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IFN-α2a or IFN-β1a in combination with ribavirin to treat Middle East respiratory syndrome coronavirus pneumonia: a retrospective study.
J Antimicrob Chemother 2015; 70(7):2129-32JA

Abstract

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.

Authors+Show Affiliations

Infectious Diseases Division, Department of Medicine, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia sarah.shalhoub@googlemail.com.King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), King Abdullah International Medical Research Center (KAIMRC), Infection Prevention and Control, King Abdulaziz Medical City, Saudi Arabia.Infection Prevention and Control, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia.Microbiology Laboratory, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia.Department of Critical Care, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia.Department of Nephrology, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia.Infectious Diseases Division, Department of Medicine, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25900158

Citation

Shalhoub, Sarah, et al. "IFN-α2a or IFN-β1a in Combination With Ribavirin to Treat Middle East Respiratory Syndrome Coronavirus Pneumonia: a Retrospective Study." The Journal of Antimicrobial Chemotherapy, vol. 70, no. 7, 2015, pp. 2129-32.
Shalhoub S, Farahat F, Al-Jiffri A, et al. IFN-α2a or IFN-β1a in combination with ribavirin to treat Middle East respiratory syndrome coronavirus pneumonia: a retrospective study. J Antimicrob Chemother. 2015;70(7):2129-32.
Shalhoub, S., Farahat, F., Al-Jiffri, A., Simhairi, R., Shamma, O., Siddiqi, N., & Mushtaq, A. (2015). IFN-α2a or IFN-β1a in combination with ribavirin to treat Middle East respiratory syndrome coronavirus pneumonia: a retrospective study. The Journal of Antimicrobial Chemotherapy, 70(7), pp. 2129-32. doi:10.1093/jac/dkv085.
Shalhoub S, et al. IFN-α2a or IFN-β1a in Combination With Ribavirin to Treat Middle East Respiratory Syndrome Coronavirus Pneumonia: a Retrospective Study. J Antimicrob Chemother. 2015;70(7):2129-32. PubMed PMID: 25900158.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - IFN-α2a or IFN-β1a in combination with ribavirin to treat Middle East respiratory syndrome coronavirus pneumonia: a retrospective study. AU - Shalhoub,Sarah, AU - Farahat,Fayssal, AU - Al-Jiffri,Abdullah, AU - Simhairi,Raed, AU - Shamma,Omar, AU - Siddiqi,Nauman, AU - Mushtaq,Adnan, Y1 - 2015/04/21/ PY - 2014/12/29/received PY - 2015/03/14/accepted PY - 2015/4/23/entrez PY - 2015/4/23/pubmed PY - 2016/3/12/medline KW - MERS-CoV KW - interferon KW - treatment SP - 2129 EP - 32 JF - The Journal of antimicrobial chemotherapy JO - J. Antimicrob. Chemother. VL - 70 IS - 7 N2 - 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. SN - 1460-2091 UR - https://www.unboundmedicine.com/medline/citation/25900158/full_citation L2 - https://academic.oup.com/jac/article-lookup/doi/10.1093/jac/dkv085 DB - PRIME DP - Unbound Medicine ER -