title: Clinical aspects and outcomes of 70 patients with Middle East respiratory syndrome coronavirus infection: a single-center experience in Saudi Arabia.
abstract: OBJECTIVE
  To report the experience with Middle East respiratory syndrome coronavirus (MERS-CoV) infection at a single center in Saudi Arabia.
  
  
  METHODS
  Cases of laboratory-confirmed MERS-CoV occurring from October 1, 2012 to May 31, 2014 were reviewed retrospectively. Information sources included medical files, infection control outbreak investigations, and the preventive medicine database of MERS-CoV-infected patients. Data were collected on clinical and epidemiological aspects and outcomes.
  
  
  RESULTS
  Seventy consecutive patients were included. Patients were mostly of older age (median 62 years), male (46, 65.7%), and had healthcare acquisition of infection (39, 55.7%). Fever (43, 61.4%), dyspnea (42, 60%), and cough (38, 54.3%) were the most common symptoms. The majority developed pneumonia (63, 90%) and required intensive care (49, 70%). Infection commonly occurred in clusters. Independent risk factors for severe infection requiring intensive care included concomitant infections (odds ratio (OR) 14.13, 95% confidence interval (CI) 1.58-126.09; p=0.018) and low albumin (OR 6.31, 95% CI 1.24-31.90; p=0.026). Mortality was high (42, 60%), and age ≥65 years was associated with increased mortality (OR 4.39, 95% CI 2.13-9.05; p<0.001).
  
  
  CONCLUSIONS
  MERS-CoV can cause severe infection requiring intensive care and has a high mortality. Concomitant infections and low albumin were found to be predictors of severe infection, while age ≥65 years was the only predictor of increased mortality.
authors.affiliation: Division of Infectious Diseases, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Saad
authors.affiliation: Division of Infectious Diseases, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia; King Saud University, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Ali S
authors.initials: AS
authors.lastname: Omrani
authors.affiliation: Department of Infection Prevention and Control, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Kamran
authors.initials: K
authors.lastname: Baig
authors.affiliation: Division of Infectious Diseases, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Abdelkarim
authors.initials: A
authors.lastname: Bahloul
authors.affiliation: Division of Infectious Diseases, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Fatehi
authors.initials: F
authors.lastname: Elzein
authors.affiliation: Department of Medicine, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Mohammad Abdul
authors.initials: MA
authors.lastname: Matin
authors.affiliation: Department of Family and Community Medicine, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Mohei A A
authors.initials: MA
authors.lastname: Selim
authors.affiliation: Department of Radiology, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Al Mutairi
authors.affiliation: Division of Infectious Diseases, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia; Department of Infection Prevention and Control, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Daifullah
authors.initials: D
authors.lastname: Al Nakhli
authors.affiliation: Division of Infectious Diseases, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia; Department of Infection Prevention and Control, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Amal Y
authors.initials: AY
authors.lastname: Al Aidaroos
authors.affiliation: Division of Infectious Diseases, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Nisreen
authors.initials: N
authors.lastname: Al Sherbeeni
authors.affiliation: Department of Family and Community Medicine, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Hesham I
authors.initials: HI
authors.lastname: Al-Khashan
authors.affiliation: Ministry of Health & college of Medicine, Al-Faisal University, Riyadh, Kingdom of Saudi Arabia. Electronic address: zmemish@yahoo.com.
authors.forename: Ziad A
authors.initials: ZA
authors.lastname: Memish
authors.affiliation: Division of Infectious Diseases, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Ali M
authors.initials: AM
authors.lastname: Albarrak
mesh_terms: D000368:Aged; D018352:Coronavirus Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D065207:Middle East Respiratory Syndrome Coronavirus; D012189:Retrospective Studies; D012529:Saudi Arabia / Q000453:epidemiology
keywords: Clinical; Epidemiology; Middle East respiratory syndrome coronavirus (MERS-CoV); Saudi Arabia