Alfaraj S H, Al-Tawfiq J A, Gautret P, Alenazi M G, Asiri A Y, Memish Z A
Corona Center, Infectious Diseases Division, Department of Pediatrics, Prince Mohammed Bin Abdulaziz Hospital, Ministry of Health, Saudi Arabia.
University of British Columbia, Vancouver, Canada.
New Microbes New Infect. 2018 Aug 11;26:49-52. doi: 10.1016/j.nmni.2018.08.008. eCollection 2018 Nov.
The emergence of Middle East respiratory syndrome coronavirus (MERS-CoV) in September 2012 in Saudi Arabia had attracted the attention of the global health community. In 2017 the Saudi Ministry of Health released a visual triage system with scoring to alert healthcare workers in emergency departments (EDs) and haemodialysis units for the possibility of occurrence of MERS-CoV infection. We performed a retrospective analysis of this visual score to determine its sensitivity and specificity. The study included all cases from 2014 to 2017 in a MERS-CoV referral centre in Riyadh, Saudi Arabia. During the study period there were a total of 2435 suspected MERS cases. Of these, 1823 (75%) tested negative and the remaining 25% tested positive for MERS-CoV by PCR assay. The application of the visual triage score found a similar percentage of MERS-CoV and non-MERS-CoV patients, with each score from 0 to 11. The percentage of patients with a cutoff score of ≥4 was 75% in patients with MERS-CoV infection and 85% in patients without MERS-CoV infection (p 0.0001). The sensitivity and specificity of this cutoff score for MERS-CoV infection were 74.1% and 18.6%, respectively. The sensitivity and specificity of the scoring system were low, and further refinement of the score is needed for better prediction of MERS-CoV infection.
2012年9月中东呼吸综合征冠状病毒（MERS-CoV）在沙特阿拉伯出现，引起了全球卫生界的关注。2017年，沙特卫生部发布了一种带有评分的视觉分诊系统，以提醒急诊科（ED）和血液透析单位的医护人员注意MERS-CoV感染发生的可能性。我们对该视觉评分进行了回顾性分析，以确定其敏感性和特异性。该研究纳入了沙特阿拉伯利雅得一家MERS-CoV转诊中心2014年至2017年的所有病例。在研究期间，共有2435例疑似MERS病例。其中，1823例（75%）检测为阴性，其余25%通过PCR检测MERS-CoV呈阳性。视觉分诊评分的应用发现，MERS-CoV患者和非MERS-CoV患者的比例相似，评分从0到11。MERS-CoV感染患者中临界值分数≥4的患者比例为75%，非MERS-CoV感染患者中这一比例为85%（p<0.0001）。该临界值分数对MERS-CoV感染的敏感性和特异性分别为74.1%和18.6%。该评分系统的敏感性和特异性较低，需要进一步完善评分以更好地预测MERS-CoV感染。
