Al-Tawfiq Jaffar A, Momattin Hisham, Dib Jean, Memish Ziad A
Internal Medicine, Saudi Aramco Medical Services Organization, PO Box 76, Room A-428-2, Building 61, Dhahran Health Center, Dhahran 31311, Saudi Arabia; Indiana University School of Medicine, Indiana, USA.
Pharmacy Services Division, Saudi Aramco Medical Services Organization, Dhahran, Saudi Arabia.
Int J Infect Dis. 2014 Mar;20:42-6. doi: 10.1016/j.ijid.2013.12.003. Epub 2014 Jan 6.
The Middle East respiratory syndrome coronavirus (MERS-CoV) has been reported to have a high case-fatality rate. Currently, there is no specific therapy or vaccine with proven effectiveness for MERS-CoV infections.
A combination of ribavirin and interferon therapy was used for the treatment of five MERS-CoV-positive patients. We reviewed the therapeutic schedule and the outcome of these patients.
All patients were critically ill with acute respiratory distress syndrome treated with adjunctive corticosteroids and were on mechanical ventilation at the time of initiation of therapy. The median time from admission to therapy with ribavirin and interferon was 19 (range 10-22) days. None of the patients responded to the supportive or therapeutic interventions and all died of their illness.
While ribavirin and interferon may be effective in some patients, our practical experience suggests that critically ill patients with multiple comorbidities who are diagnosed late in the course of their illness may not benefit from combination antiviral therapy as preclinical data suggest. There is clearly an urgent need for a novel effective antiviral therapy for this emerging global threat.
据报道，中东呼吸综合征冠状病毒（MERS-CoV）具有较高的病死率。目前，尚无经证实对MERS-CoV感染有效的特异性治疗方法或疫苗。
采用利巴韦林和干扰素联合疗法治疗5例MERS-CoV阳性患者。我们回顾了这些患者的治疗方案和治疗结果。
所有患者均患有严重的急性呼吸窘迫综合征，接受了辅助性皮质类固醇治疗，在开始治疗时均接受机械通气。从入院到开始使用利巴韦林和干扰素治疗的中位时间为19天（范围10 - 22天）。所有患者对支持性或治疗性干预均无反应，均因病死亡。
虽然利巴韦林和干扰素可能对某些患者有效，但我们的实际经验表明，如临床前数据所示，患有多种合并症且在病程晚期才被诊断的重症患者可能无法从联合抗病毒治疗中获益。显然，对于这种新出现的全球威胁，迫切需要一种新型有效的抗病毒疗法。
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