrahim M. Alkhamis</name>
</author>
<author><name sortKey="Abedi, Glen R" sort="Abedi, Glen R" uniqKey="Abedi G" first="Glen R" last="Abedi">Glen R. Abedi</name>
</author>
<author><name sortKey="Lu, Xiaoyan" sort="Lu, Xiaoyan" uniqKey="Lu X" first="Xiaoyan" last="Lu">Xiaoyan Lu</name>
</author>
<author><name sortKey="Binder, Alison M" sort="Binder, Alison M" uniqKey="Binder A" first="Alison M" last="Binder">Alison M. Binder</name>
</author>
<author><name sortKey="Alanazi, Khalid H" sort="Alanazi, Khalid H" uniqKey="Alanazi K" first="Khalid H" last="Alanazi">Khalid H. Alanazi</name>
</author>
<author><name sortKey="Tamin, Azaibi" sort="Tamin, Azaibi" uniqKey="Tamin A" first="Azaibi" last="Tamin">Azaibi Tamin</name>
</author>
<author><name sortKey="Banjar, Weam M" sort="Banjar, Weam M" uniqKey="Banjar W" first="Weam M" last="Banjar">Weam M. Banjar</name>
</author>
<author><name sortKey="Lester, Sandra" sort="Lester, Sandra" uniqKey="Lester S" first="Sandra" last="Lester">Sandra Lester</name>
</author>
<author><name sortKey="Abdalla, Osman" sort="Abdalla, Osman" uniqKey="Abdalla O" first="Osman" last="Abdalla">Osman Abdalla</name>
</author>
<author><name sortKey="Dahl, Rebecca M" sort="Dahl, Rebecca M" uniqKey="Dahl R" first="Rebecca M" last="Dahl">Rebecca M. Dahl</name>
</author>
<author><name sortKey="Mohammed, Mutaz" sort="Mohammed, Mutaz" uniqKey="Mohammed M" first="Mutaz" last="Mohammed">Mutaz Mohammed</name>
</author>
<author><name sortKey="Trivedi, Suvang" sort="Trivedi, Suvang" uniqKey="Trivedi S" first="Suvang" last="Trivedi">Suvang Trivedi</name>
</author>
<author><name sortKey="Algarni, Homoud S" sort="Algarni, Homoud S" uniqKey="Algarni H" first="Homoud S" last="Algarni">Homoud S. Algarni</name>
</author>
<author><name sortKey="Sakthivel, Senthilkumar K" sort="Sakthivel, Senthilkumar K" uniqKey="Sakthivel S" first="Senthilkumar K" last="Sakthivel">Senthilkumar K. Sakthivel</name>
</author>
<author><name sortKey="Algwizani, Abdullah" sort="Algwizani, Abdullah" uniqKey="Algwizani A" first="Abdullah" last="Algwizani">Abdullah Algwizani</name>
</author>
<author><name sortKey="Bafaqeeh, Fahad" sort="Bafaqeeh, Fahad" uniqKey="Bafaqeeh F" first="Fahad" last="Bafaqeeh">Fahad Bafaqeeh</name>
</author>
<author><name sortKey="Alzahrani, Abdullah" sort="Alzahrani, Abdullah" uniqKey="Alzahrani A" first="Abdullah" last="Alzahrani">Abdullah Alzahrani</name>
</author>
<author><name sortKey="Alsharef, Ali Abraheem" sort="Alsharef, Ali Abraheem" uniqKey="Alsharef A" first="Ali Abraheem" last="Alsharef">Ali Abraheem Alsharef</name>
</author>
<author><name sortKey="Alhakeem, Raafat F" sort="Alhakeem, Raafat F" uniqKey="Alhakeem R" first="Raafat F" last="Alhakeem">Raafat F. Alhakeem</name>
</author>
<author><name sortKey="Jokhdar, Hani A Aziz" sort="Jokhdar, Hani A Aziz" uniqKey="Jokhdar H" first="Hani A Aziz" last="Jokhdar">Hani A Aziz Jokhdar</name>
</author>
<author><name sortKey="Ghazal, Sameeh S" sort="Ghazal, Sameeh S" uniqKey="Ghazal S" first="Sameeh S" last="Ghazal">Sameeh S. Ghazal</name>
</author>
<author><name sortKey="Thornburg, Natalie J" sort="Thornburg, Natalie J" uniqKey="Thornburg N" first="Natalie J" last="Thornburg">Natalie J. Thornburg</name>
</author>
<author><name sortKey="Erdman, Dean D" sort="Erdman, Dean D" uniqKey="Erdman D" first="Dean D" last="Erdman">Dean D. Erdman</name>
</author>
<author><name sortKey="Assiri, Abdullah M" sort="Assiri, Abdullah M" uniqKey="Assiri A" first="Abdullah M" last="Assiri">Abdullah M. Assiri</name>
</author>
<author><name sortKey="Watson, John T" sort="Watson, John T" uniqKey="Watson J" first="John T" last="Watson">John T. Watson</name>
</author>
<author><name sortKey="Gerber, Susan I" sort="Gerber, Susan I" uniqKey="Gerber S" first="Susan I" last="Gerber">Susan I. Gerber</name>
</author>
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<publicationStmt><idno type="wicri:source">PubMed</idno>
<date when="2019">2019</date>
<idno type="RBID">pubmed:30882305</idno>
<idno type="pmid">30882305</idno>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Middle East Respiratory Syndrome Coronavirus Infection Dynamics and Antibody Responses among Clinically Diverse Patients, Saudi Arabia.</title>
<author><name sortKey="Al Abdely, Hail M" sort="Al Abdely, Hail M" uniqKey="Al Abdely H" first="Hail M" last="Al-Abdely">Hail M. Al-Abdely</name>
</author>
<author><name sortKey="Midgley, Claire M" sort="Midgley, Claire M" uniqKey="Midgley C" first="Claire M" last="Midgley">Claire M. Midgley</name>
</author>
<author><name sortKey="Alkhamis, Abdulrahim M" sort="Alkhamis, Abdulrahim M" uniqKey="Alkhamis A" first="Abdulrahim M" last="Alkhamis">Abdulrahim M. Alkhamis</name>
</author>
<author><name sortKey="Abedi, Glen R" sort="Abedi, Glen R" uniqKey="Abedi G" first="Glen R" last="Abedi">Glen R. Abedi</name>
</author>
<author><name sortKey="Lu, Xiaoyan" sort="Lu, Xiaoyan" uniqKey="Lu X" first="Xiaoyan" last="Lu">Xiaoyan Lu</name>
</author>
<author><name sortKey="Binder, Alison M" sort="Binder, Alison M" uniqKey="Binder A" first="Alison M" last="Binder">Alison M. Binder</name>
</author>
<author><name sortKey="Alanazi, Khalid H" sort="Alanazi, Khalid H" uniqKey="Alanazi K" first="Khalid H" last="Alanazi">Khalid H. Alanazi</name>
</author>
<author><name sortKey="Tamin, Azaibi" sort="Tamin, Azaibi" uniqKey="Tamin A" first="Azaibi" last="Tamin">Azaibi Tamin</name>
</author>
<author><name sortKey="Banjar, Weam M" sort="Banjar, Weam M" uniqKey="Banjar W" first="Weam M" last="Banjar">Weam M. Banjar</name>
</author>
<author><name sortKey="Lester, Sandra" sort="Lester, Sandra" uniqKey="Lester S" first="Sandra" last="Lester">Sandra Lester</name>
</author>
<author><name sortKey="Abdalla, Osman" sort="Abdalla, Osman" uniqKey="Abdalla O" first="Osman" last="Abdalla">Osman Abdalla</name>
</author>
<author><name sortKey="Dahl, Rebecca M" sort="Dahl, Rebecca M" uniqKey="Dahl R" first="Rebecca M" last="Dahl">Rebecca M. Dahl</name>
</author>
<author><name sortKey="Mohammed, Mutaz" sort="Mohammed, Mutaz" uniqKey="Mohammed M" first="Mutaz" last="Mohammed">Mutaz Mohammed</name>
</author>
<author><name sortKey="Trivedi, Suvang" sort="Trivedi, Suvang" uniqKey="Trivedi S" first="Suvang" last="Trivedi">Suvang Trivedi</name>
</author>
<author><name sortKey="Algarni, Homoud S" sort="Algarni, Homoud S" uniqKey="Algarni H" first="Homoud S" last="Algarni">Homoud S. Algarni</name>
</author>
<author><name sortKey="Sakthivel, Senthilkumar K" sort="Sakthivel, Senthilkumar K" uniqKey="Sakthivel S" first="Senthilkumar K" last="Sakthivel">Senthilkumar K. Sakthivel</name>
</author>
<author><name sortKey="Algwizani, Abdullah" sort="Algwizani, Abdullah" uniqKey="Algwizani A" first="Abdullah" last="Algwizani">Abdullah Algwizani</name>
</author>
<author><name sortKey="Bafaqeeh, Fahad" sort="Bafaqeeh, Fahad" uniqKey="Bafaqeeh F" first="Fahad" last="Bafaqeeh">Fahad Bafaqeeh</name>
</author>
<author><name sortKey="Alzahrani, Abdullah" sort="Alzahrani, Abdullah" uniqKey="Alzahrani A" first="Abdullah" last="Alzahrani">Abdullah Alzahrani</name>
</author>
<author><name sortKey="Alsharef, Ali Abraheem" sort="Alsharef, Ali Abraheem" uniqKey="Alsharef A" first="Ali Abraheem" last="Alsharef">Ali Abraheem Alsharef</name>
</author>
<author><name sortKey="Alhakeem, Raafat F" sort="Alhakeem, Raafat F" uniqKey="Alhakeem R" first="Raafat F" last="Alhakeem">Raafat F. Alhakeem</name>
</author>
<author><name sortKey="Jokhdar, Hani A Aziz" sort="Jokhdar, Hani A Aziz" uniqKey="Jokhdar H" first="Hani A Aziz" last="Jokhdar">Hani A Aziz Jokhdar</name>
</author>
<author><name sortKey="Ghazal, Sameeh S" sort="Ghazal, Sameeh S" uniqKey="Ghazal S" first="Sameeh S" last="Ghazal">Sameeh S. Ghazal</name>
</author>
<author><name sortKey="Thornburg, Natalie J" sort="Thornburg, Natalie J" uniqKey="Thornburg N" first="Natalie J" last="Thornburg">Natalie J. Thornburg</name>
</author>
<author><name sortKey="Erdman, Dean D" sort="Erdman, Dean D" uniqKey="Erdman D" first="Dean D" last="Erdman">Dean D. Erdman</name>
</author>
<author><name sortKey="Assiri, Abdullah M" sort="Assiri, Abdullah M" uniqKey="Assiri A" first="Abdullah M" last="Assiri">Abdullah M. Assiri</name>
</author>
<author><name sortKey="Watson, John T" sort="Watson, John T" uniqKey="Watson J" first="John T" last="Watson">John T. Watson</name>
</author>
<author><name sortKey="Gerber, Susan I" sort="Gerber, Susan I" uniqKey="Gerber S" first="Susan I" last="Gerber">Susan I. Gerber</name>
</author>
</analytic>
<series><title level="j">Emerging infectious diseases</title>
<idno type="eISSN">1080-6059</idno>
<imprint><date when="2019" type="published">2019</date>
</imprint>
</series>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term>
<term>Aged</term>
<term>Antibodies, Neutralizing</term>
<term>Antibodies, Viral (blood)</term>
<term>Antibodies, Viral (immunology)</term>
<term>Coronavirus Infections (diagnosis)</term>
<term>Coronavirus Infections (epidemiology)</term>
<term>Coronavirus Infections (immunology)</term>
<term>Coronavirus Infections (virology)</term>
<term>Female</term>
<term>Genes, Viral</term>
<term>Host-Pathogen Interactions (immunology)</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Middle East Respiratory Syndrome Coronavirus (classification)</term>
<term>Middle East Respiratory Syndrome Coronavirus (physiology)</term>
<term>Public Health Surveillance</term>
<term>RNA, Viral</term>
<term>Saudi Arabia (epidemiology)</term>
<term>Symptom Assessment</term>
<term>Viral Load</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>ARN viral</term>
<term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Anticorps antiviraux (immunologie)</term>
<term>Anticorps antiviraux (sang)</term>
<term>Anticorps neutralisants</term>
<term>Arabie saoudite (épidémiologie)</term>
<term>Charge virale</term>
<term>Coronavirus du syndrome respiratoire du Moyen-Orient ()</term>
<term>Coronavirus du syndrome respiratoire du Moyen-Orient (physiologie)</term>
<term>Femelle</term>
<term>Gènes viraux</term>
<term>Humains</term>
<term>Infections à coronavirus (diagnostic)</term>
<term>Infections à coronavirus (immunologie)</term>
<term>Infections à coronavirus (virologie)</term>
<term>Infections à coronavirus (épidémiologie)</term>
<term>Interactions hôte-pathogène (immunologie)</term>
<term>Mâle</term>
<term>Sujet âgé</term>
<term>Surveillance de la santé publique</term>
<term>Évaluation des symptômes</term>
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</keywords>
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</keywords>
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<term>RNA, Viral</term>
</keywords>
<keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Saudi Arabia</term>
</keywords>
<keywords scheme="MESH" qualifier="classification" xml:lang="en"><term>Middle East Respiratory Syndrome Coronavirus</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Coronavirus Infections</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Infections à coronavirus</term>
</keywords>
<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Coronavirus Infections</term>
</keywords>
<keywords scheme="MESH" qualifier="immunologie" xml:lang="fr"><term>Anticorps antiviraux</term>
<term>Infections à coronavirus</term>
<term>Interactions hôte-pathogène</term>
</keywords>
<keywords scheme="MESH" qualifier="immunology" xml:lang="en"><term>Coronavirus Infections</term>
<term>Host-Pathogen Interactions</term>
</keywords>
<keywords scheme="MESH" qualifier="physiologie" xml:lang="fr"><term>Coronavirus du syndrome respiratoire du Moyen-Orient</term>
</keywords>
<keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Middle East Respiratory Syndrome Coronavirus</term>
</keywords>
<keywords scheme="MESH" qualifier="sang" xml:lang="fr"><term>Anticorps antiviraux</term>
</keywords>
<keywords scheme="MESH" qualifier="virologie" xml:lang="fr"><term>Infections à coronavirus</term>
</keywords>
<keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Coronavirus Infections</term>
</keywords>
<keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Arabie saoudite</term>
<term>Infections à coronavirus</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adult</term>
<term>Aged</term>
<term>Female</term>
<term>Genes, Viral</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Public Health Surveillance</term>
<term>Symptom Assessment</term>
<term>Viral Load</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>ARN viral</term>
<term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Anticorps neutralisants</term>
<term>Charge virale</term>
<term>Coronavirus du syndrome respiratoire du Moyen-Orient</term>
<term>Femelle</term>
<term>Gènes viraux</term>
<term>Humains</term>
<term>Mâle</term>
<term>Sujet âgé</term>
<term>Surveillance de la santé publique</term>
<term>Évaluation des symptômes</term>
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<keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Arabie saoudite</term>
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<front><div type="abstract" xml:lang="en">Middle East respiratory syndrome coronavirus (MERS-CoV) shedding and antibody responses are not fully understood, particularly in relation to underlying medical conditions, clinical manifestations, and mortality. We enrolled MERS-CoV-positive patients at a hospital in Saudi Arabia and periodically collected specimens from multiple sites for real-time reverse transcription PCR and serologic testing. We conducted interviews and chart abstractions to collect clinical, epidemiologic, and laboratory information. We found that diabetes mellitus among survivors was associated with prolonged MERS-CoV RNA detection in the respiratory tract. Among case-patients who died, development of robust neutralizing serum antibody responses during the second and third week of illness was not sufficient for patient recovery or virus clearance. Fever and cough among mildly ill patients typically aligned with RNA detection in the upper respiratory tract; RNA levels peaked during the first week of illness. These findings should be considered in the development of infection control policies, vaccines, and antibody therapeutics.</div>
</front>
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