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

Autor: Sarah Shalhoub, Fayssal M. Farahat, Nauman Siddiqi, Raed Simhairi, Adnan Mushtaq, Abdullah Al-Jiffri, Omar Shamma
Rok vydání: 2014
Předmět:
Male
viruses
medicine.disease_cause
Gastroenterology
chemistry.chemical_compound
Plasma
MERS-CoV
Pharmacology (medical)
Respiratory system
Lung
Original Research
Aged
80 and over
treatment
Mortality rate
virus diseases
interferon
Middle Aged
Viral Load
Infectious Diseases
Treatment Outcome
Middle East Respiratory Syndrome Coronavirus
Drug Therapy
Combination
Female
Coronavirus Infections
Microbiology (medical)
Adult
medicine.medical_specialty
Middle East respiratory syndrome coronavirus
Pneumonia
Viral
Real-Time Polymerase Chain Reaction
Antiviral Agents
Internal medicine
Diabetes mellitus
Ribavirin
medicine
Humans
Aged
Retrospective Studies
Pharmacology
business.industry
Interferon-alpha
Retrospective cohort study
Interferon-beta
medicine.disease
Pneumonia
chemistry
Immunology
Middle East respiratory syndrome
business
Zdroj: Journal of Antimicrobial Chemotherapy
ISSN: 1460-2091
Popis: Objectives Middle East respiratory syndrome coronavirus (MERS-CoV) is associated with significant mortality. We examined the utility of plasma MERS-CoV PCR as a prognostic indicator and compared the efficacies of IFN-α2a and IFN-β1a when combined with ribavirin in reducing MERS-CoV-related mortality rates. Methods We retrospectively analysed 32 patients with confirmed MERS-CoV infection, admitted between April 2014 and June 2014, by positive respiratory sample RT–PCR. Plasma MERS-CoV RT–PCR was performed at the time of diagnosis for 19 patients. Results The overall mortality rate was 69% (22/32). Ninety percent (9/10) of patients with positive plasma MERS-CoV PCR died compared with 44% (4/9) of those with negative plasma MERS-CoV PCR. Mortality rate in patients who received IFN-α2a was 85% (11/13) compared with 64% (7/11) in those who received IFN-β1a (P = 0.24). The mortality rate in patients with renal failure (14), including 8 on haemodialysis, was 100%. Age >50 years and diabetes mellitus were found to be significantly associated with mortality (OR = 26.1; 95% CI 3.58–190.76; P = 0.001 and OR = 15.74; 95% CI 2.46–100.67; P = 0.004, respectively). The median duration of viral shedding in patients who recovered was 11 days (range 6–38 days). Absence of fever was noted in 5/32 patients. Conclusions Plasma MERS-CoV RT–PCR may serve as an effective tool to predict MERS-CoV-associated mortality. Older age and comorbid conditions may have contributed to the lack of efficacy of IFN-α2a or IFN-β1a with ribavirin in treating MERS-CoV. Absence of fever should not exclude MERS-CoV.
Databáze: OpenAIRE
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