Patient characteristics infected with Middle East respiratory syndrome coronavirus infection in a tertiary hospital

Alraddadi, Basem; Bawareth, Noha; Omar, Haneen; Alsalmi, Hanadi; Alshukairi, Abeer N.; Qushmaq, Ismael; Feteih, Maun; Qutob, Mohammed; Wali, Ghassan; Khalid, Imran

doi:10.4103/1817-1737.180027

Cited by 32 publications

(15 citation statements)

References 11 publications

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“…Effective nosocomial transmission and consequent hospital outbreaks posed a major challenge on HCWs. A number of single center MERS cohort studies included affected HCWs[ 5 , 13 ]. The numbers of included HCWs, however, in each of those studies are very few, and some of whom had minimal or no symptoms.…”

Section: Discussionmentioning

confidence: 99%

Critically ill healthcare workers with the middle east respiratory syndrome (MERS): A multicenter study

et al. 2018

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BackgroundMiddle East Respiratory Syndrome Coronavirus (MERS-CoV) leads to healthcare-associated transmission to patients and healthcare workers with potentially fatal outcomes.AimWe aimed to describe the clinical course and functional outcomes of critically ill healthcare workers (HCWs) with MERS.MethodsData on HCWs was extracted from a multi-center retrospective cohort study on 330 critically ill patients with MERS admitted between (9/2012–9/2015). Baseline demographics, interventions and outcomes were recorded and compared between survivors and non-survivors. Survivors were approached with questionnaires to elucidate their functional outcomes using Karnofsky Performance Status Scale.FindingsThirty-Two HCWs met the inclusion criteria. Comorbidities were recorded in 34% (11/32) HCW. Death resulted in 8/32 (25%) HCWs including all 5 HCWs with chronic renal impairment at baseline. Non-surviving HCW had lower PaO2/FiO2 ratios 63.5 (57, 116.2) vs 148 (84, 194.3), p = 0.043, and received more ECMO therapy compared to survivors, 9/32 (28%) vs 4/24 (16.7%) respectively (p = 0.02).Thirteen of the surviving (13/24) HCWs responded to the questionnaire. Two HCWs confirmed functional limitations. Median number of days from hospital discharge until the questionnaires were filled was 580 (95% CI 568, 723.5) days.ConclusionApproximately 10% of critically ill patients with MERS were HCWs. Hospital mortality rate was substantial (25%). Patients with chronic renal impairment represented a particularly high-risk group that should receive extra caution during suspected or confirmed MERS cases clinical care assignment and during outbreaks. Long-term repercussions of critical illness due to MERS on HCWs in particular, and patients in general, remain unknown and should be investigated in larger studies.

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Section: Discussionmentioning

confidence: 99%

Critically ill healthcare workers with the middle east respiratory syndrome (MERS): A multicenter study

et al. 2018

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“…Only 4 (17%) required ICU admission and one (4%) died. In other case series of MERS, significant proportions have been HCW, but the clinical features of the HCW and non HCW MERS patients have not been systematically compared [6,8,16]. It is clear that the overall clinical presentation and outcomes in HCW and non-HCW MERS is markedly different.…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study of Clinical Presentation and Risk Factors for Adverse Outcome in Patients Hospitalised with Acute Respiratory Disease Due to MERS Coronavirus or Other Causes

et al. 2016

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Middle East Respiratory syndrome (MERS) first emerged in Saudi Arabia in 2012 and remains a global health concern. The objective of this study was to compare the clinical features and risk factors for adverse outcome in patients with RT-PCR confirmed MERS and in those with acute respiratory disease who were MERS-CoV negative, presenting to the King Fahad Medical City (KFMC) in Riyadh between October 2012 and May 2014. The demographics, clinical and laboratory characteristics and clinical outcomes of patients with RT-PCR confirmed MERS-CoV infection was compared with those testing negative MERS-CoV PCR. Health care workers (HCW) with MERS were compared with MERS patients who were not health care workers. One hundred and fifty nine patients were eligible for inclusion. Forty eight tested positive for MERS CoV, 44 (92%) being hospital acquired infections and 23 were HCW. There were 111 MERS-CoV negative patients with acute respiratory illnesses included in this study as “negative controls”. Patient with confirmed MERS-CoV infection were not clinically distinguishable from those with negative MERS-CoV RT-PCR results although diarrhoea was commoner in MERS patients. A high level of suspicion in initiating laboratory tests for MERS-CoV is therefore indicated. Variables associated with adverse outcome were older age and diabetes as a co-morbid illness. Interestingly, co-morbid illnesses other than diabetes were not significantly associated with poor outcome. Health care workers with MERS had a markedly better clinical outcome compared to non HCW MERS patients.

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“…This interest is further enhanced by the fact that MERS-CoV infection resulted in 2428 cases in 27 countries around the world as of June 23, 2019 [1] and most of the cases are linked to the Middle East [2]. So far there have been three patterns of the transmission of MERS-CoV virus mainly: sporadic cases [3], intra-familial transmissions [4][5][6] and healthcare-associated transmission [3,[7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]. The disease carries a high case fatality rate of 34.5% [1] and so far there has been no proven effective therapy and no approved therapies for MERS-CoV infection by international or national societies.…”

Section: Introductionmentioning

confidence: 99%

A Systematic Review of therapeutic agents for the treatment of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV)

Momattin

Al-Ali

Al‐Tawfiq

2019

Travel Medicine and Infectious Disease

114

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Direct. Based on the inclusions and exclusions criteria, 30 articles were included in the final review and comprised: 22 in vitro studies, 8 studies utilizing animal models, 13 studies in humans, and one study included both in vitro and animal model. There are a few promising therapeutic agents on the horizon. The combination of lopinavir/ritonavir and interferon-beta-1b showed excellent results in common marmosets and currently is in a randomized control trial. Ribavirin and interferon were the most widely used combination and experience comes from a number of observational studies. Although, the data are heterogenous, this combination might be of potential benefit and deserve further investigation. There were no randomized clinical trials to recommend specific therapy for the treatment of MERS-CoV infection. Only one such study is planned for randomization and is pending completion. The study is based on a combination of lopinavir/ritonavir and interferon-beta-1b. A fully human polyclonal IgG antibody (SAB-301) was safe and well tolerated in healthy individuals and this agent may deserve further testing for efficacy. Conclusion: Despite multiple studies in humans there is no consensus on the optimal therapy for MERS-CoV. Randomized clinical trials are needed and potential therapies should be evaluated only in such clinical trials. In order to further enhance the therapeutic aroma for MERS-CoV infection, repurposing old drugs against MERS-CoV is an interesting strategy and deserves further consideration and use in clinical settings.

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Patient characteristics infected with Middle East respiratory syndrome coronavirus infection in a tertiary hospital

Cited by 32 publications

References 11 publications

Critically ill healthcare workers with the middle east respiratory syndrome (MERS): A multicenter study

Critically ill healthcare workers with the middle east respiratory syndrome (MERS): A multicenter study

A Comparative Study of Clinical Presentation and Risk Factors for Adverse Outcome in Patients Hospitalised with Acute Respiratory Disease Due to MERS Coronavirus or Other Causes

A Systematic Review of therapeutic agents for the treatment of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV)

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