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Paradigm Shift Intervention Monitoring
In Riyadh Betacornavirus Fatal Cluster
The above comments provide additional detail on the Riyadh fatal cluster, which support human to human transmission. The detail includes the time gap between disease onset / hospitalization dates, which supports infection of the son by his father. Moreover the report of renal failure in both cases further support novel betacoronavirus infection, even though lab confirmation in the father has not been reported.
The first two confirmed cases also had renal failure. The case in Saudi Arabia died, while the Qatar case was placed on an ECMO machine to assist breathing after both lungs were severely damaged. Reports of renal failure in all three fatal cases, as well as severe confirmed cases bear striking similarities to the 2002/2003 SARS cases. Renal failure was reported in 5-6% of the cases and the vast majority of such cases were fatal.
Thus, the report of renal failure in at least 4 of the 8 confirmed / suspect cases strongly suggests that a much larger number of cases have not been reported / detected. The failure to confirm the novel coronavirus in one of the symptomatic family members raises additional testing concerns.
Although media reports continue to emphasize the lack of confirmed human transmission, the delayed onset dates and renal failure in the two fatal cases in the familial cluster support human transmission in cases other than the 8 confirmed / suspect cases reported to date.