(5) Radiological assessment: chest X-ray (posteroanterior and lateral views) and computed tomography (CT). (6) Arterial blood gases, including; PH, PaO 2 , SaO 2 , PaCO 2 and HCO 3 . (7) Acute Physiology and Chronic Health Evaluation II (APACHE II) score, the Sequential Organ Failure Assessment score (SOFA) and the Clinical Pulmonary Infection Score (CPIS). (8) Throat swab (Eurotubo, Deltalab, 08191 Rubı´, Barcelona, Spain), sputum, tracheal aspirate or bronchoalveolar lavage specimens were taken and stored at 28°C, and transported within 72 h to the reference laboratories, where they were subjected to real-time reverse-tran scriptase-polymerase-chain-reaction (rRT-PCR) assays to test for MERS-CoV (Altona Diagnostics GmbH, 22767 Hamburg, Germany).