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Frontiers of Medicine >> 2019, Volume 13, Issue 1 doi: 10.1007/s11684-017-0603-y

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

1. University of British Columbia, Vancouver, V6T 1Z4, Canada
2. Corona Center, Infectious Diseases Division, Department of Pediatric, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh 11676, Saudi Arabia
3. Indiana University School of Medicine, Indianapolis, IN 46202, USA
4. Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia
5. Department of Surgery, King Saud University, Riyadh 11692, Saudi Arabia
6. College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
7. Infectious Diseases Division, Department of Medicine, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh 11676, Saudi Arabia
8. Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA

Accepted: 2018-04-09 Available online: 2019-03-12

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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 × 10 /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.

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