Tags

Type your tag names separated by a space and hit enter

Treatment outcomes for patients with Middle Eastern Respiratory Syndrome Coronavirus (MERS CoV) infection at a coronavirus referral center in the Kingdom of Saudi Arabia.
BMC Infect Dis. 2016 Apr 21; 16:174.BI

Abstract

BACKGROUND

Middle Eastern Respiratory Syndrome coronavirus (MERS-CoV) is a poorly understood disease with no known treatments. We describe the clinical features and treatment outcomes of patients with laboratory confirmed MERS-CoV at a regional referral center in the Kingdom of Saudi Arabia.

METHODS

In 2014, a retrospective chart review was performed on patients with a laboratory confirmed diagnosis of MERS-CoV to determine clinical and treatment characteristics associated with death. Confounding was evaluated and a multivariate logistic regression was performed to assess the independent effect of treatments administered.

RESULTS

Fifty-one patients had an overall mortality of 37 %. Most patients were male (78 %) with a mean age of 54 years. Almost a quarter of the patients were healthcare workers (23.5 %) and 41 % had a known exposure to another person with MERS-CoV. Survival was associated with male gender, working as a healthcare worker, history of hypertension, vomiting on admission, elevated respiratory rate, abnormal lung exam, elevated alanine transaminase (ALT), clearance of MERS-CoV on repeat PCR polymerase chain reaction (PCR) testing, and mycophenolate mofetil treatment. Survival was reduced in the presence of coronary artery disease, hypotension, hypoxemia, CXR (chest X-ray) abnormalities, leukocytosis, creatinine >1 · 5 mg/dL, thrombocytopenia, anemia, and renal failure. In a multivariate analysis of treatments administered, severity of illness was the greatest predictor of reduced survival.

CONCLUSIONS

Care for patients with MERS-CoV remains a challenge. In this retrospective cohort, interferon beta and mycophenolate mofetil treatment were predictors of increased survival in the univariate analysis. Severity of illness was the greatest predictor of reduced survival in the multivariate analysis. Larger randomized trials are needed to better evaluate the efficacy of these treatment regimens for MERS-CoV.

Authors+Show Affiliations

King Fahd General Hospital, Jeddah, Kingdom of Saudi Arabia.King Fahd General Hospital, Jeddah, Kingdom of Saudi Arabia.King Fahd General Hospital, Jeddah, Kingdom of Saudi Arabia.King Fahd General Hospital, Jeddah, Kingdom of Saudi Arabia.King Fahd General Hospital, Jeddah, Kingdom of Saudi Arabia.King Fahd General Hospital, Jeddah, Kingdom of Saudi Arabia.King Fahd General Hospital, Jeddah, Kingdom of Saudi Arabia.Department of Medicine, Division of General Internal Medicine, The Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA.Department of Internal Medicine, Division of Infectious Diseases, The Johns Hopkins University, School of Medicine, Baltimore, 21224, Maryland, USA.Department of Internal Medicine, Division of Infectious Diseases, The Johns Hopkins University, School of Medicine, Baltimore, 21224, Maryland, USA. gsood1@jhmi.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27097824

Citation

Al Ghamdi, Mohammed, et al. "Treatment Outcomes for Patients With Middle Eastern Respiratory Syndrome Coronavirus (MERS CoV) Infection at a Coronavirus Referral Center in the Kingdom of Saudi Arabia." BMC Infectious Diseases, vol. 16, 2016, p. 174.
Al Ghamdi M, Alghamdi KM, Ghandoora Y, et al. Treatment outcomes for patients with Middle Eastern Respiratory Syndrome Coronavirus (MERS CoV) infection at a coronavirus referral center in the Kingdom of Saudi Arabia. BMC Infect Dis. 2016;16:174.
Al Ghamdi, M., Alghamdi, K. M., Ghandoora, Y., Alzahrani, A., Salah, F., Alsulami, A., Bawayan, M. F., Vaidya, D., Perl, T. M., & Sood, G. (2016). Treatment outcomes for patients with Middle Eastern Respiratory Syndrome Coronavirus (MERS CoV) infection at a coronavirus referral center in the Kingdom of Saudi Arabia. BMC Infectious Diseases, 16, 174. https://doi.org/10.1186/s12879-016-1492-4
Al Ghamdi M, et al. Treatment Outcomes for Patients With Middle Eastern Respiratory Syndrome Coronavirus (MERS CoV) Infection at a Coronavirus Referral Center in the Kingdom of Saudi Arabia. BMC Infect Dis. 2016 Apr 21;16:174. PubMed PMID: 27097824.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment outcomes for patients with Middle Eastern Respiratory Syndrome Coronavirus (MERS CoV) infection at a coronavirus referral center in the Kingdom of Saudi Arabia. AU - Al Ghamdi,Mohammed, AU - Alghamdi,Khalid M, AU - Ghandoora,Yasmeen, AU - Alzahrani,Ameera, AU - Salah,Fatmah, AU - Alsulami,Abdulmoatani, AU - Bawayan,Mayada F, AU - Vaidya,Dhananjay, AU - Perl,Trish M, AU - Sood,Geeta, Y1 - 2016/04/21/ PY - 2015/09/30/received PY - 2016/03/31/accepted PY - 2016/4/22/entrez PY - 2016/4/22/pubmed PY - 2016/11/10/medline KW - Coronavirus KW - MERS CoV KW - Middle Eastern Respiratory Syndrome coronavirus KW - Survival KW - Treatment outcome SP - 174 EP - 174 JF - BMC infectious diseases JO - BMC Infect Dis VL - 16 N2 - BACKGROUND: Middle Eastern Respiratory Syndrome coronavirus (MERS-CoV) is a poorly understood disease with no known treatments. We describe the clinical features and treatment outcomes of patients with laboratory confirmed MERS-CoV at a regional referral center in the Kingdom of Saudi Arabia. METHODS: In 2014, a retrospective chart review was performed on patients with a laboratory confirmed diagnosis of MERS-CoV to determine clinical and treatment characteristics associated with death. Confounding was evaluated and a multivariate logistic regression was performed to assess the independent effect of treatments administered. RESULTS: Fifty-one patients had an overall mortality of 37 %. Most patients were male (78 %) with a mean age of 54 years. Almost a quarter of the patients were healthcare workers (23.5 %) and 41 % had a known exposure to another person with MERS-CoV. Survival was associated with male gender, working as a healthcare worker, history of hypertension, vomiting on admission, elevated respiratory rate, abnormal lung exam, elevated alanine transaminase (ALT), clearance of MERS-CoV on repeat PCR polymerase chain reaction (PCR) testing, and mycophenolate mofetil treatment. Survival was reduced in the presence of coronary artery disease, hypotension, hypoxemia, CXR (chest X-ray) abnormalities, leukocytosis, creatinine >1 · 5 mg/dL, thrombocytopenia, anemia, and renal failure. In a multivariate analysis of treatments administered, severity of illness was the greatest predictor of reduced survival. CONCLUSIONS: Care for patients with MERS-CoV remains a challenge. In this retrospective cohort, interferon beta and mycophenolate mofetil treatment were predictors of increased survival in the univariate analysis. Severity of illness was the greatest predictor of reduced survival in the multivariate analysis. Larger randomized trials are needed to better evaluate the efficacy of these treatment regimens for MERS-CoV. SN - 1471-2334 UR - https://www.unboundmedicine.com/medline/citation/27097824/Treatment_outcomes_for_patients_with_Middle_Eastern_Respiratory_Syndrome_Coronavirus__MERS_CoV__infection_at_a_coronavirus_referral_center_in_the_Kingdom_of_Saudi_Arabia_ L2 - https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-016-1492-4 DB - PRIME DP - Unbound Medicine ER -