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Presentation and outcome of Middle East respiratory syndrome in Saudi intensive care unit patients.
Crit Care. 2016 May 07; 20(1):123.CC

Abstract

BACKGROUND

Middle East respiratory syndrome coronavirus infection is associated with high mortality rates but limited clinical data have been reported. We describe the clinical features and outcomes of patients admitted to an intensive care unit (ICU) with Middle East respiratory syndrome coronavirus (MERS-CoV) infection.

METHODS

Retrospective analysis of data from all adult (>18 years old) patients admitted to our 20-bed mixed ICU with Middle East respiratory syndrome coronavirus infection between October 1, 2012 and May 31, 2014. Diagnosis was confirmed in all patients using real-time reverse transcription polymerase chain reaction on respiratory samples.

RESULTS

During the observation period, 31 patients were admitted with MERS-CoV infection (mean age 59 ± 20 years, 22 [71 %] males). Cough and tachypnea were reported in all patients; 22 (77.4 %) patients had bilateral pulmonary infiltrates. Invasive mechanical ventilation was applied in 27 (87.1 %) and vasopressor therapy in 25 (80.6 %) patients during the intensive care unit stay. Twenty-three (74.2 %) patients died in the ICU. Nonsurvivors were older, had greater APACHE II and SOFA scores on admission, and were more likely to have received invasive mechanical ventilation and vasopressor therapy. After adjustment for the severity of illness and the degree of organ dysfunction, the need for vasopressors was an independent risk factor for death in the ICU (odds ratio = 18.33, 95 % confidence interval: 1.11-302.1, P = 0.04).

CONCLUSIONS

MERS-CoV infection requiring admission to the ICU is associated with high morbidity and mortality. The need for vasopressor therapy is the main risk factor for death in these patients.

Authors+Show Affiliations

Department of Intensive Care Services, Prince Sultan Military Medical City, Riyadh, 11159, Saudi Arabia. gmekhlafi@yahoo.com.Intensive Care Unit, Prince Sultan Cardiac Center, Riyadh, 11159, Saudi Arabia.Department of Intensive Care Services, Prince Sultan Military Medical City, Riyadh, 11159, Saudi Arabia.Department of Intensive Care Services, Prince Sultan Military Medical City, Riyadh, 11159, Saudi Arabia.Department of Intensive Care Services, Prince Sultan Military Medical City, Riyadh, 11159, Saudi Arabia.Department of Intensive Care Services, Prince Sultan Military Medical City, Riyadh, 11159, Saudi Arabia.Department of Intensive Care Services, Prince Sultan Military Medical City, Riyadh, 11159, Saudi Arabia.Department of Intensive Care Services, Prince Sultan Military Medical City, Riyadh, 11159, Saudi Arabia.Department of Intensive Care Services, Prince Sultan Military Medical City, Riyadh, 11159, Saudi Arabia.Department of Intensive Care Services, Prince Sultan Military Medical City, Riyadh, 11159, Saudi Arabia.Department of Intensive Care Services, Prince Sultan Military Medical City, Riyadh, 11159, Saudi Arabia.Department of Intensive Care Services, Prince Sultan Military Medical City, Riyadh, 11159, Saudi Arabia.Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, 11211, Saudi Arabia.Department of Anesthesiology and Intensive Care, Uniklinikum Jena, 07743, Jena, Germany.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27153800

Citation

Almekhlafi, Ghaleb A., et al. "Presentation and Outcome of Middle East Respiratory Syndrome in Saudi Intensive Care Unit Patients." Critical Care (London, England), vol. 20, no. 1, 2016, p. 123.
Almekhlafi GA, Albarrak MM, Mandourah Y, et al. Presentation and outcome of Middle East respiratory syndrome in Saudi intensive care unit patients. Crit Care. 2016;20(1):123.
Almekhlafi, G. A., Albarrak, M. M., Mandourah, Y., Hassan, S., Alwan, A., Abudayah, A., Altayyar, S., Mustafa, M., Aldaghestani, T., Alghamedi, A., Talag, A., Malik, M. K., Omrani, A. S., & Sakr, Y. (2016). Presentation and outcome of Middle East respiratory syndrome in Saudi intensive care unit patients. Critical Care (London, England), 20(1), 123. https://doi.org/10.1186/s13054-016-1303-8
Almekhlafi GA, et al. Presentation and Outcome of Middle East Respiratory Syndrome in Saudi Intensive Care Unit Patients. Crit Care. 2016 May 7;20(1):123. PubMed PMID: 27153800.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Presentation and outcome of Middle East respiratory syndrome in Saudi intensive care unit patients. AU - Almekhlafi,Ghaleb A, AU - Albarrak,Mohammed M, AU - Mandourah,Yasser, AU - Hassan,Sahar, AU - Alwan,Abid, AU - Abudayah,Abdullah, AU - Altayyar,Sultan, AU - Mustafa,Mohamed, AU - Aldaghestani,Tareef, AU - Alghamedi,Adnan, AU - Talag,Ali, AU - Malik,Muhammad K, AU - Omrani,Ali S, AU - Sakr,Yasser, Y1 - 2016/05/07/ PY - 2016/01/26/received PY - 2016/04/19/accepted PY - 2016/5/8/entrez PY - 2016/5/8/pubmed PY - 2017/1/18/medline KW - Coronavirus KW - Epidemic KW - MERS-CoV KW - Respiratory failure KW - Saudi Arabia SP - 123 EP - 123 JF - Critical care (London, England) JO - Crit Care VL - 20 IS - 1 N2 - BACKGROUND: Middle East respiratory syndrome coronavirus infection is associated with high mortality rates but limited clinical data have been reported. We describe the clinical features and outcomes of patients admitted to an intensive care unit (ICU) with Middle East respiratory syndrome coronavirus (MERS-CoV) infection. METHODS: Retrospective analysis of data from all adult (>18 years old) patients admitted to our 20-bed mixed ICU with Middle East respiratory syndrome coronavirus infection between October 1, 2012 and May 31, 2014. Diagnosis was confirmed in all patients using real-time reverse transcription polymerase chain reaction on respiratory samples. RESULTS: During the observation period, 31 patients were admitted with MERS-CoV infection (mean age 59 ± 20 years, 22 [71 %] males). Cough and tachypnea were reported in all patients; 22 (77.4 %) patients had bilateral pulmonary infiltrates. Invasive mechanical ventilation was applied in 27 (87.1 %) and vasopressor therapy in 25 (80.6 %) patients during the intensive care unit stay. Twenty-three (74.2 %) patients died in the ICU. Nonsurvivors were older, had greater APACHE II and SOFA scores on admission, and were more likely to have received invasive mechanical ventilation and vasopressor therapy. After adjustment for the severity of illness and the degree of organ dysfunction, the need for vasopressors was an independent risk factor for death in the ICU (odds ratio = 18.33, 95 % confidence interval: 1.11-302.1, P = 0.04). CONCLUSIONS: MERS-CoV infection requiring admission to the ICU is associated with high morbidity and mortality. The need for vasopressor therapy is the main risk factor for death in these patients. SN - 1466-609X UR - https://www.unboundmedicine.com/medline/citation/27153800/Presentation_and_outcome_of_Middle_East_respiratory_syndrome_in_Saudi_intensive_care_unit_patients_ L2 - https://ccforum.biomedcentral.com/articles/10.1186/s13054-016-1303-8 DB - PRIME DP - Unbound Medicine ER -