Predictive factors for pneumonia development and progression to respiratory failure in MERS-CoV infected patients

Ko, Jae-Hoon; Park, Ga Eun; Lee, Ji Yong; Cho, Sun Young; Ha, Young Eun; Kang, Cheol In; Kang, Jeung-Mo; Kim, Yae Jean; Huh, Hee Jae; Ki, Chang Seok; Jeong, Byeong‐Ho; Park, Jinkyeong; Chung, Chi Ryang; Chung, Doo Ryeon; Song, Jae Hoon; Peck, Kyong Ran

doi:10.1016/j.jinf.2016.08.005

Cited by 132 publications

(139 citation statements)

References 31 publications

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“…In addition, out study demonstrated that patients' age and comorbidity did not differ significantly between intubation and nonintubation groups in patients with MERS pneumonia. These results are in contrast with the previous reports, including one by Das et al, which suggested that geriatric immunocompromised patients with MERS are at higher risk of fatal outcomes [15][16][17][18]. We found out that development of MERS pneumonia, rather than final outcome, was more frequently noted in patients with comorbidities.…”

Section: Discussioncontrasting

confidence: 99%

“…One of the unique issues of Korean MERS outbreak is the so-called, super-spreaders, who resulted in extremely high human-to-human transmission rate. A total of 136 cases (73.1%) among 186 MERS patients of Korean outbreak, were actually transmitted from only three patients [8,18]. A recent report by Ko et al, specified the presence of radiographic abnormality, indicating MERS pneumonia in all three patients suspected of super spreading the infection [18].…”

Section: Discussionmentioning

confidence: 99%

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Clinical implication of radiographic scores in acute Middle East respiratory syndrome coronavirus pneumonia: Report from a single tertiary-referral center of South Korea

Jae

Chung

Kim

et al. 2018

European Journal of Radiology

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A B S T R A C TThe aim of this study is to determine the earliest cutoff of radiographic score as a potential prognostic indicator of fatal outcomes in patients with acute Middle East respiratory syndrome coronavirus (MERS-CoV) pneumonia. The institutional review board approved this retrospective study. Serial chest radiographies (CXRs) were obtained from viral exposure until death or discharge in 35 patients with laboratory confirmed MERS-CoV infection. Radiographic scores were calculated by multiplying a four-point scale of involved lung area and threepoint scale of abnormal opacification, in each of the six lung zones. Receiver operating characteristics (ROC) analyses were performed to identify optimal day and radiographic score for the prediction of respiratory distress, and univariate and multivariate logistic regression analyses were performed to assess significant predictive factors for intubation or tracheostomy. Among 35 patients (22 men, 13 women; median age: 48 years), 25 demonstrated abnormal opacity on CXR (MERS pneumonia), whereas no abnormality was detected in 10 patients (MERS upper respiratory tract infection). Seven patients required ventilator support (intubation group) and three of them eventually expired. The average incubation period was 5.4 days (standard deviation, ± 2.8; range, 2-11). Patients in the intubation group had a higher incidence of diffuse lung involvement, higher radiographic scores, and fibrosing sequela on follow up study compared with those in the non-intubation group. However, patients' age and comorbidity did not differ significantly between the two groups. The ROC analysis revealed an area under curve of 0.726 for the radiographic score on day 10 with an optimal cutoff score of 10 for prediction of intubation, with a sensitivity of 71% and specificity of 67%. Our study suggest that MERS patients with radiographic score > 10 on day 10 from viral exposure require aggressive therapy with careful surveillance and follow-up evaluation.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical implication of radiographic scores in acute Middle East respiratory syndrome coronavirus pneumonia: Report from a single tertiary-referral center of South Korea

Jae

Chung

Kim

et al. 2018

European Journal of Radiology

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“…The patients with at least two, one and none of the predictive pneumonia factors developed pneumonia in 100%, 50% and 0% of cases, respectively [61].…”

Section: Risk Factors For Severe Mersmentioning

confidence: 99%

“…The three most frequent symptoms are: fever (77% [IQR: 59-82]), cough (90% [52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69]), and dyspnea (68% ).…”

Section: Clinical Symptomsmentioning

confidence: 99%

Focus on Middle East respiratory syndrome coronavirus (MERS-CoV)

Bleibtreu

Bertine

Bertin

et al. 2020

Médecine et Maladies Infectieuses

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a b s t r a c tSince the first case of human infection by the Middle East respiratory syndrome coronavirus (MERS-CoV) in Saudi Arabia in June 2012, more than 2260 cases of confirmed MERS-CoV infection and 803 related deaths have been reported since the 16th of October 2018. The vast majority of these cases (71%) were reported in Saudi Arabia but the epidemic has now spread to 27 countries and has not ceased 6 years later, unlike SARS-CoV that disappeared a little less than 2 years after emerging. Due to the high fatality rate observed in MERS-CoV infected patients (36%), much effort has been put into understanding the origin and pathophysiology of this novel coronavirus to prevent it from becoming endemic in humans. This review focuses in particular on the origin, epidemiology and clinical manifestations of MERS-CoV, as well as the diagnosis and treatment of infected patients. The experience gained over recent years on how to manage the different risks related to this kind of epidemic will be key to being prepared for future outbreaks of communicable disease. Mots clés : Maladies émergentes MERS-CoV Coronavirus Pneumonie r é s u m é Depuis le premier cas d'infection liée au Middle East Respiratory Syndrome -Coronavirus (MERS-CoV), détecté en Arabie Saoudite en juin 2012, le MERS-CoV a donné lieu, au 16 octobre 2018, à plus de 2260 cas d'infections confirmées et à 803 décès. La grande majorité des cas (71 %) ont été déclarés en ArabieSaoudite mais l'épidémie a depuis touché 27 pays et n'est toujours pas enrayée 6 ans après son émergence, contrairement au SRAS-CoV qui a disparu un peu moins de deux ans après sa première détection. En raison du taux important de décès observé parmi les patients infectés par le MERS-CoV (36 %), beaucoup d'efforts ont été déployés pour comprendre l'origine et la physiopathologie de ce nouveau coronavirus ainsi que pour lutter contre une éventuelle installation endémique de ce virus au sein de la population humaine. Cette revue s'attache plus particulièrement à retracer l'origine et l'épidémiologie du MERS-CoV à décrire la clinique observée chez les patients ainsi que la prise en charge diagnostique et thérapeutique des patients infectés. L'expérience acquise au cours des dernières années dans la gestion des différents risques liés à ce type d'épidémie est importante pour pouvoir faire face à la prochaine émergence d'infection transmissible.

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“…4 Multiple health care−associated outbreaks were described mainly in the Kingdom of Saudi Arabia 5,6 and 1 large outbreak in South Korea spanning >17 health care settings. 7,8 In a systematic screening of all admitted patients with community-acquired pneumonia to a hospital in Saudi Arabia, only 20 (0.74%) of 2,657 screened patients were positive for MERS-CoV by polymerase chain reaction testing. 9 The spectrum of MERS-CoV infection ranges from mild to severe and fulminant infections with severe acute respiratory disease.…”

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confidence: 99%

Middle East respiratory syndrome coronavirus in the last two years: Health care workers still at risk

Al‐Tawfiq

Memish

2019

American Journal of Infection Control

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Background: An important emerging respiratory virus is the Middle East respiratory syndrome coronavirus (MERS-CoV). MERS-CoV had been associated with a high case fatality rate especially among severe cases. Methods: This is a retrospective analysis of reported MERS-CoV cases between December 2016 and January 2019, as retrieved from the World Health Organization. The aim of this study is to examine the epidemiology of reported cases and quantify the percentage of health care workers (HCWs) among reported cases. Results: There were 403 reported cases with a majority being men (n = 300; 74.4%). These cases were reported from Lebanon, Malaysia, Oman, Qatar, Saudi Arabia, and United Arab Emirates. HCWs represented 26% and comorbidities were reported among 71% of non-HCWs and 1.9% among HCWs (P < .0001). Camel exposure and camel milk ingestion were reported in 64% each, and the majority (97.8%) of those with camel exposures had camel milk ingestion. There were 58% primary cases and 42% were secondary cases. The case fatality rate was 16% among HCWs compared with 34% among other patients (P = .001). The mean age § SD was 47.65 § 16.28 for HCWs versus 54.23 § 17.34 for non-HCWs (P = .001). Conclusions: MERS-CoV infection continues to have a high case fatality rate and a large proportion of patients were HCWs. Further understanding of the disease transmission and prevention mainly in health care settings are needed.

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Predictive factors for pneumonia development and progression to respiratory failure in MERS-CoV infected patients

Abstract: For successful control of MERS outbreak, MERS-CoV infected patients with ≥ two predictive factors should be intensively managed from the initial presentation.

Cited by 132 publications

References 31 publications

Clinical implication of radiographic scores in acute Middle East respiratory syndrome coronavirus pneumonia: Report from a single tertiary-referral center of South Korea

Clinical implication of radiographic scores in acute Middle East respiratory syndrome coronavirus pneumonia: Report from a single tertiary-referral center of South Korea

Focus on Middle East respiratory syndrome coronavirus (MERS-CoV)

Middle East respiratory syndrome coronavirus in the last two years: Health care workers still at risk

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