Middle East respiratory syndrome coronavirus infection medical therapy
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Middle East Respiratory Syndrome Coronavirus Infection Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
Middle East Respiratory Syndrome (MERS) is a viral respiratory illness. It is caused by an emerging coronavirus, specifically a betacoronavirus called MERS-CoV (Middle East Respiratory Syndrome Coronavirus), first discovered in 2012. Being a relatively novel virus, treatment options are very limited, with no antiviral therapy approved for treating patients yet. Outbreaks of MERS-CoV represent a great challenge since there is very limited time to develop and test new pharmaceutical drugs. Up until now, supportive medical care, along with untested convalescent plasma, have been the only treatment options. However, reuse of drugs for other viruses is presenting as an attractive alternative for MERS-CoV.[1]
Medical Therapy
MERS represents a great challenge in terms of treatment because it is caused by a relatively novel virus, to which there is no specific approved therapy yet. According to the International Severe Acute Respiratory & Emerging Infection Consortium (ISARIC), supportive medical care continues to be the approved treatment for MERS. Recent studies are showing the potential use of other drugs and therapies to treat MERS-CoV, however, lack of evidence makes these new therapies uncertain.[1] According to the ISARIC, some approaches, additionally to routine investigations, are more worth of consideration for experimentation. These include:
- Convalescent plasma - this therapy, along with other possessing neutralizing antibodies, has the strongest evidence for intervention.
Convalescent plasma obtained from an individual who has recovered from MERS-CoV contains high levels of neutralising antibody (PHE unpublished data). Though potentially very limited in availability, if it can be accessed the evidence suggests this is likely to be the best therapy to neutralize extracellular virus. Use should be accompanied by an appropriately planned evaluation of effectiveness.
- Intravenous immunoglobulin -
- Interferon -
References
- ↑ 1.0 1.1 Dyall J, Coleman CM, Hart BJ, Venkataraman T, Holbrook MR, Kindrachuk J; et al. (2014). "Repurposing of clinically developed drugs for treatment of Middle East Respiratory Coronavirus Infection". Antimicrob Agents Chemother. doi:10.1128/AAC.03036-14. PMID 24841273.