{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T09:09:05Z","timestamp":1790845745891,"version":"4.1.0"},"reference-count":106,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T00:00:00Z","timestamp":1759708800000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Following the end of the COVID\u201019 global emergency, concern has shifted to \u201cDisease X,\u201d a hypothetical, highly transmissible, and deadly pathogen, and Middle East Respiratory Syndrome Coronavirus (MERS\u2010CoV) is a prime candidate for this. This review explores its epidemiology, mutations, transmission, and potential to become a pandemic\u2010capable pathogen, aiming to support future research and public health preparedness against the disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive search of major databases was conducted for peer\u2010reviewed English articles (2000\u20132025) focusing on virology, outbreaks, treatments, and public health using relevant but definite keywords. Studies met strict inclusion criteria and standardized methods to ensure quality, reproducibility, and transparency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Since it was identified in 2012, MERS\u2010CoV has spread across 27 countries, presenting a high case fatality rate (~34.5%) and zoonotic origin. It is primarily linked to dromedary camels, but shows limited human\u2010to\u2010human transmission (\n                      <jats:italic>R<\/jats:italic>\n                      \u2080\u2009&lt;\u20091). Unlike SARS\u2010CoV\u20102, MERS\u2010CoV's spread is confined to close contact and healthcare settings, largely in the Middle East and parts of Africa. Its pathogenesis involves severe respiratory illness, driven by immune evasion and systemic inflammation, especially in individuals with comorbidities. While MERS\u2010CoV lacks pandemic\u2010level transmissibility, its genetic plasticity poses a risk for future evolution. Vaccine and therapeutic development remain limited due to sporadic outbreaks and low global urgency.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite not currently fitting the Disease X archetype, MERS\u2010CoV's high mortality, zoonotic spillover potential, and possibility for increased transmissibility warrant continued surveillance, targeted research, and strengthened public health infrastructure to prevent localized outbreaks from escalating into broader crises.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.71327","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T04:51:28Z","timestamp":1759812688000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A Narrative Review on the Recent Insights Into the Pathogenicity and Potential Role of Middle East Respiratory Syndrome Coronavirus (MERS\u2010CoV) in the Emergence of \u201cDisease X\u201d"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7243-4791","authenticated-orcid":false,"given":"Zubaier","family":"Ahmed","sequence":"first","affiliation":[{"name":"School of Pharmacy BRAC University Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazi Milenur Rahman","family":"Prattay","sequence":"additional","affiliation":[{"name":"School of Pharmacy BRAC University Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Sharmin","sequence":"additional","affiliation":[{"name":"School of Pharmacy BRAC University Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6087-0425","authenticated-orcid":false,"family":"Fatema\u2010Tuz\u2010Zohora","sequence":"additional","affiliation":[{"name":"Department of Pharmacy University of Asia Pacific Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asef","family":"Raj","sequence":"additional","affiliation":[{"name":"School of Pharmacy BRAC University Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Forhad Bin","family":"Faruk","sequence":"additional","affiliation":[{"name":"Department of Pharmacy North South University Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bagdad","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Pharmaceutics, College of Pharmacy Ohio State University Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Humair Bin Md","family":"Omer","sequence":"additional","affiliation":[{"name":"School of Pharmacy BRAC University Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anika Awal","family":"Omi","sequence":"additional","affiliation":[{"name":"BIRDEM General Hospital Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fazle","family":"Rabbi","sequence":"additional","affiliation":[{"name":"School of Pharmacy BRAC University Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasiba Binte","family":"Bahar","sequence":"additional","affiliation":[{"name":"Department of Pharmacy University of Asia Pacific Dhaka Bangladesh"},{"name":"Department of Pharmaceutical Technology, Faculty of Pharmacy University of Dhaka Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumiya Sharmin","family":"Mou","sequence":"additional","affiliation":[{"name":"Department of Pharmacy University of Asia Pacific Dhaka Bangladesh"},{"name":"Department of Pharmaceutical Technology, Faculty of Pharmacy University of Dhaka Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehedi","family":"Islam","sequence":"additional","affiliation":[{"name":"School of Pharmacy BRAC University Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eshaba","family":"Karim","sequence":"additional","affiliation":[{"name":"School of Pharmacy BRAC University Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md. 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