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Middle East respiratory syndrome coronavirus: another zoonotic betacoronavirus causing SARS-like disease.
Clin Microbiol Rev. 2015 Apr; 28(2):465-522.CM

Abstract

The source of the severe acute respiratory syndrome (SARS) epidemic was traced to wildlife market civets and ultimately to bats. Subsequent hunting for novel coronaviruses (CoVs) led to the discovery of two additional human and over 40 animal CoVs, including the prototype lineage C betacoronaviruses, Tylonycteris bat CoV HKU4 and Pipistrellus bat CoV HKU5; these are phylogenetically closely related to the Middle East respiratory syndrome (MERS) CoV, which has affected more than 1,000 patients with over 35% fatality since its emergence in 2012. All primary cases of MERS are epidemiologically linked to the Middle East. Some of these patients had contacted camels which shed virus and/or had positive serology. Most secondary cases are related to health care-associated clusters. The disease is especially severe in elderly men with comorbidities. Clinical severity may be related to MERS-CoV's ability to infect a broad range of cells with DPP4 expression, evade the host innate immune response, and induce cytokine dysregulation. Reverse transcription-PCR on respiratory and/or extrapulmonary specimens rapidly establishes diagnosis. Supportive treatment with extracorporeal membrane oxygenation and dialysis is often required in patients with organ failure. Antivirals with potent in vitro activities include neutralizing monoclonal antibodies, antiviral peptides, interferons, mycophenolic acid, and lopinavir. They should be evaluated in suitable animal models before clinical trials. Developing an effective camel MERS-CoV vaccine and implementing appropriate infection control measures may control the continuing epidemic.

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Authors+Show Affiliations

Chan JF
State Key Laboratory of Emerging Infectious Diseases and Research Centre of Infection and Immunology, The University of Hong Kong, Hong Kong Special Administrative Region, China Carol Yu Centre for Infection, Department of Microbiology, The University of Hong Kong, Hong Kong Special Administrative Region, China.
Lau SK
State Key Laboratory of Emerging Infectious Diseases and Research Centre of Infection and Immunology, The University of Hong Kong, Hong Kong Special Administrative Region, China Carol Yu Centre for Infection, Department of Microbiology, The University of Hong Kong, Hong Kong Special Administrative Region, China.
To KK
State Key Laboratory of Emerging Infectious Diseases and Research Centre of Infection and Immunology, The University of Hong Kong, Hong Kong Special Administrative Region, China Carol Yu Centre for Infection, Department of Microbiology, The University of Hong Kong, Hong Kong Special Administrative Region, China.
Cheng VC
Carol Yu Centre for Infection, Department of Microbiology, The University of Hong Kong, Hong Kong Special Administrative Region, China.
Woo PC
State Key Laboratory of Emerging Infectious Diseases and Research Centre of Infection and Immunology, The University of Hong Kong, Hong Kong Special Administrative Region, China Carol Yu Centre for Infection, Department of Microbiology, The University of Hong Kong, Hong Kong Special Administrative Region, China.
Yuen KY
State Key Laboratory of Emerging Infectious Diseases and Research Centre of Infection and Immunology, The University of Hong Kong, Hong Kong Special Administrative Region, China Carol Yu Centre for Infection, Department of Microbiology, The University of Hong Kong, Hong Kong Special Administrative Region, China kyyuen@hku.hk.

MeSH

AnimalsAntiviral AgentsCoronavirus InfectionsDisease Models, AnimalHumansInfection ControlMiddle East Respiratory Syndrome CoronavirusZoonoses

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

25810418

Clinical Trial Links

Primary Prevention of Infection by COVID-19 in Workers
Sequential Oxygen Therapy Strategy for Patients With COVID-19

Citation

Chan, Jasper F W., et al. "Middle East Respiratory Syndrome Coronavirus: Another Zoonotic Betacoronavirus Causing SARS-like Disease." Clinical Microbiology Reviews, vol. 28, no. 2, 2015, pp. 465-522.
Chan JF, Lau SK, To KK, et al. Middle East respiratory syndrome coronavirus: another zoonotic betacoronavirus causing SARS-like disease. Clin Microbiol Rev. 2015;28(2):465-522.
Chan, J. F., Lau, S. K., To, K. K., Cheng, V. C., Woo, P. C., & Yuen, K. Y. (2015). Middle East respiratory syndrome coronavirus: another zoonotic betacoronavirus causing SARS-like disease. Clinical Microbiology Reviews, 28(2), 465-522. https://doi.org/10.1128/CMR.00102-14
Chan JF, et al. Middle East Respiratory Syndrome Coronavirus: Another Zoonotic Betacoronavirus Causing SARS-like Disease. Clin Microbiol Rev. 2015;28(2):465-522. PubMed PMID: 25810418.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Middle East respiratory syndrome coronavirus: another zoonotic betacoronavirus causing SARS-like disease. AU - Chan,Jasper F W, AU - Lau,Susanna K P, AU - To,Kelvin K W, AU - Cheng,Vincent C C, AU - Woo,Patrick C Y, AU - Yuen,Kwok-Yung, PY - 2015/3/27/entrez PY - 2015/3/27/pubmed PY - 2015/4/22/medline SP - 465 EP - 522 JF - Clinical microbiology reviews JO - Clin Microbiol Rev VL - 28 IS - 2 N2 - The source of the severe acute respiratory syndrome (SARS) epidemic was traced to wildlife market civets and ultimately to bats. Subsequent hunting for novel coronaviruses (CoVs) led to the discovery of two additional human and over 40 animal CoVs, including the prototype lineage C betacoronaviruses, Tylonycteris bat CoV HKU4 and Pipistrellus bat CoV HKU5; these are phylogenetically closely related to the Middle East respiratory syndrome (MERS) CoV, which has affected more than 1,000 patients with over 35% fatality since its emergence in 2012. All primary cases of MERS are epidemiologically linked to the Middle East. Some of these patients had contacted camels which shed virus and/or had positive serology. Most secondary cases are related to health care-associated clusters. The disease is especially severe in elderly men with comorbidities. Clinical severity may be related to MERS-CoV's ability to infect a broad range of cells with DPP4 expression, evade the host innate immune response, and induce cytokine dysregulation. Reverse transcription-PCR on respiratory and/or extrapulmonary specimens rapidly establishes diagnosis. Supportive treatment with extracorporeal membrane oxygenation and dialysis is often required in patients with organ failure. Antivirals with potent in vitro activities include neutralizing monoclonal antibodies, antiviral peptides, interferons, mycophenolic acid, and lopinavir. They should be evaluated in suitable animal models before clinical trials. Developing an effective camel MERS-CoV vaccine and implementing appropriate infection control measures may control the continuing epidemic. SN - 1098-6618 UR - https://www.unboundmedicine.com/medline/citation/25810418/Middle_East_respiratory_syndrome_coronavirus:_another_zoonotic_betacoronavirus_causing_SARS_like_disease_ DB - PRIME DP - Unbound Medicine ER -