Middle East Respiratory Syndrome Coronavirus (MERS-CoV)


Epidemiology

Clinical Risk Factors (Ann Intern Med, 2014) [MEDLINE]

  • Cardiovascular Disease
    • Cardiac Surgery: present in 25% of cases
    • Congestive Heart Failure (CHF) (see Congestive Heart Failure, [[Congestive Heart Failure]]): present in 17% of cases
    • Hypertension (see Hypertension, [[Hypertension]]): present in 50% of cases
    • Myocardial Infarction: present in 33% of cases
    • Valvular Disease: present in 8% of cases
  • Diabetes Mellitus (DM) (see Diabetes Mellitus, [[Diabetes Mellitus]]): present in 67% of cases
  • Pulmonary Disease
    • Asthma (see Asthma, [[Asthma]]): present in 8% of cases
  • Renal Disease
    • Chronic Kidney Disease (CKD) (see Chronic Kidney Disease, [[Chronic Kidney Disease]]): present in 42% of cases
  • Vascular Disease
  • Other
    • Melanoma (see Melanoma, [[Melanoma]]): present in 8% of cases
    • Neuromuscular Disease: present in 8% of cases
    • Obesity (see Obesity, [[Obesity]]): present in 25% of cases
    • Renal/Liver Transplant (see Renal Transplant, [[Renal Transplant]] and Liver Transplant, [[Liver Transplant]]): present in 8% of cases

Microbiology

Transmission


Diagnosis

Arterial Blood Gas (ABG) (see Arterial Blood Gas, [[Arterial Blood Gas]])

Chest X-Ray (see Chest X-Ray, [[Chest X-Ray]])

Chest CT (see Chest Computed Tomography, [[Chest Computed Tomography]])

Lower Respiratory Tract Specimen MERS-CoV Real-Time Reverse Transcriptase Polymerase Chain Reaction (rRT-PCR)

  • Samples
    • Bronchoalveolar Lavage (BAL) Fluid (see Bronchoscopy, [[Bronchoscopy]])
    • Endotracheal Aspirate
    • Sputum
  • Recommended as First Line Testing by the CDC

Upper Respiratory Tract Specimen

Acute and Convalescent Paired Serum Samples

Stool Sample

Blood MERS-CoV Polymerase Chain Reaction (PCR)


Clinical Manifestations

General Comments

Cardiovascular Manifestations

Gastrointestinal Manifestations

Neurologic Manifestations

Otolaryngologic Manifestations

Pulmonary Manifestations

Renal Manifestations

Rheumatologic Manifestations

Other Manifestations


Treatment

Supportive Care

Ribavirin and Interferon-Beta (see Ribavirin, [[Ribavirin]] and xxxx, [[xxxx]])

Inhaled Nitric Oxide (iNO) (see Nitric Oxide, [[Nitric Oxide]])


References