A Narrative Review on the Recent Insights Into the Pathogenicity and Potential Role of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in the Emergence of "Disease X".
Level 5 - mechanism / opinion, no new human data
Narrative review synthesizing existing literature without systematic quantitative pooling
PubMed 41064195 · doi:10.1002/hsr2.71327
What was done
The authors conducted a narrative literature search across major databases for English-language peer-reviewed articles published between 2000 and 2025 covering MERS-CoV epidemiology, virology, mutations, transmission, pathogenesis, treatments, and public health readiness.
What was found
Since 2012, MERS-CoV has spread across 27 countries with a case fatality rate of ~34.5%. It is primarily zoonotic (linked to dromedary camels) with limited human-to-human transmission (R₀ < 1) mostly confined to healthcare settings and close contacts in the Middle East and Africa. Pathogenesis involves severe respiratory illness driven by immune evasion and systemic inflammation. Specific vaccines and therapeutics remain limited.
Why it matters
This review evaluates the biological characteristics and evolutionary potential of MERS-CoV in the context of emerging hypothetical pandemic threats ("Disease X"), highlighting areas needing surveillance and preparedness.
Limits
As a narrative review, the paper introduces no new primary clinical or laboratory data. The abstract does not specify the number of included studies, search protocol details, or a formal risk-of-bias assessment.
Cited by
- contradicts SARS had a case fatality rate of 10% and MERS had a case fatality rate of 20%.