Middle East respiratory syndrome coronavirus (MERS-CoV) shedding and antibody responses are not fully understood, particularly in relation to underlying medical conditions, clinical manifestations, and mortality. We enrolled MERS-CoV–positive patients at a hospital in Saudi Arabia and periodically collected specimens from multiple sites for real-time reverse transcription PCR and serologic testing. We conducted interviews and chart abstractions to collect clinical, epidemiologic, and laboratory information. We found that diabetes mellitus among survivors was associated with prolonged MERS-CoV RNA detection in the respiratory tract. Among case-patients who died, development of robust neutralizing serum antibody responses during the second and third week of illness was not sufficient for patient recovery or virus clearance. Fever and cough among mildly ill patients typically aligned with RNA detection in the upper respiratory tract; RNA levels peaked during the first week of illness. These findings should be considered in the development of infection control policies, vaccines, and antibody therapeutics.
【저자키워드】 viruses, respiratory infections, Mortality, Antibody Response, Diabetes Mellitus, MERS, MERS-CoV, asymptomatic infections, Coronavirus infections, Kinetics, Viral load, Middle East respiratory syndrome, 【초록키워드】 infection control, Vaccines, hospital, cough, Saudi Arabia, Laboratory, RNA, Antibody therapeutics, clinical manifestations, Patient, Neutralizing, respiratory tract, information, reverse transcription PCR, serologic testing, Medical conditions, Middle East, virus clearance, specimen, respiratory syndrome coronavirus, survivor, robust, upper respiratory, enrolled, collected, died, peaked, conducted, serum antibody response, aligned, ill patient, MERS-CoV RNA, 【제목키워드】 Dynamics, Saudi Arabia, response, respiratory, Middle East,