TY - JOUR AU - Al-Abdely, Hail AU - Midgley, Claire AU - Alkhamis, Abdulrahim AU - Abedi, Glen AU - Lu, Xiaoyan AU - Binder, Alison AU - Alanazi, Khalid AU - Tamin, Azaibi AU - Banjar, Weam AU - Lester, Sandra AU - Abdalla, Osman AU - Dahl, Rebecca AU - Mohammed, Mutaz AU - Trivedi, Suvang AU - Algarni, Homoud AU - Sakthivel, Senthilkumar AU - Algwizani, Abdullah AU - Bafaqeeh, Fahad AU - Alzahrani, Abdullah AU - Alsharef, Ali Abraheem AU - Alhakeem, Raafat AU - Jokhdar, Hani Aziz AU - Ghazal, Sameeh AU - Thornburg, Natalie AU - Erdman, Dean AU - Assiri, Abdullah AU - Watson, John AU - Gerber, Susan T1 - Middle East Respiratory Syndrome Coronavirus Infection Dynamics and Antibody Responses among Clinically Diverse Patients, Saudi Arabia T2 - Emerging Infectious Disease journal PY - 2019 VL - 25 IS - 4 SP - 753 SN - 1080-6059 AB - 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. KW - Middle East respiratory syndrome KW - coronavirus infections KW - diabetes mellitus KW - kinetics KW - viral load KW - antibody response KW - asymptomatic infections KW - mortality KW - viruses KW - respiratory infections KW - MERS KW - MERS-CoV DO - 10.3201/eid2504.181595 UR - https://wwwnc.cdc.gov/eid/article/25/4/18-1595_article ER - End of Reference