Neurological Complications of Middle East Respiratory Syndrome Coronavirus: A Report of Two Cases and Review of the Literature

Table 1

The human corona viruses (HCoV).

Virus	Year of discovery	Reservoir	Receptor	Cell type infected	Mode of transmission	Clinical presentation	Disease type	Severity and prognosis
OC43	1966	Bats	Receptor unknown, sialic acid and HLA class 1 involvement	Ciliated airway epithelial cells, macrophages in culture, and neuronal cells	Droplets	Coryza, cough, and fever	Upper respiratory infection, gastrointestinal infection, and pneumonia	Mild and harmless
229E	1967	Bats and camelids	APN	Nonciliated airway epithelial; cells, human monocytes, and neuronal cells	Droplets	Coryza, cough, and fever	Upper respiratory infection, gastrointestinal infection, and pneumonia	Mild and harmless
NL63	2004	Bats	ACE2	Ciliated airway epithelial cells	Droplets	Fever, cough, sore; throat, and rhinitis	Upper and lower respiratory infection, associated with croup in children	Mild and harmless
HKU1	2005	Bats	Unknown	Ciliated airway epithelial cells	Droplets	Rhinorrhea, fever, coughing, wheezing, and myalgia	Upper respiratory infection; and pneumonia,; enteric symptoms	Mild and harmless
SARS	2003	Bats, raccoon dogs, and civet cats	ACE2, role for DC-SIGN also known as CS209	Epithelial cells, ciliated cells, and type II pneumocytes	Droplets	Malaise, headache, chills, myalgia, fever, cough, and dyspnea	Lower respiratory infection, pneumonia, diffuse alveolar damage, and ARDS	Severe respiratory illness with high morbidity and mortality
MERS	2012	Bats and dromedary camels	DPP4 also known as CD26	Airway epithelial cells, renal epithelial cells, and dendritic cell	Droplets	Fever, cough, and breathing difficulties	Lower respiratory infection, pneumonia, ARDS, renal failure, and multiorgan failure	Severe respiratory illness with high morbidity and mortality

HLA: human leukocyte antigen, APN: aminopeptidase N, ACE2: angiotensin converting enzyme 2, DC-SIGN: dendritic cell-specific intercellular adhesion molecule-3-grabbing nonintegrin, CD209: cluster of differentiation 209, DPP4: dipeptidyl peptidase 4, CD26: cluster of differentiation 26, ARDS: acute respiratory distress syndrome.