Middle East Respiratory Syndrome Coronavirus Infection Dynamics and Antibody Responses among Clinically Diverse Patients, Saudi Arabia
Identifieur interne : 000C20 ( Pmc/Curation ); précédent : 000C19; suivant : 000C21Middle 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.
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.
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DOI: 10.3201/eid2504.181595
PubMed: 30882305
PubMed Central: 6433025
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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></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><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><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Emerg Infect Dis</journal-id><journal-id journal-id-type="iso-abbrev">Emerging Infect. Dis</journal-id><journal-id journal-id-type="publisher-id">EID</journal-id><journal-title-group><journal-title>Emerging Infectious Diseases</journal-title></journal-title-group><issn pub-type="ppub">1080-6040</issn><issn pub-type="epub">1080-6059</issn><publisher><publisher-name>Centers for Disease Control and Prevention</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">30882305</article-id><article-id pub-id-type="pmc">6433025</article-id><article-id pub-id-type="publisher-id">18-1595</article-id><article-id pub-id-type="doi">10.3201/eid2504.181595</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research</subject></subj-group><subj-group subj-group-type="TOC-title"><subject>Middle East Respiratory Syndrome Coronavirus Infection Dynamics and Antibody Responses among Clinically Diverse Patients, Saudi Arabia</subject></subj-group></article-categories><title-group><article-title>Middle East Respiratory Syndrome Coronavirus Infection Dynamics and Antibody Responses among Clinically Diverse Patients, Saudi Arabia</article-title><alt-title alt-title-type="running-head">MERS-CoV, Saudi Arabia</alt-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Al-Abdely</surname><given-names>Hail M.</given-names></name><xref ref-type="fn" rid="FN1"><sup>1</sup></xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Midgley</surname><given-names>Claire M.</given-names></name><xref ref-type="fn" rid="FN1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Alkhamis</surname><given-names>Abdulrahim M.</given-names></name></contrib><contrib contrib-type="author"><name><surname>Abedi</surname><given-names>Glen R.</given-names></name></contrib><contrib contrib-type="author"><name><surname>Lu</surname><given-names>Xiaoyan</given-names></name></contrib><contrib contrib-type="author"><name><surname>Binder</surname><given-names>Alison M.</given-names></name></contrib><contrib contrib-type="author"><name><surname>Alanazi</surname><given-names>Khalid H.</given-names></name></contrib><contrib contrib-type="author"><name><surname>Tamin</surname><given-names>Azaibi</given-names></name></contrib><contrib contrib-type="author"><name><surname>Banjar</surname><given-names>Weam M.</given-names></name></contrib><contrib contrib-type="author"><name><surname>Lester</surname><given-names>Sandra</given-names></name></contrib><contrib contrib-type="author"><name><surname>Abdalla</surname><given-names>Osman</given-names></name></contrib><contrib contrib-type="author"><name><surname>Dahl</surname><given-names>Rebecca M.</given-names></name></contrib><contrib contrib-type="author"><name><surname>Mohammed</surname><given-names>Mutaz</given-names></name></contrib><contrib contrib-type="author"><name><surname>Trivedi</surname><given-names>Suvang</given-names></name></contrib><contrib contrib-type="author"><name><surname>Algarni</surname><given-names>Homoud S.</given-names></name></contrib><contrib contrib-type="author"><name><surname>Sakthivel</surname><given-names>Senthilkumar K.</given-names></name></contrib><contrib contrib-type="author"><name><surname>Algwizani</surname><given-names>Abdullah</given-names></name></contrib><contrib contrib-type="author"><name><surname>Bafaqeeh</surname><given-names>Fahad</given-names></name></contrib><contrib contrib-type="author"><name><surname>Alzahrani</surname><given-names>Abdullah</given-names></name></contrib><contrib contrib-type="author"><name><surname>Alsharef</surname><given-names>Ali Abraheem</given-names></name></contrib><contrib contrib-type="author"><name><surname>Alhakeem</surname><given-names>Raafat F.</given-names></name></contrib><contrib contrib-type="author"><name><surname>Jokhdar</surname><given-names>Hani A. Aziz</given-names></name></contrib><contrib contrib-type="author"><name><surname>Ghazal</surname><given-names>Sameeh S.</given-names></name></contrib><contrib contrib-type="author"><name><surname>Thornburg</surname><given-names>Natalie J.</given-names></name></contrib><contrib contrib-type="author"><name><surname>Erdman</surname><given-names>Dean D.</given-names></name></contrib><contrib contrib-type="author"><name><surname>Assiri</surname><given-names>Abdullah M.</given-names></name></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Watson</surname><given-names>John T.</given-names></name></contrib><contrib contrib-type="author"><name><surname>Gerber</surname><given-names>Susan I.</given-names></name></contrib><aff id="aff1">Ministry of Health, Riyadh, Saudi Arabia (H.M. Al-Abdely, A.M. Alkhamis, K.H. Alanazi, W.M. Banjar, O. Abdalla, M. Mohammed, H.S. Algarni, A. Alzahrani, A.A. Alsharef, R.F. Alhakeem, H.A.A. Jokhdar, A.M. Assiri);</aff><aff id="aff2">Centers for Disease Control and Prevention, Atlanta, Georgia, USA (C.M. Midgley, G.R. Abedi, X. Lu, A.M. Binder, A. Tamin, S. Lester, R.M. Dahl, S.K. Sakthivel, N.J. Thornburg, D.D. Erdman, J.T. Watson, S.I. Gerber);</aff><aff id="aff3">Princess Nourah Bint Abdulrahman University, Riyadh (W.M. Banjar);</aff><aff id="aff4">Prince Mohammed Bin Abdulaziz Hospital, Riyadh (A. Algwizani, F. Bafaqeeh, S.S. Ghazal)</aff></contrib-group><author-notes><corresp id="cor1">Address for correspondence: Claire M. Midgley or John T. Watson, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30329-4027; email: <email xlink:href="ydk5@cdc.gov">ydk5@cdc.gov</email> or <email xlink:href="acq4@cdc.gov">acq4@cdc.gov</email></corresp></author-notes><pub-date pub-type="ppub"><month>4</month><year>2019</year></pub-date><volume>25</volume><issue>4</issue><fpage>753</fpage><lpage>766</lpage><abstract><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></abstract><kwd-group kwd-group-type="author"><title>Keywords: </title><kwd>Middle East respiratory syndrome</kwd><kwd>coronavirus infections</kwd><kwd>diabetes mellitus</kwd><kwd>kinetics</kwd><kwd>viral load</kwd><kwd>antibody response</kwd><kwd>asymptomatic infections</kwd><kwd>mortality</kwd><kwd>viruses</kwd><kwd>respiratory infections</kwd><kwd>MERS</kwd><kwd>MERS-CoV</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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