Giuseppe
Emeritus
[Source: ScienceDirect, full page: (LINK). Abstract, edited.]
Journal of Infectious Diseases, Available online 6 January 2014 / In Press, Accepted Manuscript
Ribavirin and interferon therapy in patients infected with the Middle East respiratory syndrome coronavirus: an observational study
Jaffar A. Al-Tawfiq<SUP>a</SUP><SUP>, </SUP><SUP>b</SUP> Hisham Momattin<SUP>c </SUP>Jean Dib<SUP>c </SUP>Ziad A. Memish<SUP>d</SUP><SUP>, </SUP><SUP>e</SUP>
<SUP></SUP>
<SUP>a</SUP> Internal Medicine, Saudi Aramco Medical Services Organization, PO Box 76, Room A-428-2, Building 61, Dhahran Health Center, Dhahran 31311, Saudi Arabia; <SUP>b</SUP> Indiana University School of Medicine, Indiana, USA; <SUP>c</SUP> Pharmacy Services Division, Saudi Aramco Medical Services Organization, Dhahran, Saudi Arabia; <SUP>d</SUP> WHO Collaborating Center for Mass Gathering Medicine, Ministry of Health, Riyadh, Saudi Arabia; <SUP>e</SUP> Al-Faisal University, Riyadh, Saudi Arabia
Received 9 December 2013 - Accepted 9 December 2013 - Available online 6 January 2014
Open Access
Summary
Background
The Middle East respiratory syndrome coronavirus (MERS-CoV) has been reported to have a high case-fatality rate. Currently, there is no specific therapy or vaccine with proven effectiveness for MERS-CoV infections.
Methods
A combination of ribavirin and interferon therapy was used for the treatment of five MERS-CoV-positive patients. We reviewed the therapeutic schedule and the outcome of these patients.
Results
All patients were critically ill with acute respiratory distress syndrome treated with adjunctive corticosteroids and were on mechanical ventilation at the time of initiation of therapy. The median time from admission to therapy with ribavirin and interferon was 19 (range 10?22) days. None of the patients responded to the supportive or therapeutic interventions and all died of their illness.
Conclusions
While ribavirin and interferon may be effective in some patients, our practical experience suggests that critically ill patients with multiple comorbidities who are diagnosed late in the course of their illness may not benefit from combination antiviral therapy as preclinical data suggest. There is clearly an urgent need for a novel effective antiviral therapy for this emerging global threat.
Keywords
MERS-CoV, Interferon ;, Ribavirin ;, Pegylated interferon
Corresponding author. Tel.: +966 13 877 3524, fax: +966 13 877 3790
Copyright ? 2014 Published by Elsevier Ltd.
Note to users: Accepted manuscripts are Articles in Press that have been peer reviewed and accepted for publication by the Editorial Board of this journal. They have not yet been copy edited and/or formatted in the journal house style, and may not yet have the full ScienceDirect functionality, e.g., supplementary files may still need to be added, links to references may not resolve yet etc. The text could still change before final publication.
Although accepted manuscripts do not have all bibliographic details available yet, they can already be cited using the year of online publication and the DOI, as follows: author(s), article title, journal (year), DOI. Please consult the journal's reference style for the exact appearance of these elements, abbreviation of journal names and use of punctuation.
When the final article is assigned to an issue of the journal, the Article in Press version will be removed and the final version will appear in the associated published issue of the journal. The date the article was first made available online will be carried over.
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Journal of Infectious Diseases, Available online 6 January 2014 / In Press, Accepted Manuscript
Ribavirin and interferon therapy in patients infected with the Middle East respiratory syndrome coronavirus: an observational study
Jaffar A. Al-Tawfiq<SUP>a</SUP><SUP>, </SUP><SUP>b</SUP> Hisham Momattin<SUP>c </SUP>Jean Dib<SUP>c </SUP>Ziad A. Memish<SUP>d</SUP><SUP>, </SUP><SUP>e</SUP>
<SUP></SUP>
<SUP>a</SUP> Internal Medicine, Saudi Aramco Medical Services Organization, PO Box 76, Room A-428-2, Building 61, Dhahran Health Center, Dhahran 31311, Saudi Arabia; <SUP>b</SUP> Indiana University School of Medicine, Indiana, USA; <SUP>c</SUP> Pharmacy Services Division, Saudi Aramco Medical Services Organization, Dhahran, Saudi Arabia; <SUP>d</SUP> WHO Collaborating Center for Mass Gathering Medicine, Ministry of Health, Riyadh, Saudi Arabia; <SUP>e</SUP> Al-Faisal University, Riyadh, Saudi Arabia
Received 9 December 2013 - Accepted 9 December 2013 - Available online 6 January 2014
Open Access
Summary
Background
The Middle East respiratory syndrome coronavirus (MERS-CoV) has been reported to have a high case-fatality rate. Currently, there is no specific therapy or vaccine with proven effectiveness for MERS-CoV infections.
Methods
A combination of ribavirin and interferon therapy was used for the treatment of five MERS-CoV-positive patients. We reviewed the therapeutic schedule and the outcome of these patients.
Results
All patients were critically ill with acute respiratory distress syndrome treated with adjunctive corticosteroids and were on mechanical ventilation at the time of initiation of therapy. The median time from admission to therapy with ribavirin and interferon was 19 (range 10?22) days. None of the patients responded to the supportive or therapeutic interventions and all died of their illness.
Conclusions
While ribavirin and interferon may be effective in some patients, our practical experience suggests that critically ill patients with multiple comorbidities who are diagnosed late in the course of their illness may not benefit from combination antiviral therapy as preclinical data suggest. There is clearly an urgent need for a novel effective antiviral therapy for this emerging global threat.
Keywords
MERS-CoV, Interferon ;, Ribavirin ;, Pegylated interferon
Corresponding author. Tel.: +966 13 877 3524, fax: +966 13 877 3790
Copyright ? 2014 Published by Elsevier Ltd.
Note to users: Accepted manuscripts are Articles in Press that have been peer reviewed and accepted for publication by the Editorial Board of this journal. They have not yet been copy edited and/or formatted in the journal house style, and may not yet have the full ScienceDirect functionality, e.g., supplementary files may still need to be added, links to references may not resolve yet etc. The text could still change before final publication.
Although accepted manuscripts do not have all bibliographic details available yet, they can already be cited using the year of online publication and the DOI, as follows: author(s), article title, journal (year), DOI. Please consult the journal's reference style for the exact appearance of these elements, abbreviation of journal names and use of punctuation.
When the final article is assigned to an issue of the journal, the Article in Press version will be removed and the final version will appear in the associated published issue of the journal. The date the article was first made available online will be carried over.
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