Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Dec:29:301-6.
doi: 10.1016/j.ijid.2014.09.003. Epub 2014 Oct 7.

Clinical aspects and outcomes of 70 patients with Middle East respiratory syndrome coronavirus infection: a single-center experience in Saudi Arabia

Mustafa Saad  1 , Ali S Omrani  2 , Kamran Baig  3 , Abdelkarim Bahloul  1 , Fatehi Elzein  1 , Mohammad Abdul Matin  4 , Mohei A A Selim  5 , Mohammed Al Mutairi  6 , Daifullah Al Nakhli  7 , Amal Y Al Aidaroos  7 , Nisreen Al Sherbeeni  1 , Hesham I Al-Khashan  5 , Ziad A Memish  8 , Ali M Albarrak  1
Affiliations

Clinical aspects and outcomes of 70 patients with Middle East respiratory syndrome coronavirus infection: a single-center experience in Saudi Arabia

Mustafa Saad et al. Int J Infect Dis. 2014 Dec.

Abstract

Objectives: 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.

Keywords: Clinical; Epidemiology; Middle East respiratory syndrome coronavirus (MERS-CoV); Saudi Arabia.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Distribution of laboratory-confirmed cases of MERS-CoV (primary axis) and suspected cases (secondary axis) by month of diagnosis.
Figure 2
Figure 2
Transmission graph of healthcare-associated clusters in 70 patients with laboratory-confirmed MERS-CoV infection.
See this image and copyright information in PMC

Comment in

References

    1. Zaki A.M., van Boheemen S., Bestebroer T.M., Osterhaus A.D., Fouchier R.A. Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia. N Engl J Med. 2012;367:1814–1820. - PubMed
    1. World Health Organization. Middle East respiratory syndrome coronavirus (MERS-CoV)—summary and literature update as of 11 June 2014. Geneva: WHO; 2014. Available at: http://www.who.int/csr/disease/coronavirus_infections/MERS-CoV_summary_u... (accessed September 20, 2014).
    1. Assiri A., Al-Tawfiq J.A., Al-Rabeeah A.A., Al-Rabiah F.A., Al-Hajjar S., Al-Barrak A. Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study. Lancet Infect Dis. 2013;13:752–761. - PMC - PubMed
    1. The WHO MERS-CoV Research Group State of knowledge and data gaps of Middle East respiratory syndrome coronavirus (MERS-CoV) in humans. PLoS Curr. 2013;5 pii: ecurrents.outbreaks.0bf719e352e7478f8ad85fa30127ddb8. - PMC - PubMed
    1. Dyall J., Coleman C.M., Hart B.J., Venkataraman T., Holbrook M.R., Kindrachuk J. Repurposing of clinically developed drugs for treatment of Middle East respiratory coronavirus infection. Antimicrob Agents Chemother. 2014;58:4885–4893. - PMC - PubMed