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Clinical predictors of mortality of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection: A cohort study.
Travel Med Infect Dis. 2019 May - Jun; 29:48-50.TM

Abstract

BACKGROUND

Since the emergence of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in 2012, the virus had caused a high case fatality rate. The clinical presentation of MERS varied from asymptomatic to severe bilateral pneumonia, depending on the case definition and surveillance strategies. There are few studies examining the mortality predictors in this disease. In this study, we examined clinical predictors of mortality of Middle East Respiratory Syndrome (MERS) infection.

METHODS

This is a retrospective analysis of symptomatic admitted patients to a large tertiary MERS-CoV center in Saudi Arabia over the period from April 2014 to March 2018. Clinical and laboratory data were collected and analysis was done using a binary regression model.

RESULTS

A total of 314 symptomatic MERS-CoV patients were included in the analysis, with a mean age of 48 (±17.3) years. Of these cases, 78 (24.8%) died. The following parameters were associated with increased mortality, age, WBC, neutrophil count, serum albumin level, use of a continuous renal replacement therapy (CRRT) and corticosteroid use. The odd ratio for mortality was highest for CRRT and corticosteroid use (4.95 and 3.85, respectively). The use of interferon-ribavirin was not associated with mortality in this cohort.

CONCLUSION

Several factors contributed to increased mortality in this cohort of MERS-CoV patients. Of these factors, the use of corticosteroid and CRRT were the most significant. Further studies are needed to evaluate whether these factors were a mark of severe disease or actual contributors to higher mortality.

Authors+Show Affiliations

Corona Center, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia; Infectious Diseases Division, Department of Pediatrics, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia; University of British Columbia, Vancouver, BC, Canada.Speciality Internal Medicine Unit and Quality Department, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.Critical Care Department, Prince Mohammed Bin Abdulaziz Hospital, Ministry of Health, Saudi Arabia.Corona Center, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia.Corona Center, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia.College of Medicine, Alfaisal University, Riyadh, Saudi Arabia; Infectious Diseases Division, Department of Medicine, Department of Research, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA. Electronic address: zmemish@yahoo.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30872071

Citation

Alfaraj, Sarah H., et al. "Clinical Predictors of Mortality of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Infection: a Cohort Study." Travel Medicine and Infectious Disease, vol. 29, 2019, pp. 48-50.
Alfaraj SH, Al-Tawfiq JA, Assiri AY, et al. Clinical predictors of mortality of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection: A cohort study. Travel Med Infect Dis. 2019;29:48-50.
Alfaraj, S. H., Al-Tawfiq, J. A., Assiri, A. Y., Alzahrani, N. A., Alanazi, A. A., & Memish, Z. A. (2019). Clinical predictors of mortality of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection: A cohort study. Travel Medicine and Infectious Disease, 29, 48-50. https://doi.org/10.1016/j.tmaid.2019.03.004
Alfaraj SH, et al. Clinical Predictors of Mortality of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Infection: a Cohort Study. Travel Med Infect Dis. 2019 May - Jun;29:48-50. PubMed PMID: 30872071.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical predictors of mortality of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection: A cohort study. AU - Alfaraj,Sarah H, AU - Al-Tawfiq,Jaffar A, AU - Assiri,Ayed Y, AU - Alzahrani,Nojoom A, AU - Alanazi,Amal A, AU - Memish,Ziad A, Y1 - 2019/03/11/ PY - 2018/10/29/received PY - 2019/02/25/revised PY - 2019/03/06/accepted PY - 2019/3/16/pubmed PY - 2019/7/20/medline PY - 2019/3/16/entrez SP - 48 EP - 50 JF - Travel medicine and infectious disease JO - Travel Med Infect Dis VL - 29 N2 - BACKGROUND: Since the emergence of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in 2012, the virus had caused a high case fatality rate. The clinical presentation of MERS varied from asymptomatic to severe bilateral pneumonia, depending on the case definition and surveillance strategies. There are few studies examining the mortality predictors in this disease. In this study, we examined clinical predictors of mortality of Middle East Respiratory Syndrome (MERS) infection. METHODS: This is a retrospective analysis of symptomatic admitted patients to a large tertiary MERS-CoV center in Saudi Arabia over the period from April 2014 to March 2018. Clinical and laboratory data were collected and analysis was done using a binary regression model. RESULTS: A total of 314 symptomatic MERS-CoV patients were included in the analysis, with a mean age of 48 (±17.3) years. Of these cases, 78 (24.8%) died. The following parameters were associated with increased mortality, age, WBC, neutrophil count, serum albumin level, use of a continuous renal replacement therapy (CRRT) and corticosteroid use. The odd ratio for mortality was highest for CRRT and corticosteroid use (4.95 and 3.85, respectively). The use of interferon-ribavirin was not associated with mortality in this cohort. CONCLUSION: Several factors contributed to increased mortality in this cohort of MERS-CoV patients. Of these factors, the use of corticosteroid and CRRT were the most significant. Further studies are needed to evaluate whether these factors were a mark of severe disease or actual contributors to higher mortality. SN - 1873-0442 UR - https://www.unboundmedicine.com/medline/citation/30872071/Clinical_predictors_of_mortality_of_Middle_East_Respiratory_Syndrome_Coronavirus__MERS_CoV__infection:_A_cohort_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1477-8939(18)30382-X DB - PRIME DP - Unbound Medicine ER -