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Volume 25, Number 4—April 2019
Research

Middle East Respiratory Syndrome Coronavirus Infection Dynamics and Antibody Responses among Clinically Diverse Patients, Saudi Arabia

Hail M. Al-Abdely1, Claire M. Midgley1Comments to Author , Abdulrahim M. Alkhamis, Glen R. Abedi, Xiaoyan Lu, Alison M. Binder, Khalid H. Alanazi, Azaibi Tamin, Weam M. Banjar, Sandra Lester, Osman Abdalla, Rebecca M. Dahl, Mutaz Mohammed, Suvang Trivedi, Homoud S. Algarni, Senthilkumar K. Sakthivel, Abdullah Algwizani, Fahad Bafaqeeh, Abdullah Alzahrani, Ali Abraheem Alsharef, Raafat F. Alhakeem, Hani A. Aziz Jokhdar, Sameeh S. Ghazal, Natalie J. Thornburg, Dean D. Erdman, Abdullah M. Assiri, John T. WatsonComments to Author , and Susan I. Gerber
Author affiliations: Ministry of Health, Riyadh, Saudi Arabia (H.M. Al-Abdely, A.M. Alkhamis, K.H. Alanazi, W.M. Banjar, O. Abdalla, M. Mohammed, H.S. Algarni, A. Alzahrani, A.A. Alsharef, R.F. Alhakeem, H.A.A. Jokhdar, A.M. Assiri); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (C.M. Midgley, G.R. Abedi, X. Lu, A.M. Binder, A. Tamin, S. Lester, R.M. Dahl, S.K. Sakthivel, N.J. Thornburg, D.D. Erdman, J.T. Watson, S.I. Gerber); Princess Nourah Bint Abdulrahman University, Riyadh (W.M. Banjar); Prince Mohammed Bin Abdulaziz Hospital, Riyadh (A. Algwizani, F. Bafaqeeh, S.S. Ghazal)

Main Article

Figure 3

MERS-CoV RNA detection in the respiratory tract, based on clinical diagnostic reports, among MERS-CoV patients, Saudi Arabia, August 1, 2015–August 31, 2016. A–C) UpE real-time reverse transcription PCR Ct values of group 1 (A), 2 (B), and 3 (C) patients, by days since illness onset (day 0). Panel A depicts URT specimens, and panels B and C depict LRT specimens collected during MV; Pt 29 (a G2 patient who received BiPAP ventilation) is depicted in panel A because only URT specimens were collecte

Figure 3. MERS-CoV RNA detection in the respiratory tract, based on clinical diagnostic reports, among MERS-CoV patients, Saudi Arabia, August 1, 2015–August 31, 2016. A–C) UpE real-time reverse transcription PCR Ct values of group 1 (A), 2 (B), and 3 (C) patients, by days since illness onset (day 0). Panel A depicts URT specimens, and panels B and C depict LRT specimens collected during MV; Pt 29 (a G2 patient who received BiPAP ventilation) is depicted in panel A because only URT specimens were collected for this patient. The dashed line represents the limit of detection, above which specimens were considered MERS-CoV–negative or not detected. Probable results, meaning that only 1 of 2 real-time reverse transcription PCR assays were positive, are depicted on the dashed line for graphing purposes. Patients with limited Ct values or unknown specimen types are not depicted. Patients 11 and 32 did not report any symptoms throughout their illness. Pt 30 is depicted alongside G2 patients. Pt 23 reached negativity 37 days after illness onset, as described previously (36). *Indicates patients with a documented history of diabetes mellitus. D, E) Minimum Ct values reported, which was determined for a subset of patients with sufficient data. Panel D depicts URT specimen results among group 1 patients and Pt 29; panel E depicts LRT specimen results in group 2 and 3 patients, collected from the LRT during MV. Group 1, on room air; group 2, ventilated but survived; group 3, died. BiPAP, bilevel positive airway pressure; Ct, cycle threshold; CoV, coronavirus; LRT, lower respiratory tract; MERS, Middle East respiratory syndrome; min, minimum; MV, mechanical ventilation; Pt, patient; URT, upper respiratory tract; upE, upstream of the envelope.

Main Article

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1These first authors contributed equally to this article.

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