Middle East respiratory syndrome coronavirus in pediatrics: a report of seven cases from Saudi Arabia

This article is made available for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.Infection with Middle East respiratory syndrome coronavirus (MERS-CoV) emerged in 2012 as an important respiratory disease with high fatality rates of 40%–60%. Despite the increased number of cases over subsequent years, the number of pediatric cases remained low. A review of studies conducted from June 2012 to April 19, 2016 reported 31 pediatric MERS-CoV cases. In this paper, we present the clinical and laboratory features of seven patients with pediatric MERS. Five patients had no underlying medical illnesses, and three patients were asymptomatic. Of the seven cases, four (57%) patients sought medical advice within 1–7 days from the onset of symptoms. The three other patients (43%) were asymptomatic and were in contact with patients with confirmed diagnosis of MERS-CoV. The most common presenting symptoms were fever (57%), cough (14%), shortness of breath (14%), vomiting (28%), and diarrhea (28%). Two (28.6%) patients had platelet counts of < 150 × 109/L, and one patient had an underlying end-stage renal disease. The remaining patients presented with normal blood count, liver function, and urea and creatinine levels. The documented MERS-CoV Ct values were 32–38 for four of the seven cases. Two patients (28.6%) had abnormal chest radiographic findings of bilateral infiltration. One patient (14.3%) required ventilator support, and two patients (28.6%) required oxygen supplementation. All the seven patients were discharged without complications

Molecular aspects of MERS-CoV

This article is made available for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.Middle East respiratory syndrome coronavirus (MERS-CoV) is a betacoronavirus which can cause acute respiratory distress in humans and is associated with a relatively high mortality rate. Since it was first identified in a patient who died in a Jeddah hospital in 2012, the World Health Organization has been notified of 1735 laboratory-confirmed cases from 27 countries, including 628 deaths. Most cases have occurred in Saudi Arabia. MERS-CoVancestors may be found in OldWorld bats of the Vespertilionidae family. After a proposed bat to camel switching event, transmission of MERS-CoV to humans is likely to have been the result of multiple zoonotic transfers from dromedary camels. Human-to-human transmission appears to require close contact with infected persons, with outbreaks mainly occurring in hospital environments. Outbreaks have been associated with inadequate infection prevention and control implementation, resulting in recommendations on basic and more advanced infection prevention and control measures by the World Health Organization, and issuing of government guidelines based on these recommendations in affected countries including Saudi Arabia. Evolutionary changes in the virus, particularly in the viral spike protein which mediates virus-host cell contact may potentially increase transmission of this virus. Efforts are on-going to identify specific evidence-based therapies or vaccines. The broad-spectrum antiviral nitazoxanide has been shown to have in vitro activity against MERS-CoV. Synthetic peptides and candidate vaccines based on regions of the spike protein have shown promise in rodent and non-human primate models. GLS-5300, a prophylactic DNA-plasmid vaccine encoding S protein, is the first MERS-CoV vaccine to be tested in humans, while monoclonal antibody, m336 has given promising results in animal models and has potential for use in outbreak situations

The impact of co-infection of influenza A virus on the severity of Middle East Respiratory Syndrome Coronavirus

This article is made available for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.Ho and colleagues recently drew attention to the consequences of co-infection with Influenza and HIV.1 We present four cases of combined infection with influenza and Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection. Nasopharyngeal swabs or tracheal aspirates were tested for MERS-CoV using real-time reverse-transcription polymerase chain reaction (RT-PCR).2, 3 Samples were tested for Influenza A, B and H1N1 by rapid molecular test (GenEXper for detection of flu A, B and 2009 H1N1, Cepheid)

Middle East Respiratory Syndrome Coronavirus and Pulmonary Tuberculosis Coinfection: Implications for Infection Control

Coinfection of Middle East respiratory syndrome coronavirus (MERS-CoV) with tuberculosis (TB) has not been previously reported. Here, we present 2 cases with both MERS-CoV and pulmonary TB. The first case was a 13-year-old patient who was admitted with a 2-month history of fever, weight loss, night sweats, and cough. The second patient was a 30-year-old female who had a 4-week history of cough associated with shortness of breath and weight loss of 2 kg. The 2 patients were diagnosed with pulmonary TB and had positive MERS-CoV. Both patients were discharged to complete their therapy for TB at home. It is likely that both patients had pulmonary TB initially as they had prolonged symptoms and they subsequently developed MERS-CoV infection. It is important to carefully evaluate suspected MERS-CoV patients for the presence of other infectious diseases, such as TB, especially if cohorting is done for suspected MERS-CoV to avoid nosocomial transmission

Effect of Pre-germination Treatments on Seed Germination of Helianthemum lippii (L.) Dum.Cours.

Helianthemum lippii (L.) Dum. Cours. is a perennial shrubby plant 10-45 cm tall that belongs to the family Cistaceae. The effects of pretreatments on germination of Helianthemum lippii provide information regarding germination requirements of this species, which could be used for conservation studies. Five different pretreatment were applied to enhance seed germination. Scarification followed by germination at 6 different constant temperatures (10, 15, 20, 25, 30 and 35°C) with continuous light or dark, Scarification followed by GA3 soaking (100, 250,500,750 and 1000 ppm), Heat and moist stratification (only intact seeds), KNO₃ and H₃BO₃ soaking (only intact seeds). The results obtained from this study indicate that germination in H. lippii was promoted by scarification. Scarification of seeds resulted in high germination while increasing germination temperature (35°C) decreased the germination of scarified seeds. Exposure to light and dark had no effect on germination. Heat stratification, cold stratification, KNO₃ and H₃BO₃ treatments were ineffective in increasing germination of H.lippii seeds. Scarification yielded maximum germination without soaking in GA₃ It increased the germination of Helianthemum lippii seeds from 1 to 99%. Increase in GA₃ concentration decreased the germination of this species. Scarification succeeded in breaking dormancy of H.lippii seeds suggesting that this species exhibits seed coat dormancy and in nature it may happen due to the abrasion of seed coat by sand particles or other biotic and abiotic factors.Desert Plants is published by The University of Arizona for the Boyce Thompson Southwestern Arboretum. For more information about this unique botanical journal, please email the College of Agriculture and Life Sciences Publications Office at [email protected]

LIQUORICE BEVERAGE EFFECT ON THE PHARMACOKINETIC PARAMETERS OF ATORVASTATIN, SIMVASTATIN, AND LOVASTATIN BY LIQUID CHROMATOGRAPHY-MASS SPECTROSCOPY/MASS SPECTROSCOPY

ABSTRACTObjective: The objective of this study is to examine the effects of pre-consumption of freshly prepared liquorice beverage (4 ml/kg) on thepharmacokinetic (PK) parameters of (80 mg/kg) oral dose of atorvastatin, simvastatin, and lovastatin in healthy rats plasma.Methods: A simple, rapid, and applicable analytical method was developed for the determination of each statin in rats' plasma. This method usesliquid chromatography-mass spectroscopy/mass spectroscopy. The mobile phase composed of methanol and formic acid in water and glimepiride asan internal standard. 108 rats were used in this study. Liquorice juice was given, and then each of the statins was given to test groups and liquoriceonly to the control groups, and then plasma samples were withdrawn on specific time schedule then PK analysis was performed.Results: The analytical method showed acceptable linearity, recovery, precision, and accuracy. Administration of liquorice resulted in a significantincrease in maximum concentration in plasma (C) of the three statins, also the area under plasma level-time curves (area under curve) was increasedsignificantly. Moreover, the bioavailability of the drugs. On the other hand, the elimination of the three drugs showed no great changes, which suggestsan interaction between liquorice and the transporting system of statins on the gut and biliary wall.maxConclusion: Consumption of liquorice results in increase bioavailability of atorvastatin, simvastatin, and lovastatin.Keywords: Liquorice, Atorvastatin, Liquid chromatography-mass spectroscopy/mass spectroscopy, Simvastatin, Lovastatin, Pharmacokineticparameters