Predictors of MERS-CoV infection: A large case control study of patients presenting with ILI at a MERS-CoV referral hospital in Saudi Arabia.
BACKGROUND
A case control study to better characterize the clinical features, laboratory, and radiological abnormalities associated with MERS-CoV infection in order to help with early identification of this syndrome from other respiratory infections.


METHODS
Eighty patients admitted to a hospital in Riyadh, diagnosed with MERS-CoV infection based on RT-PCR were matched on age, sex, and the presence of a co-morbid condition on a basis of 1:2 to other patients admitted with respiratory symptoms and tested negative for MERS-CoV on RT-PCR.


RESULTS
None of the reported MERS-CoV presenting symptoms was significantly associated with being infected with MERS-CoV. On the other hand, WBC count was significantly lower in patients with confirmed MERS-CoV infection (median 5.7 vs 9.3, P: 0.0004). Neutrophil count was as well significantly lower in MERS-CoV patients (median 3.7 vs 6.7, P: 0.0001). Both AST, and ALT values were significantly higher in MERS-CoV infected group (AST median 42 vs 36, P: 0.03, and ALT median 33 vs 28, P: 0.003). Overall our MERS-CoV mortality rate was (10%) below the national figure of (40%).


CONCLUSIONS
None of the presenting symptoms are specific for MERS-CoV infection. And out of all the investigations WBC, neutrophil counts, AST and ALT values have some predictive utility.
Infectious Diseases Division, Department of Medicine, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia. Electronic address: dr.hmohd@gmail.com.
Hamzah A
HA
Mohd
Infectious Diseases Division, Department of Medicine, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia. Electronic address: zmemish@yahoo.com.
Ziad A
ZA
Memish
Infection Control Department, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia. Electronic address: alfarajsa@pmah.med.sa.
Sarah H
SH
Alfaraj
Department of Biostatistics at Virginia Commonwealth University, Richmond, VA, USA. Electronic address: donna.mcclish@vcuhealth.org.
Donna
D
McClish
Department of Surgery, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia. Electronic address: altuwaijrit@pmah.med.sa.
Talal
T
Altuwaijri
Emergency Department, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia. Electronic address: Alanazima@pmah.med.sa.
Marzouqah S
MS
Alanazi
Pediatric Department, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia. Electronic address: aloqiels@pmah.med.sa.
Saleh A
SA
Aloqiel
Department of Medicine, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia. Electronic address: alenezia@pmah.med.sa.
Ahmed M
AM
Alenzi
Critical Care Department, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia. Electronic address: bafaqeehf@pmah.med.sa.
Fahad
F
Bafaqeeh
Nursing Department, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia. Electronic address: mohameda@pmah.med.sa.
Amal M
AM
Mohamed
Pathology and Laboratory Department, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia. Electronic address: aldosaryk@pmah.med.sa.
Kamel
K
Aldosari
Medical Affairs, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia. Electronic address: ghazals@pmah.med.sa.
Sameeh
S
Ghazal
D000328:Adult; D016022:Case-Control Studies; D018352:Coronavirus Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000401:mortality / Q000821:virology; D003428:Cross Infection / Q000453:epidemiology / Q000821:virology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D065207:Middle East Respiratory Syndrome Coronavirus / Q000235:genetics / Q000302:isolation & purification*; D011237:Predictive Value of Tests; D060888:Real-Time Polymerase Chain Reaction; D012017:Referral and Consultation; D012529:Saudi Arabia / Q000453:epidemiology; D013909:Thorax / Q000000981:diagnostic imaging; D014965:X-Rays
Coronavirus; MERS-CoV; Middle East Respirator Syndrome; Mortality; Predictors
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