Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Middle East Respiratory Syndrome Coronavirus (MERS-CoV) coinfection: A unique case series

Travel Med Infect Dis. 2021 May-Jun:41:102026. doi: 10.1016/j.tmaid.2021.102026. Epub 2021 Mar 13.

Abstract

Introduction: The emergence of the Severe Acute Respiratory Syndrome Coroanvirus 2 (SARS-CoV-2) had raised possibilities of coinfection with the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in countries were these two viruses were reported. In this study, we describe the clinical presentation and demographics of eight patients who were coinfected with SARS-CoV-2 and MERS-CoV.

Materials and methods: This is a case series of hospitalized patients admitted to intensive care units (ICUs). We collected demographics, underlying conditions, presenting symptoms and clinical outcome from the patients' medical records.

Results: During the study period from March 14, 2020 to October 19, 2020, there was a total of 67 SARS-CoV-2 ICU admitted patients who underwent simultaneous SARS-CoV-2 and MERS-CoV testing by PCR. Of those patients, 8 (12%) tested positive for both SARS-CoV-2 and MERS-CoV. There were 6 (75%) males, the mean age ± SD was 44.4 ± 11.8 years, and 7 (87.5%) were obese. Of the patients, 7 (87.5%) were non-smokers, 1 (12.5%) had diabetes mellitus, 1 (12.5%) had heart failure, and 1 (12.5%) had been on anti-platelet therapy. The mean hospital length of stay (LOS) was 21.1 ± 11.6 days and the average ICU LOS was 10.9 ± 6.03 days. All patients received supportive therapy and all were treated with corticosteroid. Of all the patients, 4 (50%) were discharged home and 3 (37.5%) died.

Conclusion: This case series is an important addition to the medical knowledge as it showed the interaction of the coinfection of SARS-CoV-2 and MERS-CoV.

Keywords: COVID-19; Coinfection; MERS-CoV; Middle East Respiratory Syndrome Coronavirus; SARS-CoV-2.

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Aged
  • COVID-19 / epidemiology*
  • COVID-19 / mortality
  • COVID-19 / virology
  • COVID-19 Drug Treatment
  • Coinfection / drug therapy
  • Coinfection / epidemiology*
  • Coinfection / mortality
  • Coinfection / virology*
  • Coronavirus Infections / drug therapy
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / mortality
  • Coronavirus Infections / virology
  • Diabetes Mellitus / epidemiology
  • Female
  • Heart Failure / epidemiology
  • Humans
  • Intensive Care Units
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Middle East Respiratory Syndrome Coronavirus / isolation & purification*
  • Obesity / epidemiology
  • SARS-CoV-2 / isolation & purification

Substances

  • Adrenal Cortex Hormones