King Abdullah International Medical Research Center (KAIMRC)/King Saud bin Abdulaziz University for Health Sciences (KSAU-HS)/King Abdulaziz Medical City (KAMC), Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia.
King Fahad General Hospital - Jeddah, Jeddah, Saudi Arabia.
Influenza Other Respir Viruses. 2018 Sep;12(5):656-661. doi: 10.1111/irv.12560. Epub 2018 Apr 25.
Research evidence exists that poor prognosis is common in Middle East respiratory syndrome coronavirus (MERS-CoV) patients.
This study estimates recovery delay intervals and identifies associated factors in a sample of Saudi Arabian patients admitted for suspected MERS-CoV and diagnosed by rRT-PCR assay.
A multicenter retrospective study was conducted on 829 patients admitted between September 2012 and June 2016 and diagnosed by rRT-PCR procedures to have MERS-CoV and non-MERS-CoV infection in which 396 achieved recovery. Detailed medical charts were reviewed for each patient who achieved recovery. Time intervals in days were calculated from presentation to the initial rRT-PCR diagnosis (diagnosis delay) and from the initial rRT-PCR diagnosis to recovery (recovery delay).
The median recovery delay in our sample was 5 days. According to the multivariate negative binomial model, elderly (age ≥ 65), MERS-CoV infection, ICU admission, and abnormal radiology findings were associated with longer recovery delay (adjusted relative risk (aRR): 1.741, 2.138, 2.048, and 1.473, respectively). Camel contact and the presence of respiratory symptoms at presentation were associated with a shorter recovery delay (expedited recovery) (aRR: 0.267 and 0.537, respectively). Diagnosis delay is a positive predictor for recovery delay (r = .421; P = .001).
The study evidence supports that longer recovery delay was seen in patients of older age, MERS-CoV infection, ICU admission, and abnormal radiology findings. Shorter recovery delay was found in patients who had camel contact and respiratory symptoms at presentation. These findings may help us understand clinical decision making on directing hospital resources toward prompt screening, monitoring, and implementing clinical recovery and treatment strategies.
有研究证据表明，中东呼吸综合征冠状病毒（MERS-CoV）患者预后较差。
本研究旨在估计沙特阿拉伯疑似 MERS-CoV 感染并经逆转录聚合酶链反应（rRT-PCR）检测确诊患者的恢复延迟时间，并分析其相关影响因素。
对 2012 年 9 月至 2016 年 6 月期间因疑似 MERS-CoV 感染住院并经 rRT-PCR 检测确诊的 829 例患者进行了一项多中心回顾性研究，其中 396 例患者痊愈。对每位痊愈患者的详细病历进行了回顾。从就诊到首次 rRT-PCR 诊断（诊断延迟）和首次 rRT-PCR 诊断到痊愈（恢复延迟）的时间间隔以天数计算。
本研究样本的中位恢复延迟时间为 5 天。根据多变量负二项回归模型，年龄≥65 岁、MERS-CoV 感染、入住重症监护病房（ICU）和影像学异常与恢复延迟时间延长有关（校正相对风险（aRR）：1.741、2.138、2.048 和 1.473）。骆驼接触和就诊时存在呼吸系统症状与恢复时间缩短（快速恢复）有关（aRR：0.267 和 0.537）。诊断延迟是恢复延迟的正向预测因素（r=0.421；P=0.001）。
本研究结果表明，年龄较大、MERS-CoV 感染、入住 ICU 和影像学异常的患者恢复延迟时间较长。就诊时与骆驼接触和存在呼吸系统症状的患者恢复延迟时间较短。这些发现可能有助于我们了解临床决策，以便及时进行筛查、监测，并实施临床康复和治疗策略。
