Alagaili et al. of serum from patients with more severe disease and sampling at earlier points during illness. Middle East respiratory syndrome coronavirus (MERS-CoV) was initially recognized in September 2012 when a patient in Saudi Arabia with a severe, acute respiratory contamination and acute renal failure died (1). As of June 19, 2016, more than 1,733 MERS-CoV cases and at least 628 associated deaths had been recognized; >80% of the cases occurred in Saudi Arabia (2). More than 20 countries outside of the Arabian Peninsula have reported MERS-CoV cases, and the 2015 outbreak in South Korea with attendant mortality has reinforced issues about international outbreaks (3). No specific treatment has been proven effective for MERS-CoV contamination. Convalescent plasma made up of MERS-CoVspecific antibodies from recovered patients has been suggested Indomethacin (Indocid, Indocin) as a potential therapy for infected persons (4). Convalescent Indomethacin (Indocid, Indocin) plasma has been used to treat several other viral infections, including those caused by the severe acute respiratory syndrome coronavirus (SARS-CoV), avian influenza A(H5N1) computer virus, and influenza A(H1N1)pdm09 computer virus (510). A recent metaanalysis of studies using passive immunotherapy for treatment of severe acute respiratory infections of viral etiology suggests that the timely use of convalescent blood products, particularly those with neutralizing antibodies, results in a reduced death rate (11). Public Health England and ISARIC (the International Severe Acute Respiratory and Rabbit Polyclonal to ERI1 Emerging Infection Consortium) published a decision-making support tool on potential therapies for MERS-CoV that highlights convalescent plasma and other neutralizing antibodycontaining immunotherapeutics (e.g., hyperimmune immunoglobulins and monoclonal antibodies) as the most promising potential treatments for severe MERS-CoV illness and deserving of evaluation in human clinical trial(s) (4). However, no data support the feasibility of obtaining convalescent plasma from patients who have been exposed to MERS-CoV or recovered from infection with the computer virus. Camels are the likely source for most animal-to-human transmission and appear to have long-lasting antibody responses; in preclinical models, such antibodies appear effective in reducing the severity of pathologic changes in infected lungs (12). However, the antibody response to MERS-CoV contamination in humans is usually poorly defined. Thus, we planned a 2-phase study to 1 1) determine the feasibility of collecting high-titer convalescent plasma from MERS-CoV patients and contacts and, if successful, to 2) conduct a pilot therapeutic study using convalescent plasma in symptomatic MERS-CoV patients with moderate to severe illness. Herein, we statement around the feasibility study. == Methods == In collaboration with the King Abdullah International Medical Research Center, the Gulf Cooperation Council Contamination Control Center, and the World Health Business (WHO)International Severe Acute Respiratory and Emerging Contamination Consortium MERS-CoV Working Group, we developed a study protocol to screen potential donors, collect high-titer convalescent plasma, and administer the plasma in a clinical trial (13). The study was approved by the Ministry of the National Guard Health Affairs Institutional Review Table (approval no. IRBC/233/14, June 9, 2014) and registered in ClinicalTrials.gov (NCT02190799). We conducted the Indomethacin (Indocid, Indocin) study at King Abdulaziz Medical City, a 1,100-bed tertiary care center in Riyadh, Saudi Arabia. The hospital is accredited by the Joint Commission rate International, and the hospitals Department of Pathology and Laboratory Medicine is accredited by the College of American Pathologists and the American Association of Blood Banks. == Study Populace == We screened potential convalescent plasma donors from 3 cohorts: 1) patients Indomethacin (Indocid, Indocin) with acute respiratory illness who were suspected of having MERS-CoV or who were confirmed MERS-CoVpositive by real-time reverse transcription PCR (rRT-PCR) of upper or lower respiratory secretions; 2) healthcare workers exposed to a laboratory-confirmed MERS-CoV individual, as recognized by ongoing active surveillance of the hospital Contamination Prevention and Control Department; and 3) household contacts of patients with laboratory-confirmed MERS-CoV contamination. We obtained written informed consent for MERS-CoV serologic screening from all healthcare workers and household contacts. Medical teams ordered serologic screening as part of the clinical care for patients with suspected or confirmed MERS-CoV contamination; no additional informed consent was required. Healthcare workers completed a self-administered survey.