Materiały źródłowe

• #1 Centre for Health Protection – Middle East Respiratory Syndrome

  https://www.chp.gov.hk/en/healthtopics/content/24/26528.html

  There is currently no specific treatment for the disease. Treatment is supportive. […] Approximately 35% of reported MERS patients died.

• #2 Middle East Respiratory Syndrome | EBSCO Research Starters

  https://www.ebsco.com/research-starters/health-and-medicine/middle-east-respiratory-syndrome

  MERS has a notably high mortality rate, with approximately 36% of infected individuals succumbing to the disease, particularly among older adults and those with preexisting health conditions. […] Treatment primarily focuses on supportive care, including hydration and oxygen support. […] Treatment for MERS includes fluids, rest, pain relievers, and supplemental oxygen.

• #3 Treatment strategies for Middle East respiratory syndrome coronavirus

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4745090/

  Middle East respiratory syndrome coronavirus (MERS-CoV), an emerging infectious disease of growing global importance, has caused severe acute respiratory disease in more than 1600 people, resulting in almost 600 deaths. The high case fatality rate, growing geographic distribution and vaguely defined epidemiology of this novel pathogen have created an urgent need for effective public health countermeasures, including safe and effective treatment strategies. […] Despite past efforts to develop coronavirus countermeasures, there are still no licensed therapies of proven efficacy for MERS-CoV or any other coronavirus infection. Supportive measures remain the mainstay of MERS-CoV treatment strategies and include respiratory and circulatory support, preservation of renal, hepatic and neurological function, and prevention of secondary infections.

• #4 About Middle East Respiratory Syndrome (MERS) | MERS | CDC

  https://www.cdc.gov/mers/about/index.html

  No specific antiviral treatment is recommended for MERS. People with MERS often receive supportive medical care and care to help relieve symptoms.

• #5 Content – Health Encyclopedia – University of Rochester Medical Center

  https://www.urmc.rochester.edu/encyclopedia/content?contenttypeid=134&contentid=252

  Currently there is no cure for MERS. In some severe cases, the healthcare provider may use experimental therapies such as convalescent plasma. This is an antibody treatment from the blood of people who have recovered from the illness. Or the provider may use monoclonal antibodies as a treatment. More usual is treatment to help support your body while it fights the disease. This is known as supportive care. Supportive care may include: […] Treatment is mostly aimed at helping support your body while it fights the disease. This includes bed rest, pain medicines, oxygen, and IV fluids.

• #6 Middle Eastern Respiratory Syndrome (MERS) | American Lung Association

  https://www.lung.org/lung-health-diseases/lung-disease-lookup/middle-eastern-respiratory-syndrome-mers

  There is no approved treatment specifically for MERS. Most patients with mild disease recover without complications. Patients with the milder form can be treated at home and take medication for symptoms such as fever and pain. They should stay isolated to avoid spreading the disease. […] In more severe cases, the patient may develop lung or respiratory failure which requires them to be hospitalized. Doctors may suggest using a breathing tube, a mechanical ventilator or respirator, antibiotics and intravenous fluids. […] There is no current vaccine to protect people against MERS. Updates about potential vaccinations and treatment for MERS can be found on the CDC website and World Health Organization website.

• #7 Middle East Respiratory Syndrome (MERS): Causes, Symptoms, Treatment

  https://www.webmd.com/lung/mers-causes-symptoms-treatment

  How Is MERS Treated? […] There arent any approved treatments for MERS. Theres also no vaccine for it. Your doctor will instead treat and manage your symptoms. […] If your symptoms arent intense, you can stay at home and use medications to feel better. Theyll help treat your pain and fever. […] But if you have a more severe MERS case, you might need to go to the hospital. During your time at the hospital, you may need IV (intravenous) fluids, mechanical ventilation, or supplemental (extra) oxygen.

• #8 Middle East Respiratory Syndrome: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/22633-middle-east-respiratory-syndrome-mers

  Currently, there is no approved treatment for MERS. Your medical care will focus on managing your symptoms while your body fights the infection. […] More severe cases may require hospital care, including: IV (intravenous) fluids, Supplemental oxygen, Mechanical ventilation.

• #9 Middle East respiratory syndrome (MERS)

  https://www.nhs.uk/conditions/middle-east-respiratory-syndrome-mers/

  Middle East respiratory syndrome (MERS) can be life-threatening and you will usually be treated in isolation in hospital if you have it. […] Treatment involves managing your symptoms, such as: […] medicine to help lower your temperature or ease any pain […] help with breathing.

• #10 Middle East Respiratory Syndrome (MERS) – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/topic/default?id=middle-east-respiratory-syndrome-mers-134-252

  Currently no medicine is available to cure MERS. Treatment for MERS is done to help support your body while it fights the disease. This is known as supportive care. Supportive care may include: […] Care during severe illness may include: […] IV fluids. These are given through a vein to help keep your body hydrated. […] Oxygen. Supplemental oxygen or assisted ventilation may be given. This is done to keep enough oxygen in your body. […] Vasopressor medicine. These help to raise blood pressure that is too low from shock.

• #11 MERS – Wikipedia

  https://en.wikipedia.org/wiki/MERS

  There is no specific vaccine or treatment for the disease. […] Using extra-corporeal membrane oxygenation (ECMO) seems to improve outcomes significantly. […] Neither the combination of antivirals and interferons (ribavirin + interferon alfa-2a or interferon alfa-2b) nor corticosteroids improved outcomes.

• #12 MERS – Epidemiology

  https://www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/middle-east-respiratory-syndrome-mers/

  Currently, there is no specific antiviral treatment for MERS. Treatment consists of supportive care and relief of symptoms. Patients with severe respiratory disease may require mechanical ventilation or even extracorporeal membrane oxygenation (ECMO). […] The current mortality rate from MERS is about 30-40%.

• #13 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Middle-East-Respiratory-Syndrome-Coronavirus-(MERS-CoV)-Treatment-and-Prevention.aspx

  The four primary approaches by which MERS-CoV can be treated include the repurposing of existing clinically approved drugs, convalescent plasma (CP) and whole blood therapy, intravenous administration of immunoglobulin (IgG) and monoclonal antibodies (mAbs). […] Several different drugs have been evaluated for their antiviral activity against MERS-CoV, including: Ribvarin, Hexachloropene, Nitazoxanide, Homoharringtonine, Ayoclovir, Chloropromazine hydrochloride, Trifluopromazine hydrochloride, Imatinib mesylate, Dasatinib, Chloroquine, Loperamide, Lopinavir. […] CP therapy involves the use of whole blood or plasma that has been collected from patients who have recently recovered from the viral disease of interest. During the MERS-CoV epidemic, the administration of CP and other neutralizing antibodies were particularly useful, as no specific vaccine or drugs were available for treating this disease.

• #14 Investigating treatment strategies for the Middle East respiratory syndrome coronavirus – The Pharmaceutical Journal

  https://pharmaceutical-journal.com/article/feature/investigating-treatment-strategies-for-the-middle-east-respiratory-syndrome-coronavirus

  Researchers are investigating a number of ways to combat the outbreak of Middle East respiratory syndrome coronavirus, including using existing drugs. […] With millions of Muslims visiting Saudi Arabia for the Hajj pilgrimage each October, the fear is that the virus — which has no effective vaccine or treatment — could rapidly spread beyond the region, costing countless human lives. Researchers are investigating a variety of methods to combat the virus, from using combinations of approved drugs to experimental vaccine strategies. […] The guidance divides potential therapies for MERS-CoV into green, yellow, and red groups. Green indicates that the benefit is likely to exceed the risks, yellow indicates that the data are inadequate for assessment and red indicates the risk is likely to exceed the benefit. Among the green treatments are convalescent plasma, interferons, lopinavir, and polyclonal and monoclonal antibodies.

• #14 Investigating treatment strategies for the Middle East respiratory syndrome coronavirus – The Pharmaceutical Journal

  https://pharmaceutical-journal.com/article/feature/investigating-treatment-strategies-for-the-middle-east-respiratory-syndrome-coronavirus

  PHE notes that “interferon and lopinavir are likely to be the most accessible initial treatments”. However, it advises that treatment with specific drugs should ideally occur in the context of formal observational studies or controlled intervention trials. […] There appears to be little consensus on the risk posed by MERS-CoV. […] Molecular biologist Eric Snijder and his colleagues at Leiden University in the Netherlands are one of several research teams experimenting with existing medicines to see if they can identify effective treatments. […] Snijder’s team has identified four agents — chloroquine, chlorpromazine, loperamide, and lopinavir — out of 348 Food and Drug Administration-approved compounds. […] Human data on experimental drugs or off-label use of licensed drugs is either sparse or emerging.

• #15 Treatment strategies for Middle East respiratory syndrome coronavirus

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4745090/

  Rapidly scaled treatments based on naturally occurring neutralising antibodies such as convalescent plasma or hyperimmune globulin, on the other hand, have been shown to be relatively safe and potentially effective for reducing mortality from several infections such as SARS-CoV and influenza, and may hold promise for MERS-CoV as well. […] Although intensive, supportive care still serves as the primary treatment option for MERS-CoV and mAbs are the focus of the most advanced RD efforts, antiviral therapies are being actively investigated for use in severely ill patients. […] Mycophenolic acid, an inhibitor of both T and B lymphocytes, has also been found to have strong activity against MERS-CoV, as it does against other RNA viruses such as West Nile, hepatitis C and dengue. […] Treatment with interferon-alpha2b and ribavirin improves outcome in MERS-CoV-infected rhesus macaques.

• #16 Two common drugs may help treat deadly Middle East Respiratory Syndrome | UW News

  https://www.washington.edu/news/2013/09/10/two-common-drugs-may-help-treat-deadly-middle-east-respiratory-syndrome/

  Treatment with two common drugs reduced viral replication and lung damage when given to monkeys infected with the virus that causes Middle East Respiratory Syndrome. […] Currently, there is no proven effective treatment. […] The new findings show that a combination of interferon-alpha 2b and ribavirin, drugs routinely used to treat hepatitis C, may be an effective treatment for MERS-CoV infection, said Dr. Angela L. Rasmussen, a research scientist in the Department of Microbiology at the University of Washington in Seattle and co-author of the study. […] Because these two drugs are readily available, they could be used immediately to treat patients infected with MERS-CoV, Rasmussen said. […] Instead of directly targeting the virus like most conventional antivirals, these drugs work primarily by moderating the body’s immune response to the virus and by promoting repair of damaged lung tissue, said Rasmussen.

• #17 Two common drugs may help treat deadly Middle East Respiratory Syndrome | UW News

  https://www.washington.edu/news/2013/09/10/two-common-drugs-may-help-treat-deadly-middle-east-respiratory-syndrome/

  The findings of this new study suggest that, in the case of MERS-CoV infections, interferon-alpha 3b and ribavirin may work primarily by reducing damaging inflammation of the lung and promoting healing by altering the host response, rather than directly targeting the virus. […] If that is indeed true, other drugs that can similarly modulate the body’s reaction to viral infections may also prove to be effective against MERS-CoV and other infectious agents, she said.

• #18

  https://link.springer.com/article/10.1208/s12249-021-02062-2

  Khalid M, Al Rabiah F, Khan B, Al Mobeireek A, Butt TS, Al Mutairy E. Ribavirin and interferon-alpha2b as primary and preventive treatment for Middle East respiratory syndrome coronavirus: a preliminary report of two cases. Antivir Ther. 2015;20(1):8791. […] Al-Tawfiq JA, Momattin H, Dib J, Memish ZA. Ribavirin and interferon therapy in patients infected with the Middle East respiratory syndrome coronavirus: an observational study. Int J Infect Dis. 2014;20:426. […] Kim UJ, Won EJ, Kee SJ, Jung SI, Jang HC. Combination therapy with lopinavir/ritonavir, ribavirin and interferon-alpha for Middle East respiratory syndrome. Antivir Ther. 2016;21(5):4559. […] Shalhoub S, Farahat F, Al-Jiffri A, Simhairi R, Shamma O, Siddiqi N, et al. IFN-alpha2a or IFN-beta1a in combination with ribavirin to treat Middle East respiratory syndrome coronavirus pneumonia: a retrospective study. J Antimicrob Chemother. 2015;70(7):212932.

• #19 Treatment of Middle East Respiratory Syndrome with a combination of lopinavir-ritonavir and interferon-β1b (MIRACLE trial): study protocol for a randomized controlled trial | Trials | Full Text

  https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-017-2427-0

  Based on in vitro data, the combination of lopinavir and ritonavir has been considered as a candidate therapy for MERS. Lopinavir and ritonavir are antiretroviral protease inhibitors used in combination for the treatment of human immunodeficiency virus (HIV) infection and have limited side effects. The combination of lopinavir/ritonavir (Kaletra, Abbott Laboratories, Chicago, IL, USA) has also been used for the treatment of SARS. In one study, the combination of lopinavir/ritonavir used in 41 patients with SARS was associated with significantly fewer adverse clinical outcomes (acute respiratory distress syndrome or death) 21 days after the onset of symptoms compare to ribavirin alone used in 111 historical controls (2.4% versus 28.8%, p=0.001). However, the historical nature of the control comparison does not allow for a valid estimate of efficacy. In a high-throughput screening for antiviral compounds, lopinavir inhibited the replication of MERS-CoV at levels below those that occur in the circulation after a single oral dose of lopinavir/ritonavir (400 mg lopinavir with 100 mg ritonavir), suggesting that the drug can achieve therapeutic levels in vivo.

• #20 Treatment of Middle East Respiratory Syndrome with a combination of lopinavir-ritonavir and interferon-β1b (MIRACLE trial): study protocol for a randomized controlled trial | Trials | Full Text

  https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-017-2427-0

  The objective of the MIRACLE trial (the MERS-CoV Infection treated with A Combination of Lopinavir/ritonavir and interferon-1b) is to assess the efficacy of administering a combination of lopinavir/ritonavir and recombinant IFN-1b to hospitalized adults with laboratory-confirmed MERS. The study is designed as recursive, two-stage, group sequential, multicenter, randomized, placebo-controlled, double-blind trial. […] These findings, together with the availability and safety profiles of lopinavir/ritonavir and IFN-1b, suggest that the combination of these agents has potential efficacy for the treatment of patients with MERS.

• #21 Treatment outcomes for patients with Middle Eastern Respiratory Syndrome Coronavirus (MERS CoV) infection at a coronavirus referral center in the Kingdom of Saudi Arabia | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-016-1492-4

  Our data, albeit from a retrospective cohort support the findings that interferon beta is associated with a decrease in mortality. […] All of the eight patients who received mycophenolate mofetil in our study survived. Hence, it may be reasonable to further study this agent in controlled trials. […] This observational study investigates novel treatment options like beta interferon and mycophenolate mofetil for MERS-CoV in humans which have in vitro activity.

• #22 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Middle-East-Respiratory-Syndrome-Coronavirus-(MERS-CoV)-Treatment-and-Prevention.aspx

  Despite the utility of this treatment approach, the lack of eligible donors who were both previously infected with MERS-CoV and had sufficient levels of antibodies were scarce. Furthermore, there is a lack of evidence that definitively proves the efficacy and safety of CP and whole blood therapy in the treatment of MERS-CoV. […] To date, there is no evidence that supports the anti-MERS activity of IVIG. Furthermore, the chance that an IVIG treatment can cause renal failure or thrombosis in MERS patients is high, thereby limiting its clinical use. […] Both mAbs and polyclonal antibodies have been evaluated for their antiviral activity against MERS-CoV. In fact, severe MERS-CoV infection can be treated with the LCA60 antibody, which was originally derived from the B cells obtained from a human donor who was recovering from MERS.

• #23 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Middle-East-Respiratory-Syndrome-Coronavirus-(MERS-CoV)-Treatment-and-Prevention.aspx

  Preclinical studies have found that both mAbs and polyclonal antibodies that have been specifically targeted against the cellular receptor dipeptidyl peptidase 4 (DPP4) successfully inhibit MERS-CoV in vitro. Comparatively, two mAbs known as MERS-4 and MERS-27 have shown strong neutralizing activity against MERS-CoV as a result of their inhibitory action in the receptor-binding domain of the MERS-CoV S protein. Another study found that two novel antibodies known as REGN3051 and REGN3048 are effective in treating MERS-CoV in animal models.

• #24 MERS Middle East Respiratory Syndrome Archives | Respiratory Therapy

  https://respiratory-therapy.com/tag/mers-middle-east-respiratory-syndrome/

  Monoclonal Antibodies Effective against MERS Coronavirus in First Human Trial: The first Phase 1 clinical trial of two monoclonal antibodies to treat Middle East respiratory syndrome coronavirus (MERS-CoV) found that they were well tolerated and generally safe when administered simultaneously to healthy adults. […] Experimental MERS Treatments Begin Clinical Trial: Researchers will begin a Phase 2 study of two human monoclonal antibodies (mAbs) designed to treat people infected with Middle East respiratory syndrome coronavirus (MERS-CoV). […] A Cure for MERS (in Mice): Regeneron Pharmaceuticals has figured out how to give mice the virus that causes MERS, and also how to prevent the disease and effectively treat the infected mice. […] University Of Maryland Researchers ID Drugs To Fight MERS Outbreaks: A team led by a University of Maryland School of Medicine (UMSOM) researcher has identified a number of existing drugs that could be repurposed to fight outbreaks of Middle East respiratory syndrome coronavirus (MERS-CoV) and SARS.

• #25 Investigating treatment strategies for the Middle East respiratory syndrome coronavirus – The Pharmaceutical Journal

  https://pharmaceutical-journal.com/article/feature/investigating-treatment-strategies-for-the-middle-east-respiratory-syndrome-coronavirus

  Chan is currently collaborating with the University of Michigan on an experimental antiviral called BanLec, which has shown in vitro efficacy against MERS-CoV. Chan’s group has also developed an antiviral peptide, HR2P, with a six-helix bundle fusion core structure of the corona virus’s spike protein, which has shown a potent inhibitory effect against MERS-CoV. […] Developing a camel vaccine is an attractive strategy, not only because it avoids the immense financial cost of developing a human vaccine, but because regulatory hurdles that apply to investigatory veterinary medicine are vastly decreased in the countries with index cases.

• #26 Post-Travel Evaluation to Rule Out Viral Special Pathogen Infection | Yellow Book | CDC

  https://wwwnc.cdc.gov/travel/yellowbook/2020/travel-related-infectious-diseases/middle-east-respiratory-syndrome-mers

  The patient’s clinical features and epidemiologic risk factors should be used to guide empiric treatment. Broad spectrum antimicrobial therapy is reasonable for an ill patient, ideally with prior collection of biospecimens for culture even if laboratory capacity has not yet been determined. If testing for malaria is delayed, empiric antimalarial therapy may be appropriate, as is initiation of doxycycline if a rickettsial disease is suspected. Antivirals used for influenza and COVID-19 are also available and have good safety profiles. […] Middle East respiratory syndrome coronavirus (MERS-CoV) Airborne isolation room […] For patients with suspected or confirmed infection, regardless of clinical stability, healthcare workers should, at a minimum, wear: Gloves, Gown, N95 or higher respiratory protection, Eye protection (goggles, face shield).

• #27 Middle East Respiratory Syndrome Coronavirus (MERS-CoV) – ISID

  https://isid.org/guide/pathogens/mers-cov/

  To date there are no effective vaccine or therapeutic agents approved for MERS-CoV and treatment is purely supportive. […] Randomized controlled trials on specific therapeutic agents, monoclonal antibodies, immunotherapy with convalescent patient plasma and MERS-CoV-specific antibodies are needed to find an effective therapy. […] The strict application of contact and airborne isolation in HCFs catering for patients suspected to have MERS-CoV is essential to ensure early detection and proper isolation of patients suspected to have MERS-CoV. […] Supplemental oxygen for hypoxemia. […] Antibacterial agents for community-acquired pneumonia. […] Consider a neuraminidase inhibitor for treatment of influenza, if available. […] Continuing high caliber, multicenter, collaborative, randomized, controlled research will generate solid evidence to help resolve our knowledge gaps about the disease and its pathogenesis to ensure rapid development of effective therapeutics and preventive strategies.

• #28 Coronaviruses and Acute Respiratory Syndromes (MERS and SARS) – Infections – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/infections/respiratory-viruses/coronaviruses-and-acute-respiratory-syndromes-mers-and-sars

  Middle East respiratory syndrome is a coronavirus infection that causes severe flu-like symptoms. […] There is no specific treatment for MERS. Acetaminophen or a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen is given to relieve fever and muscle aches. […] Precautions are taken to prevent the spread of the virus. For example, the person is isolated in a room with a ventilation system that limits the spread of microorganisms in the air. People who go into the room must wear a special mask, eye protection, and a gown, cap, and gloves. Doors to the room should be kept closed except when people enter or leave the room, and people should enter and leave as few times as possible.

• #29

  https://www.who.int/health-topics/middle-east-respiratory-syndrome-coronavirus-mers

  No vaccine or specific treatment is currently available, although several MERS-CoV specific vaccines and treatments are in development. Treatment is supportive and based on the patients clinical condition. […] The consumption of raw or undercooked animal products, including milk and meat, carries a high risk of infection that can cause disease in humans. Animal products that are processed appropriately through cooking or pasteurization are safe for consumption but should also be handled with care to avoid cross contamination with uncooked foods. […] Infection prevention and control during health care for probable or confirmed cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection. […] Clinical management of severe acute respiratory infection when Middle East respiratory syndrome coronavirus (MERS-CoV) infection is suspected: interim guidance. […] Home care for patients with Middle East respiratory syndrome coronavirus (MERS-CoV) infection presenting with mild symptoms and management of contacts. […] Management of asymptomatic persons who are RT-PCR positive for Middle East respiratory syndrome coronavirus (MERS-CoV).

• #30 Pharmacologic Treatments and Supportive Care for Middle East Respiratory Syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7258456/

  Available animal and cell line models have suggested that specific therapeutics might be effective in treating Middle East respiratory syndrome (MERS). […] One study, at moderate RoB, showed reduced mortality rates in severe MERS patients with extracorporeal membrane oxygenation; no other studies showed a significant lifesaving benefit to any treatment. […] No evidence-based recommended pharmacologic therapy for the treatment of MERS-CoV infection exists; however, limited data from available animal and cell line models have led to multiple different combinations of antiviral drugs and other adjunctive therapies to be proposed and used in humans. […] Low-quality evidence suggests no benefit from corticosteroids or combination of ribavirin with any type of IFN but also very low evidence of harm. Low-quality evidence from a single study suggests no benefit from macrolide therapy. Low-quality evidence indicated a benefit from ECMO for severe MERS cases from a single study. Low-quality evidence suggests no benefit from NIV. All other treatments assessed had very low-quality of evidence.

• #31 Pharmacologic Treatments and Supportive Care for Middle East Respiratory Syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7258456/

  On the basis of this review, no specific pharmacologic therapies have sufficient evidence of effectiveness to warrant a treatment recommendation, although ECMO might be considered for severe MERS. […] Collaborative clinical trials evaluating potential therapies are urgently needed to guide treatment decisions.

• #32 WHO EMRO | Middle East respiratory syndrome (MERS) | MERS-CoV | Health topics

  https://www.emro.who.int/health-topics/mers-cov/mers-cov.html

  Preventing MERS relies on avoiding unpasteurized or uncooked animal products, practicing safe hygiene habits in health care settings and around dromedaries, community education and awareness training for health workers, as well as implementing effective control measures. […] There is no specific antiviral treatment recommended for MERS-CoV infection and no vaccine currently available.

• #33 Middle East respiratory syndrome coronavirus: Treatment and prevention – UpToDate

  https://www.uptodate.com/contents/middle-east-respiratory-syndrome-coronavirus-treatment-and-prevention

  Middle East respiratory syndrome coronavirus: Treatment and prevention […] The treatment and prevention of MERS-CoV are discussed here. […] The World Health Organization (WHO) has issued recommendations for the management of severe respiratory infections suspected to be caused by MERS-CoV. No antiviral agents are specifically recommended for the treatment of MERS-CoV infection.

• #34 Update on therapeutic options for Middle East Respiratory Syndrome Coronavirus (MERS-CoV)

  https://scholarworks.indianapolis.iu.edu/items/3039fa49-1c61-4cb5-a3de-97bec0b9e9e0

  INTRODUCTION: The Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is an important emerging respiratory pathogen. MERS-CoV resulted in multiple hospital outbreaks within and outside the Arabian Peninsula. The disease has a high case fatality rate, with the need for a therapeutic option. […] In this review, we provide an overview of the progress in the development of therapeutic strategies for MERS. […] There are multiple agents tried in vitro and in vivo. None of these agents were used in large clinical studies. Available clinical studies are limited to the use of the combination of interferon and other agents. These clinical studies are based solely on case reports and case series. There are no prospective or randomized trials. There is a need to have prospective and randomized clinical trials for the therapy of MERS-CoV. However, this strategy might be hampered by the sporadic cases outside the large hospital outbreaks.

• #35 Factsheet about Middle East respiratory syndrome coronavirus (MERS-CoV)

  https://www.ecdc.europa.eu/en/middle-east-respiratory-syndrome-coronavirus/factsheet

  The most recent WHO case definitions for MERS-CoV and surveillance guidance can be found on the WHO Global Alert and Response webpage for coronavirus. […] High-quality supportive care should be provided to all patients diagnosed with MERS-CoV, tailored to their individual conditions. A decision support tool for treatment of MERS was published by ISARIC (International Severe Acute Respiratory and Emerging Infection Consortium) on 29 July 2013 and updated with Public Health England in July 2014. This reviews the available evidence on treatment of MERS patients and is largely based on the experience of treating SARS. […] Several treatment options, where benefits are likely to exceed risks, are identified in the most recently updated guidance. In particular ISARIC considers that convalescent plasma, interferons, lopinavir and mono- or polyclonal antibodies would all likely have a beneficial risk-benefit profile. However, all of these options remain investigational and should only be used in settings of formal observational studies or controlled intervention trials. ISARIC has published standardised protocols to aid such studies.

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