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WHO Confirms Third Fatal Novel Beta Coronavirus Case
Recombinomics Commentary 15:30
November 29, 2012

The clinical picture in all cases was an acute respiratory infection presenting with signs and symptoms of pneumonia. Four patients developed acute renal failure; one of these died. The remaining three patients had pneumonia that required intensive support, without renal failure, and recovered. Three confirmed cases and the one probable case all belong to the same family and were living in the same household.

The above comments are from the WHO November 28 guidelines on surveillance testing for the novel betacoronavirus first reported in September.  The update increases the number of confirmed cases to seven and cites four cases with renal failure.  The first two cases had renal failure and media reports indicated the two fatal cases (70 year old father and his son) also had renal failure.  Therefore the 7th confirmed case would be the father (70M) and the WHO comments above should read that one of the cases survived (the 49M from Qatar), instead of stating that only one died.

The November 23 WHO update cited two deaths in the Riyadh cluster, which were in addition to the Jeddah case (60M) who died in June.

Renal failure in four of eight cases, as well as the death of 3 of the 4 cases with renal failure is remarkably similar to clinical presentation and outcomes for the most severe SARS CoV cases from 2003.  The intensive support for the other three confirmed cases also matches results for the SARS CoV outbreak, where almost 10% of lab confirmed cases died, and the deaths were concentrated in middle aged to older patients, which had ages similar to the four cases with renal failure. 

Although the WHO has not released the ages for the cases without renal failure, all appear to be middle aged adults.

Release of ages and disease onset dates for the seven confirmed and one probable case would be useful.

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