Neurological Complications during Treatment of Middle East Respiratory Syndrome

Kim, Jee-Eun; Heo, Jae-Hyeok; Kim, Hye-ok; Song, Sook-hee; Park, Sang-Soon; Park, Tai-Hwan; Ahn, Jin-Young; Kim, Min-Ky; Choi, Jae-Phil

Twenty-three laboratory-confirmed MERS-CoV-infected patients were admitted during the study period. The virus transmission was associated with health-care facilities in all of the identified patients. The mean follow-up period was 49 days [interquartile range (IQR)=12-290 days]. Of the total 23 confirmed cases, 19 patients survived following treatment with a combination of antiviral agents and maximal supportive care. A triple antiviral treatment regimen comprising subcutaneous pegylated interferon alpha-2a (180 µg per week for 2 weeks), high-dose oral ribavirin [2,000 mg loading dose, followed by 1,200 mg every 8 h (q8h) for 4 days and then 600 mg q8h for 4-6 days], and oral lopinavir/ritonavir (400 mg/100 mg q12h for 10 days) was administered to all patients regardless of disease severity, which was in accordance with the interim recommendations generated during the early period of the Korean MERS epidemic. 13 The demographic characteristics and clinical outcomes of all patients are presented in Table 1 . Four patients died due to early or late respiratory failure caused by the progression of the disease.