Abstract
BackgroundThe Middle East Respiratory Syndrome coronavirus (MERS-CoV) is an emerging respiratory pathogen with a high mortality rate and no specific treatments available to date. The purpose of this study was to determine the feasibility of conducting a randomized controlled trial (RCT) of convalescent plasma therapy for MERS-CoV-infected patients by using MERS-CoV-specific convalescent plasma obtained from previously recovered patients.MethodsA survey was adapted from validated questionnaire originally aimed to measure network capacities and capabilities within the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC). The questionnaire was modified for this study to include 26 items that were divided into three main domains of interest: (1) the ability to care for critically ill MERS-CoV patients; (2) laboratory capacity to diagnose MERS-CoV and blood bank ability to prepare convalescent plasma; and (3), research capacity to conduct randomized controlled trials. The questionnaire was emailed to physicians.ResultsOf 582 physicians who were invited to the survey, 327 responded (56.2 %). The professional focus of the majority of respondents was critical care (106/249 (43 %)), pediatrics (59/249, (24 %)) or internal medicine (52/249 (21 %)) but none was blood banking. Nearly all respondents (251/263 (95 %)) reported to have access to ICU facilities within their institutions. Most respondents (219/270 (81 %)) reported that intensivists were the most physician group responsible for treatment decisions about critically ill SARI patients. While 125/165 respondents (76 %) reported that they conduct research in ICUs, and 80/161 (49.7 %) had been involved in the conduct of RCTs, including using a placebo comparison (60/161 (37 %)), only 49/226 (21 %) of respondents regularly participated in research networks.ConclusionsOur survey indicated that in the Kingdom of Saudi Arabia (KSA), ICUs are the most likely clinical locations for conducting a clinical trial of convalescent plasma therapy for MERS-CoV, and that most ICUs have experience with such research designs.Electronic supplementary materialThe online version of this article (doi:10.1186/s12871-016-0198-x) contains supplementary material, which is available to authorized users.
Highlights
The Middle East Respiratory Syndrome coronavirus (MERS-CoV) is an emerging respiratory pathogen with a high mortality rate and no specific treatments available to date
A novel coronavirus was first diagnosed in Saudi Arabia in June 2012 in a man who presented with pneumonia and acute renal failure [1]
This newly discovered virus leading to severe pneumonia and acute respiratory distress syndrome (ARDS) was later named Middle East respiratory syndrome coronavirus (MERS-CoV)
Summary
The Middle East Respiratory Syndrome coronavirus (MERS-CoV) is an emerging respiratory pathogen with a high mortality rate and no specific treatments available to date. A novel coronavirus was first diagnosed in Saudi Arabia in June 2012 in a man who presented with pneumonia and acute renal failure [1]. This newly discovered virus leading to severe pneumonia and acute respiratory distress syndrome (ARDS) was later named Middle East respiratory syndrome coronavirus (MERS-CoV). Convalescent plasma that contains MERS-CoV-specific immunoglobulin and is obtained from previously recovered patients has been suggested as a potential therapy for patients with MERS-CoV infection. The document suggests that current evidence is strongest for testing convalescent plasma (CP) or other therapeutics which contain neutralizing antibodies (such as hyperimmune immunoglobulin) for treatment of serious MERS-CoV illness
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