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

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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 × 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.
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