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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Middle East Respiratory Syndrome Coronavirus (MERS-CoV) coinfection: A unique case series

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DOI: 10.1016/j.tmaid.2021.102026

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COVID-19; SARS-CoV-2; MERS-CoV; Coinfection; Middle East Respiratory Syndrome Coronavirus

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This study described the clinical characteristics and demographics of 8 patients coinfected with SARS-CoV-2 and MERS-CoV, highlighting a higher proportion of males, an average age of approximately 44 years, and a majority of obese patients. The average length of hospital stay was 21.1 days, most patients received corticosteroid treatment, and the outcomes were generally positive with half of the patients being discharged and a minority dying.
Introduction: The emergence of the Severe Acute Respiratory Syndrome Coroanvirus 2 (SARS-CoV-2) had raised possibilities of coinfection with the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in countries were these two viruses were reported. In this study, we describe the clinical presentation and demographics of eight patients who were coinfected with SARS-CoV-2 and MERS-CoV. Materials and methods: This is a case series of hospitalized patients admitted to intensive care units (ICUs). We collected demographics, underlying conditions, presenting symptoms and clinical outcome from the patients' medical records. Results: During the study period from March 14, 2020 to October 19, 2020, there was a total of 67 SARS-CoV-2 ICU admitted patients who underwent simultaneous SARS-CoV-2 and MERS-CoV testing by PCR. Of those patients, 8 (12%) tested positive for both SARS-CoV-2 and MERS-CoV. There were 6 (75%) males, the mean age +/- SD was 44.4 +/- 11.8 years, and 7 (87.5%) were obese. Of the patients, 7 (87.5%) were non-smokers, 1 (12.5%) had diabetes mellitus, 1 (12.5%) had heart failure, and 1 (12.5%) had been on anti-platelet therapy. The mean hospital length of stay (LOS) was 21.1 +/- 11.6 days and the average ICU LOS was 10.9 +/- 6.03 days. All patients received supportive therapy and all were treated with corticosteroid. Of all the patients, 4 (50%) were discharged home and 3 (37.5%) died. Conclusion: This case series is an important addition to the medical knowledge as it showed the interaction of the coinfection of SARS-CoV-2 and MERS-CoV.

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