Corona Center, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia; Infectious Diseases Division, Department of Pediatrics, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia; University of British Columbia, Vancouver, BC, Canada.
Speciality Internal Medicine Unit and Quality Department, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Travel Med Infect Dis. 2019 May-Jun;29:48-50. doi: 10.1016/j.tmaid.2019.03.004. Epub 2019 Mar 11.
Since the emergence of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in 2012, the virus had caused a high case fatality rate. The clinical presentation of MERS varied from asymptomatic to severe bilateral pneumonia, depending on the case definition and surveillance strategies. There are few studies examining the mortality predictors in this disease. In this study, we examined clinical predictors of mortality of Middle East Respiratory Syndrome (MERS) infection.
This is a retrospective analysis of symptomatic admitted patients to a large tertiary MERS-CoV center in Saudi Arabia over the period from April 2014 to March 2018. Clinical and laboratory data were collected and analysis was done using a binary regression model.
A total of 314 symptomatic MERS-CoV patients were included in the analysis, with a mean age of 48 (±17.3) years. Of these cases, 78 (24.8%) died. The following parameters were associated with increased mortality, age, WBC, neutrophil count, serum albumin level, use of a continuous renal replacement therapy (CRRT) and corticosteroid use. The odd ratio for mortality was highest for CRRT and corticosteroid use (4.95 and 3.85, respectively). The use of interferon-ribavirin was not associated with mortality in this cohort.
Several factors contributed to increased mortality in this cohort of MERS-CoV patients. Of these factors, the use of corticosteroid and CRRT were the most significant. Further studies are needed to evaluate whether these factors were a mark of severe disease or actual contributors to higher mortality.
自 2012 年中东呼吸综合征冠状病毒（MERS-CoV）出现以来，该病毒已导致高病死率。根据病例定义和监测策略，MERS 的临床表现从无症状到严重双侧肺炎不等。关于该疾病的死亡率预测因素的研究很少。在这项研究中，我们检查了中东呼吸综合征（MERS）感染的死亡率的临床预测因素。
这是对沙特阿拉伯一家大型三级 MERS-CoV 中心在 2014 年 4 月至 2018 年 3 月期间收治的有症状住院患者进行的回顾性分析。收集了临床和实验室数据，并使用二元回归模型进行了分析。
共有 314 例有症状的 MERS-CoV 患者纳入分析，平均年龄为 48（±17.3）岁。其中 78 例（24.8%）死亡。以下参数与死亡率增加相关，年龄、白细胞计数、中性粒细胞计数、血清白蛋白水平、连续肾脏替代治疗（CRRT）和皮质类固醇的使用。死亡率的比值比最高的是 CRRT 和皮质类固醇（分别为 4.95 和 3.85）。在该队列中，干扰素-利巴韦林的使用与死亡率无关。
该 MERS-CoV 患者队列中，有几个因素导致死亡率增加。其中，皮质类固醇和 CRRT 的使用是最显著的因素。需要进一步研究以评估这些因素是否是疾病严重程度的标志，还是导致死亡率更高的实际因素。
