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. 2016 Jun;48(2):118-26.
doi: 10.3947/ic.2016.48.2.118. Epub 2016 Jun 30.

Clinical Presentation and Outcomes of Middle East Respiratory Syndrome in the Republic of Korea

Won Suk Choi  1 , Cheol-In Kang  2 , Yonjae Kim  3 , Jae-Phil Choi  4 , Joon Sung Joh  5 , Hyoung-Shik Shin  3 , Gayeon Kim  3 , Kyong Ran Peck  2 , Doo Ryeon Chung  2 , Hye Ok Kim  4 , Sook Hee Song  4 , Yang Ree Kim  6 , Kyung Mok Sohn  7 , Younghee Jung  8 , Ji Hwan Bang  9 , Nam Joong Kim  9 , Kkot Sil Lee  10 , Hye Won Jeong  11 , Ji-Young Rhee  12 , Eu Suk Kim  13 , Heungjeong Woo  14 , Won Sup Oh  15 , Kyungmin Huh  16 , Young Hyun Lee  17 , Joon Young Song  1 , Jacob Lee  14 , Chang-Seop Lee  18 , Baek-Nam Kim  19 , Young Hwa Choi  20 , Su Jin Jeong  21 , Jin-Soo Lee  22 , Ji Hyun Yoon  23 , Yu Mi Wi  24 , Mi Kyong Joung  25 , Seong Yeon Park  26 , Sun Hee Lee  27 , Sook-In Jung  28 , Shin-Woo Kim  29 , Jae Hoon Lee  30 , Hyuck Lee  31 , Hyun Kyun Ki  32 , Yeon-Sook Kim  7 ; Korean Society of Infectious Diseases
Affiliations

Clinical Presentation and Outcomes of Middle East Respiratory Syndrome in the Republic of Korea

Won Suk Choi et al. Infect Chemother. 2016 Jun.

Abstract

Background: From May to July 2015, the Republic of Korea experienced the largest outbreak of Middle East respiratory syndrome (MERS) outside the Arabian Peninsula. A total of 186 patients, including 36 deaths, had been diagnosed with MERS-coronavirus (MERS-CoV) infection as of September 30th, 2015.

Materials and methods: We obtained information of patients who were confirmed to have MERS-CoV infection. MERS-CoV infection was diagnosed using real-time reverse-transcriptase polymerase chain reaction assay.

Results: The median age of the patients was 55 years (range, 16 to 86). A total of 55.4% of the patients had one or more coexisting medical conditions. The most common symptom was fever (95.2%). At admission, leukopenia (42.6%), thrombocytopenia (46.6%), and elevation of aspartate aminotransferase (42.7%) were observed. Pneumonia was detected in 68.3% of patients at admission and developed in 80.8% during the disease course. Antiviral agents were used for 74.7% of patients. Mechanical ventilation, extracorporeal membrane oxygenation, and convalescent serum were employed for 24.5%, 7.1%, and 3.8% of patients, respectively. Older age, presence of coexisting medical conditions including diabetes or chronic lung disease, presence of dyspnea, hypotension, and leukocytosis at admission, and the use of mechanical ventilation were revealed to be independent predictors of death.

Conclusion: The clinical features of MERS-CoV infection in the Republic of Korea were similar to those of previous outbreaks in the Middle East. However, the overall mortality rate (20.4%) was lower than that in previous reports. Enhanced surveillance and active management of patients during the outbreak may have resulted in improved outcomes.

Keywords: Middle East respiratory syndrome; Republic of Korea.

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