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.
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.
King Fahad Medical City, Riyadh, Saudi Arabia.
Musa A
MA
Garbati
King Fahad Medical City, Riyadh, Saudi Arabia.
Shamsudeen F
SF
Fagbo
School of Public Health, The University of Hong Kong, Hong Kong SAR.
Vicky J
VJ
Fang
King Fahad Medical City, Riyadh, Saudi Arabia.
Leila
L
Skakni
King Fahad Medical City, Riyadh, Saudi Arabia.
Mercy
M
Joseph
King Fahad Medical City, Riyadh, Saudi Arabia.
Tariq A
TA
Wani
School of Public Health, The University of Hong Kong, Hong Kong SAR.
Benjamin J
BJ
Cowling
School of Public Health, The University of Hong Kong, Hong Kong SAR.
Malik
M
Peiris
King Fahad Medical City, Riyadh, Saudi Arabia.
Ahmed
A
Hakawi
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D018352:Coronavirus Infections / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D065207:Middle East Respiratory Syndrome Coronavirus / Q000502:physiology*; D011379:Prognosis; D012307:Risk Factors; D055815:Young Adult