Latest coronavirus research reveals important differences between new virus and SARS

New research published in The Lancet Infectious Diseases provides the first complete viral load profile— a comprehensive clinical description of where and how much of the virus circulates through the body— of a patient infected with Middle East respiratory syndrome coronavirus.

The report describes a 73-year-old man from Abu Dhabi, who died in Munich in April 2013, having contracted MERS-CoV a few weeks earlier.

Little comprehensive clinical data on the exists, and this is only the fifth patient for whom the virus's progression and characteristics have been described in a medical journal. The patient described in the new paper entered hospital in Abu Dhabi 2 days after developing flu-like symptoms, where he was diagnosed with pneumonia and received antibiotics and artificial ventilation. On the 12th day of illness, the patient was flown to hospital in Munich. After experiencing deteriorating , and suffering , the patient died, 18 days after becoming ill.

After admission to the Munich hospital, researchers regularly measured the patient's , finding it to be highest in the , supporting earlier findings and current advice that specimens from this area should be obtained for diagnosis wherever possible. Low, but detectable, viral loads were also found in urine and stool samples, but not in the patient's blood.

The presence of the virus in urine may indicate that it is able to replicate in a patient's kidneys, which may also explain why this patient— and two other patients in France, described in a recent Lancet article1—experienced kidney failure. However, the researchers point out that the antibiotics prescribed in the early stages of the patient's illness may have also affected , so more research will be needed to establish where and how the virus reproduces in the body after infection.

Low concentrations of the virus in also suggests a key difference between how the new virus circulates in the body compared with severe acute respiratory syndrome (SARS) coronavirus, which tended to be found in high concentrations in stool. Learning more about where and how the virus circulates will have critical implications for diagnosis and infection control, say the authors. "Laboratory data like these are critical to reach recommendations for diagnostics, to make projections about the prognosis of the patient, as well as to estimate infection risks", says Professor Christian Drosten, a lead author of the study.

"In the absence of qualitative laboratory data from well-documented MERS cases, most of these considerations were up to now made upon an assumed analogy to SARS. However, we're now finding that certain elementary traits of the MERS virus appear to be different to SARS."

According to Professor Clemens-Martin Wendtner, co-lead author of the study, "With only five complete genome sequences so far available there is an urgent need for more genetic data to reveal the spatial and temporal distribution of these cases, estimate the number of independent human chains of transmission, and thus better evaluate the threat this virus poses to world health."

More information: 1. www.thelancet.com/journals/lan… (13)60982-4/fulltext
2. The Lancet Infectious Diseases Published online June 17, 2013 dx.doi.org/10.1016/S1473-3099(13)70154-3

Related Stories

France says new suspected cases of MERS virus

Jun 12, 2013

France's health ministry said Wednesday that a man suspected of having contracted MERS had tested negative for the SARS-like virus which has killed more than 30 people, mostly in Saudi Arabia.

WHO says MERS virus death toll hits 33

Jun 14, 2013

The global death toll from the SARS-like virus MERS has risen to 33, after two new fatalities in Saudi Arabia, the World Health Organization (WHO) said on Friday.

France reports new suspected cases of MERS virus

Jun 11, 2013

French medical authorities on Tuesday reported two new suspected cases of infection with the SARS-like virus MERS which has killed more than 30 people worldwide, the bulk of them in Saudi Arabia.

New Saudi death from MERS virus

Jun 06, 2013

The Saudi health ministry on Thursday announced the death of one of its citizens in the eastern region of Al-Ahsaa after he contracted MERS, a SARS-like virus.

Recommended for you

Female baby boomers with asthma? You may need help

5 hours ago

Women over the age of 65 face numerous barriers to good health: an increased risk for obesity, greater struggles against poverty and higher rates of asthma with worse health outcomes. An article published in the August issue ...

New guidelines help keep asthma out of 'yellow zone'

5 hours ago

If you have asthma, you may have an asthma action plan with a "stoplight system" to help you recognize and respond to changes and understand when symptoms are getting worse and need more attention. If you're in the green ...

User comments