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Volume 25, Number 4—April 2019
Research

Middle East Respiratory Syndrome Coronavirus Infection Dynamics and Antibody Responses among Clinically Diverse Patients, Saudi Arabia

Hail M. Al-Abdely1, Claire M. Midgley1Comments to Author , Abdulrahim M. Alkhamis, Glen R. Abedi, Xiaoyan Lu, Alison M. Binder, Khalid H. Alanazi, Azaibi Tamin, Weam M. Banjar, Sandra Lester, Osman Abdalla, Rebecca M. Dahl, Mutaz Mohammed, Suvang Trivedi, Homoud S. Algarni, Senthilkumar K. Sakthivel, Abdullah Algwizani, Fahad Bafaqeeh, Abdullah Alzahrani, Ali Abraheem Alsharef, Raafat F. Alhakeem, Hani A. Aziz Jokhdar, Sameeh S. Ghazal, Natalie J. Thornburg, Dean D. Erdman, Abdullah M. Assiri, John T. WatsonComments to Author , and Susan I. Gerber
Author affiliations: Ministry of Health, Riyadh, Saudi Arabia (H.M. Al-Abdely, A.M. Alkhamis, K.H. Alanazi, W.M. Banjar, O. Abdalla, M. Mohammed, H.S. Algarni, A. Alzahrani, A.A. Alsharef, R.F. Alhakeem, H.A.A. Jokhdar, A.M. Assiri); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (C.M. Midgley, G.R. Abedi, X. Lu, A.M. Binder, A. Tamin, S. Lester, R.M. Dahl, S.K. Sakthivel, N.J. Thornburg, D.D. Erdman, J.T. Watson, S.I. Gerber); Princess Nourah Bint Abdulrahman University, Riyadh (W.M. Banjar); Prince Mohammed Bin Abdulaziz Hospital, Riyadh (A. Algwizani, F. Bafaqeeh, S.S. Ghazal)

Main Article

Figure 1

Timeline of clinical course and MERS-CoV detection, by patient, Saudi Arabia, August 1, 2015–August 31, 2016. Findings are presented by time since illness onset (day 0). Patients are grouped by illness severity and outcome. For each patient, day of admission, discharge or death, period of mechanical ventilation (if applicable), and MERS-CoV detection are depicted. For a subset of patients with sufficient data, the peak RNA level (or the minimum upstream of the envelope cycle threshold value) is

Figure 1. Timeline of clinical course and MERS-CoV detection, by patient, Saudi Arabia, August 1, 2015–August 31, 2016. Findings are presented by time since illness onset (day 0). Patients are grouped by illness severity and outcome. For each patient, day of admission, discharge or death, period of mechanical ventilation (if applicable), and MERS-CoV detection are depicted. For a subset of patients with sufficient data, the peak RNA level (or the minimum upstream of the envelope cycle threshold value) is depicted. Peak RNA was based on upper respiratory tract specimen results among group 1 patients and Pt 29, and lower respiratory tract specimen results in group 2 and group 3 patients. The date of death is shown for group 3 patients. Pt 11 and Pt 32 did not report any symptoms throughout their hospitalization. Pt 30 was hospitalized and mechanically ventilated before MERS onset because of a road traffic accident; this patient was excluded from severity and clinical course analyses. Pt 23 has been described previously (36). The first positive MERS-CoV rRT-PCR for Pt 20 was collected 1 day before symptom onset. BiPAP, bilevel positive airway pressure; CoV, coronavirus; MERS, Middle East respiratory syndrome; Pt, patient; rRT-PCR, real-time reverse transcription PCR.

Main Article

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1These first authors contributed equally to this article.

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