Presentation and outcome of Middle East respiratory syndrome in Saudi intensive care unit patients
Identifieur interne : 000835 ( Main/Exploration ); précédent : 000834; suivant : 000836Presentation and outcome of Middle East respiratory syndrome in Saudi intensive care unit patients
Auteurs : Ghaleb A. Almekhlafi [Arabie saoudite] ; Mohammed M. Albarrak [Arabie saoudite] ; Yasser Mandourah [Arabie saoudite] ; Sahar Hassan [Arabie saoudite] ; Abid Alwan [Arabie saoudite] ; Abdullah Abudayah [Arabie saoudite] ; Sultan Altayyar [Arabie saoudite] ; Mohamed Mustafa [Arabie saoudite] ; Tareef Aldaghestani [Arabie saoudite] ; Adnan Alghamedi [Arabie saoudite] ; Ali Talag [Arabie saoudite] ; Muhammad K. Malik [Arabie saoudite] ; Ali S. Omrani [Arabie saoudite] ; Yasser Sakr [Allemagne]Source :
- Critical Care [ 1364-8535 ] ; 2016.
Abstract
Middle East respiratory syndrome coronavirus infection is associated with high mortality rates but limited clinical data have been reported. We describe the clinical features and outcomes of patients admitted to an intensive care unit (ICU) with Middle East respiratory syndrome coronavirus (MERS-CoV) infection.
Retrospective analysis of data from all adult (>18 years old) patients admitted to our 20-bed mixed ICU with Middle East respiratory syndrome coronavirus infection between October 1, 2012 and May 31, 2014. Diagnosis was confirmed in all patients using real-time reverse transcription polymerase chain reaction on respiratory samples.
During the observation period, 31 patients were admitted with MERS-CoV infection (mean age 59 ± 20 years, 22 [71 %] males). Cough and tachypnea were reported in all patients; 22 (77.4 %) patients had bilateral pulmonary infiltrates. Invasive mechanical ventilation was applied in 27 (87.1 %) and vasopressor therapy in 25 (80.6 %) patients during the intensive care unit stay. Twenty-three (74.2 %) patients died in the ICU. Nonsurvivors were older, had greater APACHE II and SOFA scores on admission, and were more likely to have received invasive mechanical ventilation and vasopressor therapy. After adjustment for the severity of illness and the degree of organ dysfunction, the need for vasopressors was an independent risk factor for death in the ICU (odds ratio = 18.33, 95 % confidence interval: 1.11–302.1,
MERS-CoV infection requiring admission to the ICU is associated with high morbidity and mortality. The need for vasopressor therapy is the main risk factor for death in these patients.
The online version of this article (doi:10.1186/s13054-016-1303-8) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1186/s13054-016-1303-8
PubMed: 27153800
PubMed Central: 4859954
Affiliations:
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<author><name sortKey="Almekhlafi, Ghaleb A" sort="Almekhlafi, Ghaleb A" uniqKey="Almekhlafi G" first="Ghaleb A." last="Almekhlafi">Ghaleb A. Almekhlafi</name>
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<author><name sortKey="Abudayah, Abdullah" sort="Abudayah, Abdullah" uniqKey="Abudayah A" first="Abdullah" last="Abudayah">Abdullah Abudayah</name>
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<author><name sortKey="Altayyar, Sultan" sort="Altayyar, Sultan" uniqKey="Altayyar S" first="Sultan" last="Altayyar">Sultan Altayyar</name>
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<author><name sortKey="Mustafa, Mohamed" sort="Mustafa, Mohamed" uniqKey="Mustafa M" first="Mohamed" last="Mustafa">Mohamed Mustafa</name>
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<author><name sortKey="Aldaghestani, Tareef" sort="Aldaghestani, Tareef" uniqKey="Aldaghestani T" first="Tareef" last="Aldaghestani">Tareef Aldaghestani</name>
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<author><name sortKey="Alghamedi, Adnan" sort="Alghamedi, Adnan" uniqKey="Alghamedi A" first="Adnan" last="Alghamedi">Adnan Alghamedi</name>
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<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea>Department of Intensive Care Services, Prince Sultan Military Medical City, Riyadh</wicri:regionArea>
<wicri:noRegion>Riyadh</wicri:noRegion>
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<author><name sortKey="Talag, Ali" sort="Talag, Ali" uniqKey="Talag A" first="Ali" last="Talag">Ali Talag</name>
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<author><name sortKey="Malik, Muhammad K" sort="Malik, Muhammad K" uniqKey="Malik M" first="Muhammad K." last="Malik">Muhammad K. Malik</name>
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<wicri:noRegion>Riyadh</wicri:noRegion>
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<author><name sortKey="Omrani, Ali S" sort="Omrani, Ali S" uniqKey="Omrani A" first="Ali S." last="Omrani">Ali S. Omrani</name>
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<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea>Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh</wicri:regionArea>
<wicri:noRegion>Riyadh</wicri:noRegion>
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<author><name sortKey="Sakr, Yasser" sort="Sakr, Yasser" uniqKey="Sakr Y" first="Yasser" last="Sakr">Yasser Sakr</name>
<affiliation wicri:level="1"><nlm:aff id="Aff4">Department of Anesthesiology and Intensive Care, Uniklinikum Jena, 07743 Jena, Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Department of Anesthesiology and Intensive Care, Uniklinikum Jena, 07743 Jena</wicri:regionArea>
<wicri:noRegion>07743 Jena</wicri:noRegion>
<wicri:noRegion>07743 Jena</wicri:noRegion>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>Middle East respiratory syndrome coronavirus infection is associated with high mortality rates but limited clinical data have been reported. We describe the clinical features and outcomes of patients admitted to an intensive care unit (ICU) with Middle East respiratory syndrome coronavirus (MERS-CoV) infection.</p>
</sec>
<sec><title>Methods</title>
<p>Retrospective analysis of data from all adult (>18 years old) patients admitted to our 20-bed mixed ICU with Middle East respiratory syndrome coronavirus infection between October 1, 2012 and May 31, 2014. Diagnosis was confirmed in all patients using real-time reverse transcription polymerase chain reaction on respiratory samples.</p>
</sec>
<sec><title>Results</title>
<p>During the observation period, 31 patients were admitted with MERS-CoV infection (mean age 59 ± 20 years, 22 [71 %] males). Cough and tachypnea were reported in all patients; 22 (77.4 %) patients had bilateral pulmonary infiltrates. Invasive mechanical ventilation was applied in 27 (87.1 %) and vasopressor therapy in 25 (80.6 %) patients during the intensive care unit stay. Twenty-three (74.2 %) patients died in the ICU. Nonsurvivors were older, had greater APACHE II and SOFA scores on admission, and were more likely to have received invasive mechanical ventilation and vasopressor therapy. After adjustment for the severity of illness and the degree of organ dysfunction, the need for vasopressors was an independent risk factor for death in the ICU (odds ratio = 18.33, 95 % confidence interval: 1.11–302.1, <italic>P</italic>
= 0.04).</p>
</sec>
<sec><title>Conclusions</title>
<p>MERS-CoV infection requiring admission to the ICU is associated with high morbidity and mortality. The need for vasopressor therapy is the main risk factor for death in these patients.</p>
</sec>
<sec><title>Electronic supplementary material</title>
<p>The online version of this article (doi:10.1186/s13054-016-1303-8) contains supplementary material, which is available to authorized users.</p>
</sec>
</div>
</front>
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