Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jul-Aug:30:9-18.
doi: 10.1016/j.tmaid.2019.06.012. Epub 2019 Jun 25.

A Systematic Review of therapeutic agents for the treatment of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV)

Hisham Momattin  1 , Anfal Y Al-Ali  2 , Jaffar A Al-Tawfiq  3
Affiliations

A Systematic Review of therapeutic agents for the treatment of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV)

Hisham Momattin et al. Travel Med Infect Dis. 2019 Jul-Aug.

Abstract

Background: The Middle East Respiratory Syndrome Coronavirus (MERS-CoV) was first described in 2012 and attracted a great international attention due to multiple healthcare associated outbreaks. The disease carries a high case fatality rate of 34.5%, and there is no internationally or nationally recommended therapy.

Method: We searched MEDLINE, Science Direct, Embase and Scopus databases for relevant papers published till March 2019 describing in vitro, in vivo or human therapy of MERS.

Results: Initial search identified 62 articles: 52 articles were from Medline, 6 from Embase, and 4 from Science Direct. Based on the inclusions and exclusions criteria, 30 articles were included in the final review and comprised: 22 in vitro studies, 8 studies utilizing animal models, 13 studies in humans, and one study included both in vitro and animal model. There are a few promising therapeutic agents on the horizon. The combination of lopinavir/ritonavir and interferon-beta- 1b showed excellent results in common marmosets and currently is in a randomized control trial. Ribavirin and interferon were the most widely used combination and experience comes from a number of observational studies. Although, the data are heterogenous, this combination might be of potential benefit and deserve further investigation. There were no randomized clinical trials to recommend specific therapy for the treatment of MERS-CoV infection. Only one such study is planned for randomization and is pending completion. The study is based on a combination of lopinavir/ritonavir and interferon-beta- 1b. A fully human polyclonal IgG antibody (SAB-301) was safe and well tolerated in healthy individuals and this agent may deserve further testing for efficacy.

Conclusion: Despite multiple studies in humans there is no consensus on the optimal therapy for MERS-CoV. Randomized clinical trials are needed and potential therapies should be evaluated only in such clinical trials. In order to further enhance the therapeutic aroma for MERS-CoV infection, repurposing old drugs against MERS-CoV is an interesting strategy and deserves further consideration and use in clinical settings.

Keywords: MERS; Middle east respiratory syndrome coronavirus; Therapy.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
A flow diagram of the search strategy according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines [27].
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Middle W.H.O. East respiratory syndrome coronavirus (MERS-CoV) - update: 2 DECEMBER 2013 2013. http://www.who.int/csr/don/2013_12_02/en/ - PMC - PubMed
    1. Al-Tawfiq J.A., Auwaerter P.G. Healthcare-associated infections: the hallmark of the Middle East respiratory syndrome coronavirus (MERS-CoV) with review of the literature. J Hosp Infect. 2018 doi: 10.1016/j.jhin.2018.05.021. - DOI - PMC - PubMed
    1. Al-Tawfiq J.A., Memish Z.A. Drivers of MERS-CoV transmission: what do we know? Expert Rev Respir Med. 2016;10:331–338. doi: 10.1586/17476348.2016.1150784. - DOI - PMC - PubMed
    1. Omrani A.S., Matin M.A., Haddad Q., Al-Nakhli D., Memish Z.A., Albarrak A.M. A family cluster of middle east respiratory syndrome coronavirus infections related to a likely unrecognized asymptomatic or mild case. Int J Infect Dis. 2013;17:e668–e672. doi: 10.1016/j.ijid.2013.07.001. - DOI - PMC - PubMed
    1. Memish Z.A., Zumla A.I., Al-Hakeem R.F., Al-Rabeeah A a, Stephens G.M. Family cluster of Middle East respiratory syndrome coronavirus infections. N Engl J Med. 2013;368:2487–2494. doi: 10.1056/NEJMoa1303729. - DOI - PubMed

Publication types

MeSH terms