Clinical characteristics and outcome of ICU admitted MERS corona virus infected patients
Middle East Respiratory Syndrome (MERS) is a novel respiratory illness firstly reported in Saudi Arabia in 2012. It is caused by a new corona virus, called MERS corona virus (MERS-CoV). Most people who have MERS-CoV infection developed severe acute respiratory illness. Aim of the work: This work is...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2016-01-01
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| Series: | Egyptian Journal of Chest Disease and Tuberculosis |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0422763815301199 |
| _version_ | 1818063374985986048 |
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| author | Ashraf Abdel Halim Badr Alsayed Sameh Embarak Taha Yaseen Salwa Dabbous |
| author_facet | Ashraf Abdel Halim Badr Alsayed Sameh Embarak Taha Yaseen Salwa Dabbous |
| author_sort | Ashraf Abdel Halim |
| collection | DOAJ |
| description | Middle East Respiratory Syndrome (MERS) is a novel respiratory illness firstly reported in Saudi Arabia in 2012. It is caused by a new corona virus, called MERS corona virus (MERS-CoV). Most people who have MERS-CoV infection developed severe acute respiratory illness.
Aim of the work: This work is done to determine the clinical characteristics and the outcome of intensive care unit (ICU) admitted patients with confirmed MERS-CoV infection.
Patients and methods: This study included 32 laboratory confirmed MERS corona virus infected patients who were admitted into ICU. It included 20 (62.50%) males and 12 (37.50%) females. The mean age was 43.99 ± 13.03 years. Diagnosis was done by real-time reverse transcription polymerase chain reaction (rRT-PCR) test for corona virus on throat swab, sputum, tracheal aspirate, or bronchoalveolar lavage specimens. Clinical characteristics, co-morbidities and outcome were reported for all subjects.
Results: The main symptoms among the included patients were: fever (96.87%), cough (93.75%), dyspnea (90.62%), sore throat (75%), runny nose (75%), sputum (50%), headache (43.75%), myalgia (40.62%), chest pain (37.50%), hemoptysis (37.50%), nausea and vomiting (34.37%), abdominal pain (21.87%) and diarrhea (15.62%). The presence of abdominal symptoms is significantly (P < 0.05) associated with bad prognosis. Out of the included 32 patients, 18 patients (56.25%) survived and 14 patients (43.75%) expired. There was a statistically significant difference in the duration of symptoms before hospitalization, mechanical ventilation and ICU and total hospital stay between the expired group and survivors (P < 0.01). Current smoking and smoking severity were statistically significantly (P < 0.01) higher in the expired group compared to survivors. Also, there was a statistically (P < 0.05) significant positive correlation between mortality and smoking severity (r = 0.640). Most of the expired patients presented with bilateral pulmonary infiltrates or unilateral infiltrates, but most of the survivors presented with normal radiology or increased bronchovascular markings, and this difference in the results was statistically highly significant (P < 0.01). There were statistically highly significant (P < 0.01) differences in the mean values of APACHE II score (21.11 ± 3.70 vs 24.21 ± 3.82), SOFA score (5.83 ± 2.64 vs 8.85 ± 2.17) and CPIS (7.55 ± 1.14 vs 8.64 ± 1.39) between the expired group and survivors respectively. Also, there was a statistically significant decrease in PH, PaO2, O2 saturation and HCO3 (P < 0.05) among the expired group in comparison with the survivors, but no statistical difference regarding PaCO2 (P > 0.05). There was a statistically significant positive correlation between mortality and old age (r = 0.633), obesity (r = 0.712), diabetes mellitus (r = 0.685), renal failure (r = 0.705), chronic heart diseases (0.591), COPD (r = 0.523), malignancy (r = 0.692), kidney transplantation (r = 0.644) and liver cirrhosis (r = 0.525) (P < 0.05). There was a statistically (P < 0.05) positive correlation between the number of associated co-morbidities and mortality (r = 0.735).
Conclusions: Most MERS corona patients present with fever, cough, dyspnea, sore throat, runny nose and sputum. The presence of abdominal symptoms may indicate bad prognosis. Prolonged duration of symptoms before patients’ hospitalization, prolonged duration of mechanical ventilation and hospital stay, bilateral radiological pulmonary infiltrates, and hypoxemic respiratory failure were found to be strong predictors of mortality in such patients. Also, old age, current smoking, smoking severity, presence of associated co-morbidities like obesity, diabetes mellitus, chronic heart diseases, COPD, malignancy, renal failure, renal transplantation and liver cirrhosis are associated with a poor outcome of ICU admitted MERS corona virus infected patients. |
| first_indexed | 2024-12-10T14:19:06Z |
| format | Article |
| id | doaj.art-7526d3dfe72c479c8df3102c47bf454f |
| institution | Directory Open Access Journal |
| issn | 0422-7638 |
| language | English |
| last_indexed | 2024-12-10T14:19:06Z |
| publishDate | 2016-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Egyptian Journal of Chest Disease and Tuberculosis |
| spelling | doaj.art-7526d3dfe72c479c8df3102c47bf454f2022-12-22T01:45:14ZengWolters Kluwer Medknow PublicationsEgyptian Journal of Chest Disease and Tuberculosis0422-76382016-01-01651818710.1016/j.ejcdt.2015.11.011Clinical characteristics and outcome of ICU admitted MERS corona virus infected patientsAshraf Abdel Halim0Badr Alsayed1Sameh Embarak2Taha Yaseen3Salwa Dabbous4Chest Department, Faculty of Medicine, Zagazig University, Zagazig, EgyptTabuk University, Tabuk, Saudi ArabiaChest Department, Faculty of Medicine, Zagazig University, Zagazig, EgyptICU Department, Patna University, Patna, IndiaClinical Pathology Department, Faculty of Medicine, Cairo University, Cairo, EgyptMiddle East Respiratory Syndrome (MERS) is a novel respiratory illness firstly reported in Saudi Arabia in 2012. It is caused by a new corona virus, called MERS corona virus (MERS-CoV). Most people who have MERS-CoV infection developed severe acute respiratory illness. Aim of the work: This work is done to determine the clinical characteristics and the outcome of intensive care unit (ICU) admitted patients with confirmed MERS-CoV infection. Patients and methods: This study included 32 laboratory confirmed MERS corona virus infected patients who were admitted into ICU. It included 20 (62.50%) males and 12 (37.50%) females. The mean age was 43.99 ± 13.03 years. Diagnosis was done by real-time reverse transcription polymerase chain reaction (rRT-PCR) test for corona virus on throat swab, sputum, tracheal aspirate, or bronchoalveolar lavage specimens. Clinical characteristics, co-morbidities and outcome were reported for all subjects. Results: The main symptoms among the included patients were: fever (96.87%), cough (93.75%), dyspnea (90.62%), sore throat (75%), runny nose (75%), sputum (50%), headache (43.75%), myalgia (40.62%), chest pain (37.50%), hemoptysis (37.50%), nausea and vomiting (34.37%), abdominal pain (21.87%) and diarrhea (15.62%). The presence of abdominal symptoms is significantly (P < 0.05) associated with bad prognosis. Out of the included 32 patients, 18 patients (56.25%) survived and 14 patients (43.75%) expired. There was a statistically significant difference in the duration of symptoms before hospitalization, mechanical ventilation and ICU and total hospital stay between the expired group and survivors (P < 0.01). Current smoking and smoking severity were statistically significantly (P < 0.01) higher in the expired group compared to survivors. Also, there was a statistically (P < 0.05) significant positive correlation between mortality and smoking severity (r = 0.640). Most of the expired patients presented with bilateral pulmonary infiltrates or unilateral infiltrates, but most of the survivors presented with normal radiology or increased bronchovascular markings, and this difference in the results was statistically highly significant (P < 0.01). There were statistically highly significant (P < 0.01) differences in the mean values of APACHE II score (21.11 ± 3.70 vs 24.21 ± 3.82), SOFA score (5.83 ± 2.64 vs 8.85 ± 2.17) and CPIS (7.55 ± 1.14 vs 8.64 ± 1.39) between the expired group and survivors respectively. Also, there was a statistically significant decrease in PH, PaO2, O2 saturation and HCO3 (P < 0.05) among the expired group in comparison with the survivors, but no statistical difference regarding PaCO2 (P > 0.05). There was a statistically significant positive correlation between mortality and old age (r = 0.633), obesity (r = 0.712), diabetes mellitus (r = 0.685), renal failure (r = 0.705), chronic heart diseases (0.591), COPD (r = 0.523), malignancy (r = 0.692), kidney transplantation (r = 0.644) and liver cirrhosis (r = 0.525) (P < 0.05). There was a statistically (P < 0.05) positive correlation between the number of associated co-morbidities and mortality (r = 0.735). Conclusions: Most MERS corona patients present with fever, cough, dyspnea, sore throat, runny nose and sputum. The presence of abdominal symptoms may indicate bad prognosis. Prolonged duration of symptoms before patients’ hospitalization, prolonged duration of mechanical ventilation and hospital stay, bilateral radiological pulmonary infiltrates, and hypoxemic respiratory failure were found to be strong predictors of mortality in such patients. Also, old age, current smoking, smoking severity, presence of associated co-morbidities like obesity, diabetes mellitus, chronic heart diseases, COPD, malignancy, renal failure, renal transplantation and liver cirrhosis are associated with a poor outcome of ICU admitted MERS corona virus infected patients.http://www.sciencedirect.com/science/article/pii/S0422763815301199MERSCorona virusClinical characteristicsOutcome |
| spellingShingle | Ashraf Abdel Halim Badr Alsayed Sameh Embarak Taha Yaseen Salwa Dabbous Clinical characteristics and outcome of ICU admitted MERS corona virus infected patients Egyptian Journal of Chest Disease and Tuberculosis MERS Corona virus Clinical characteristics Outcome |
| title | Clinical characteristics and outcome of ICU admitted MERS corona virus infected patients |
| title_full | Clinical characteristics and outcome of ICU admitted MERS corona virus infected patients |
| title_fullStr | Clinical characteristics and outcome of ICU admitted MERS corona virus infected patients |
| title_full_unstemmed | Clinical characteristics and outcome of ICU admitted MERS corona virus infected patients |
| title_short | Clinical characteristics and outcome of ICU admitted MERS corona virus infected patients |
| title_sort | clinical characteristics and outcome of icu admitted mers corona virus infected patients |
| topic | MERS Corona virus Clinical characteristics Outcome |
| url | http://www.sciencedirect.com/science/article/pii/S0422763815301199 |
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