IFN-?2a or IFN-?1a in combination with ribavirin to treat Middle East respiratory syndrome coronavirus pneumonia: a retrospective study.

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-?2a and IFN-?1a 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-?2a was 85% (11/13) compared with 64% (7/11) in those who received IFN-?1a (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-?2a or IFN-?1a with ribavirin in treating MERS-CoV. Absence of fever should not exclude MERS-CoV.

SUBMITTER: Shalhoub S 

PROVIDER: S-EPMC7202429 | biostudies-literature | 2015 Jul

REPOSITORIES: biostudies-literature