Choi Won Suk, Kang Cheol-In, Kim Yonjae, Choi Jae-Phil, Joh Joon Sung, Shin Hyoung-Shik, Kim Gayeon, Peck Kyong Ran, Chung Doo Ryeon, Kim Hye Ok, Song Sook Hee, Kim Yang Ree, Sohn Kyung Mok, Jung Younghee, Bang Ji Hwan, Kim Nam Joong, Lee Kkot Sil, Jeong Hye Won, Rhee Ji-Young, Kim Eu Suk, Woo Heungjeong, Oh Won Sup, Huh Kyungmin, Lee Young Hyun, Song Joon Young, Lee Jacob, Lee Chang-Seop, Kim Baek-Nam, Choi Young Hwa, Jeong Su Jin, Lee Jin-Soo, Yoon Ji Hyun, Wi Yu Mi, Joung Mi Kyong, Park Seong Yeon, Lee Sun Hee, Jung Sook-In, Kim Shin-Woo, Lee Jae Hoon, Lee Hyuck, Ki Hyun Kyun, Kim Yeon-Sook
Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Infect Chemother. 2016 Jun;48(2):118-26. doi: 10.3947/ic.2016.48.2.118. Epub 2016 Jun 30.
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.
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.
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.
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.
2015年5月至7月，大韩民国经历了阿拉伯半岛以外最大规模的中东呼吸综合征（MERS）疫情。截至2015年9月30日，共有186例患者被诊断为中东呼吸综合征冠状病毒（MERS-CoV）感染，其中36例死亡。
我们获取了确诊为MERS-CoV感染患者的信息。采用实时逆转录聚合酶链反应检测法诊断MERS-CoV感染。
患者的中位年龄为55岁（范围16至86岁）。共有55.4%的患者有一种或多种并存的基础疾病。最常见的症状是发热（95.2%）。入院时，观察到白细胞减少（42.6%）、血小板减少（46.6%）和天冬氨酸转氨酶升高（42.7%）。68.3%的患者入院时检测到肺炎，病程中80.8%的患者出现肺炎。74.7%的患者使用了抗病毒药物。分别有24.5%、7.1%和3.8%的患者使用了机械通气、体外膜肺氧合和恢复期血清。年龄较大、存在包括糖尿病或慢性肺病在内的并存基础疾病、入院时存在呼吸困难、低血压和白细胞增多以及使用机械通气被发现是死亡的独立预测因素。
大韩民国MERS-CoV感染的临床特征与中东先前疫情相似。然而，总体死亡率（20.4%）低于先前报告。疫情期间加强监测和对患者的积极管理可能导致了更好的结果。
