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. 2017 Jul 31;12(7):e0181215.
doi: 10.1371/journal.pone.0181215. eCollection 2017.

Spatial modelling of contribution of individual level risk factors for mortality from Middle East respiratory syndrome coronavirus in the Arabian Peninsula

Oyelola A Adegboye  1 , Ezra Gayawan  2 , Fahad Hanna  3
Affiliations

Spatial modelling of contribution of individual level risk factors for mortality from Middle East respiratory syndrome coronavirus in the Arabian Peninsula

Oyelola A Adegboye et al. PLoS One. .

Abstract

Background: Middle East respiratory syndrome coronavirus is a contagious respiratory pathogen that is contracted via close contact with an infected subject. Transmission of the pathogen has occurred through animal-to-human contact at first followed by human-to-human contact within families and health care facilities.

Data and methods: This study is based on a retrospective analysis of the Middle East respiratory syndrome coronavirus outbreak in the Kingdom of Saudi Arabia between June 2012 and July 2015. A Geoadditive variable model for binary outcomes was applied to account for both individual level risk factors as well spatial variation via a fully Bayesian approach.

Results: Out of 959 confirmed cases, 642 (67%) were males and 317 (33%) had died. Three hundred and sixty four (38%) cases occurred in Ar Riyad province, while 325 (34%) cases occurred in Makkah. Individuals with some comorbidity had a significantly higher likelihood of dying from MERS-CoV compared with those who did not suffer comorbidity [Odds ratio (OR) = 2.071; 95% confidence interval (CI): 1.307, 3.263]. Health-care workers were significantly less likely to die from the disease compared with non-health workers [OR = 0.372, 95% CI: 0.151, 0.827]. Patients who had fatal clinical experience and those with clinical and subclinical experiences were equally less likely to die from the disease compared with patients who did not have fatal clinical experience and those without clinical and subclinical experiences respectively. The odds of dying from the disease was found to increase as age increased beyond 25 years and was much higher for individuals with any underlying comorbidities.

Conclusion: Interventions to minimize mortality from the Middle East respiratory syndrome coronavirus should particularly focus individuals with comorbidity, non-health-care workers, patients with no clinical fatal experience, and patients without any clinical and subclinical experiences.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Map of Kingdom of Saudi Arabia showing the distribution of (a) the number of MERS cases in the 13 regions of Saudi Arabia, (b) the crude mortality rate for MERS-CoV disease.
The maps are based on regional aggregated counts of MERS cases over the study period.
Fig 2
Fig 2. Pyramids showing the distribution of mortality among infected individuals with some kind of comorbidity (top) and health-care workers (HCW, bottom), in the 13 regions of Saudi Arabia.
The horizontal axis represents the number of MERS cases.
Fig 3
Fig 3. Posterior means of nonlinear effects of age on mortality due to MERS-CoV patients (a) without any underlying comorbidities, (b) with some kind of underlying comorbidities, together with 95% credible interval, adjusted for other covariates.
Fig 4
Fig 4. Map showing the posterior means of spatial effects in mortality due to MERS-CoV.
See this image and copyright information in PMC

References

    1. Van Doremalen N, Bushmaker T, Munster VJ. Stability of Middle East respiratory syndrome coronavirus (MERS-CoV) under different environmental conditions. Euro Surveill. 2013;18(38):20590 10.2807/1560-7917.ES2013.18.38.20590 - DOI - PubMed
    1. Cauchemez S, Van Kerkhove M, Riley S, Donnelly C, Fraser C, Ferguson N. Transmission scenarios for Middle East Respiratory Syndrome Coronavirus (MERS-CoV) and how to tell them apart. Euro surveillance: bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin. 2013;18(24). - PMC - PubMed
    1. Yao Y, Bao L, Deng W, Xu L, Li F, Lv Q, et al. An animal model of MERS produced by infection of rhesus macaques with MERS coronavirus. Journal of Infectious Diseases. 2014;209(2):236–242. 10.1093/infdis/jit590 - DOI - PMC - PubMed
    1. Raj VS, Osterhaus AD, Fouchier RA, Haagmans BL. MERS: emergence of a novel human coronavirus. Current opinion in virology. 2014;5:58–62. 10.1016/j.coviro.2014.01.010 - DOI - PMC - PubMed
    1. Graham RL, Donaldson EF, Baric RS. A decade after SARS: strategies for controlling emerging coronaviruses. Nature Reviews Microbiology. 2013;11(12):836–848. 10.1038/nrmicro3143 - DOI - PMC - PubMed

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