Clinical management of respiratory syndrome in patients hospitalized for suspected Middle East respiratory syndrome coronavirus infection in the Paris area from 2013 to 2016
Identifieur interne : 000002 ( Hal/Curation ); précédent : 000001; suivant : 000003Clinical management of respiratory syndrome in patients hospitalized for suspected Middle East respiratory syndrome coronavirus infection in the Paris area from 2013 to 2016
Auteurs : Alexandre Bleibtreu [France] ; S. Jauréguiberry [France] ; N. Houhou [France] ; D. Boutolleau [France] ; H. Guillot [France] ; D. Vallois [France] ; J. Lucet [France] ; J. Robert [France] ; B. Mourvillier [France] ; J. Delemazure [France] ; M. Jaspard [France] ; F. Lescure [France] ; C. Rioux [France] ; E. Caumes [France] ; Y. Yazdanapanah [France]Source :
- BMC Infectious Diseases [ 1471-2334 ] ; 2018-07-16.
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- mix :
Abstract
Background: Patients with suspected Middle East respiratory syndrome coronavirus (MERS-CoV) infection should be hospitalized in isolation wards to avoid transmission. This suspicion can also lead to medical confusion and inappropriate management of acute respiratory syndrome due to causes other than MERS-CoV. Methods: We studied the characteristics and outcome of patients hospitalized for suspected MERS-CoV infection in the isolation wards of two referral infectious disease departments in the Paris area between January 2013 and December 2016. Results: Of 93 adult patients (49 male (52.6%), median age 63.4 years) hospitalized, 82 out of 93 adult patients had returned from Saudi Arabia, and 74 of them were pilgrims (Hajj). Chest X-ray findings were abnormal in 72 (77%) patients. The 93 patients were negative for MERS-CoV RT-PCR, and 70 (75.2%) patients had documented infection, 47 (50.5%) viral, 22 (23.6%) bacterial and one Plasmodium falciparum malaria. Microbiological analysis identified Rhinovirus (27.9%), Influenza virus (26.8%), Legionella pneumophila (7.5%), Streptococcus pneumoniae (7.5%), and non-MERS-coronavirus (6.4%). Antibiotics were initiated in 81 (87%) cases, with two antibiotics in 63 patients (67.7%). The median duration of hospitalization and isolation was 3 days (1–33) and 24 h (8–92), respectively. Time of isolation decreased over time (P < 0.01). Two patients (2%) died. Conclusion: The management of patients with possible MERS-CoV infection requires medical facilities with trained personnel, and rapid access to virological results. Empirical treatment with neuraminidase inhibitors and an association of antibiotics effective against S. pneumoniae and L. pneumophila are the cornerstones of the management of patients hospitalized for suspected MERS-CoV infection.
Url:
DOI: 10.1186/s12879-018-3223-5
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<idno type="DOI">10.1186/s12879-018-3223-5</idno>
<series><title level="j">BMC Infectious Diseases</title>
<idno type="ISSN">1471-2334</idno>
<imprint><date type="datePub">2018-07-16</date>
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<profileDesc><textClass><keywords scheme="mix" xml:lang="en"><term> Legionella</term>
<term> Middle East respiratory syndrome coronavirus (MERS-CoV)</term>
<term> Pilgrims</term>
<term> Respiratory tract infection</term>
<term> Saudi Arabia</term>
<term>Isolation ward</term>
</keywords>
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<front><div type="abstract" xml:lang="en"> <p>Background: Patients with suspected Middle East respiratory syndrome coronavirus (MERS-CoV) infection should be hospitalized in isolation wards to avoid transmission. This suspicion can also lead to medical confusion and inappropriate management of acute respiratory syndrome due to causes other than MERS-CoV. Methods: We studied the characteristics and outcome of patients hospitalized for suspected MERS-CoV infection in the isolation wards of two referral infectious disease departments in the Paris area between January 2013 and December 2016. Results: Of 93 adult patients (49 male (52.6%), median age 63.4 years) hospitalized, 82 out of 93 adult patients had returned from Saudi Arabia, and 74 of them were pilgrims (Hajj). Chest X-ray findings were abnormal in 72 (77%) patients. The 93 patients were negative for MERS-CoV RT-PCR, and 70 (75.2%) patients had documented infection, 47 (50.5%) viral, 22 (23.6%) bacterial and one Plasmodium falciparum malaria. Microbiological analysis identified Rhinovirus (27.9%), Influenza virus (26.8%), Legionella pneumophila (7.5%), Streptococcus pneumoniae (7.5%), and non-MERS-coronavirus (6.4%). Antibiotics were initiated in 81 (87%) cases, with two antibiotics in 63 patients (67.7%). The median duration of hospitalization and isolation was 3 days (1–33) and 24 h (8–92), respectively. Time of isolation decreased over time (P < 0.01). Two patients (2%) died. Conclusion: The management of patients with possible MERS-CoV infection requires medical facilities with trained personnel, and rapid access to virological results. Empirical treatment with neuraminidase inhibitors and an association of antibiotics effective against S. pneumoniae and L. pneumophila are the cornerstones of the management of patients hospitalized for suspected MERS-CoV infection.</p>
</div>
</front>
</TEI>
<hal api="V3"> <titleStmt> <title xml:lang="en">Clinical management of respiratory syndrome in patients hospitalized for suspected Middle East respiratory syndrome coronavirus infection in the Paris area from 2013 to 2016</title>
<author role="crp"> <persName> <forename type="first">Alexandre</forename>
<surname>Bleibtreu</surname>
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<author role="aut"> <persName> <forename type="first">S.</forename>
<surname>Jauréguiberry</surname>
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<idno type="halauthorid">11199561</idno>
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<author role="aut"> <persName> <forename type="first">N.</forename>
<surname>Houhou</surname>
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<idno type="halauthorid">155868</idno>
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<author role="aut"> <persName> <forename type="first">D.</forename>
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<author role="aut"> <persName> <forename type="first">H.</forename>
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<idno type="halauthorid">11259793</idno>
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</author>
<author role="aut"> <persName> <forename type="first">D.</forename>
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<idno type="halauthorid">354151</idno>
<affiliation ref="#struct-34554"></affiliation>
</author>
<author role="aut"> <persName> <forename type="first">J</forename>
<forename type="middle">C</forename>
<surname>Lucet</surname>
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<idno type="halauthorid">11259794</idno>
<affiliation ref="#struct-300156"></affiliation>
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<author role="aut"> <persName> <forename type="first">J.</forename>
<surname>Robert</surname>
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<idno type="halauthorid">63807</idno>
<affiliation ref="#struct-353778"></affiliation>
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<idno type="halauthorid">1137609</idno>
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<author role="aut"> <persName> <forename type="first">J.</forename>
<surname>Delemazure</surname>
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<idno type="halauthorid">11259795</idno>
<affiliation ref="#struct-353778"></affiliation>
</author>
<author role="aut"> <persName> <forename type="first">M.</forename>
<surname>Jaspard</surname>
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<idno type="halauthorid">525210</idno>
<affiliation ref="#struct-17930"></affiliation>
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<author role="aut"> <persName> <forename type="first">F.</forename>
<surname>Lescure</surname>
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<idno type="halauthorid">814380</idno>
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<author role="aut"> <persName> <forename type="first">C.</forename>
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<author role="aut"> <persName> <forename type="first">E.</forename>
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<author role="aut"> <persName> <forename type="first">Y.</forename>
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<idno type="halauthorid">11259796</idno>
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<editor role="depositor"> <persName> <forename>Nathalie</forename>
<surname>Duchange</surname>
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<email type="domain">inserm.fr</email>
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<date type="whenModified">2020-04-09 11:58:10</date>
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<name key="108672"> <persName> <forename>Nathalie</forename>
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<idno type="halRefHtml">BMC Infectious Diseases, BioMed Central, 2018, 18 (1), pp.331. ⟨10.1186/s12879-018-3223-5⟩</idno>
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<idno type="stamp" n="CNRS">CNRS - Centre national de la recherche scientifique</idno>
<idno type="stamp" n="APHP" corresp="INSERM">AP-HP</idno>
<idno type="stamp" n="UNIV-PARIS13">Université Paris-Nord - Paris XIII </idno>
<idno type="stamp" n="USPC">Université Sorbonne Paris Cité</idno>
<idno type="stamp" n="SORBONNE-UNIVERSITE">Sorbonne Université</idno>
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<idno type="stamp" n="SU-MEDECINE" corresp="SORBONNE-UNIVERSITE">Faculté de Médecine de Sorbonne Université</idno>
<idno type="stamp" n="IAME" corresp="UNIV-PARIS13">(Infection, Antimicrobiens, Modélisation, Evolution) - UMR 1137</idno>
<idno type="stamp" n="UNIV-PARIS7" corresp="UNIV-PARIS">Université Denis Diderot - Paris VII</idno>
<idno type="stamp" n="SORBONNE-UNIV" corresp="SORBONNE-UNIVERSITE">Sorbonne Université 01/01/2018</idno>
<idno type="stamp" n="SORBONNE-PARIS-NORD">Université Sorbonne Paris Nord</idno>
<idno type="stamp" n="UNIV-PARIS">Université de Paris</idno>
<idno type="stamp" n="UP-SANTE">Université de Paris - Faculté de Santé</idno>
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<sourceDesc> <biblStruct> <analytic> <title xml:lang="en">Clinical management of respiratory syndrome in patients hospitalized for suspected Middle East respiratory syndrome coronavirus infection in the Paris area from 2013 to 2016</title>
<author role="crp"> <persName> <forename type="first">Alexandre</forename>
<surname>Bleibtreu</surname>
</persName>
<email type="md5">a3afd31833ed0196dc9f86fff5730f6c</email>
<email type="domain">aphp.fr</email>
<idno type="halauthorid">11259791</idno>
<affiliation ref="#struct-34554"></affiliation>
<affiliation ref="#struct-17930"></affiliation>
<affiliation ref="#struct-247341"></affiliation>
</author>
<author role="aut"> <persName> <forename type="first">S.</forename>
<surname>Jauréguiberry</surname>
</persName>
<idno type="halauthorid">11199561</idno>
<affiliation ref="#struct-17930"></affiliation>
</author>
<author role="aut"> <persName> <forename type="first">N.</forename>
<surname>Houhou</surname>
</persName>
<idno type="halauthorid">155868</idno>
<affiliation ref="#struct-495283"></affiliation>
</author>
<author role="aut"> <persName> <forename type="first">D.</forename>
<surname>Boutolleau</surname>
</persName>
<idno type="halauthorid">11259792</idno>
<affiliation ref="#struct-353778"></affiliation>
<affiliation ref="#struct-246601"></affiliation>
</author>
<author role="aut"> <persName> <forename type="first">H.</forename>
<surname>Guillot</surname>
</persName>
<idno type="halauthorid">11259793</idno>
<affiliation ref="#struct-17930"></affiliation>
</author>
<author role="aut"> <persName> <forename type="first">D.</forename>
<surname>Vallois</surname>
</persName>
<idno type="halauthorid">354151</idno>
<affiliation ref="#struct-34554"></affiliation>
</author>
<author role="aut"> <persName> <forename type="first">J</forename>
<forename type="middle">C</forename>
<surname>Lucet</surname>
</persName>
<idno type="halauthorid">11259794</idno>
<affiliation ref="#struct-300156"></affiliation>
<affiliation ref="#struct-247341"></affiliation>
</author>
<author role="aut"> <persName> <forename type="first">J.</forename>
<surname>Robert</surname>
</persName>
<idno type="halauthorid">63807</idno>
<affiliation ref="#struct-353778"></affiliation>
<affiliation ref="#struct-246601"></affiliation>
</author>
<author role="aut"> <persName> <forename type="first">B.</forename>
<surname>Mourvillier</surname>
</persName>
<idno type="halauthorid">1137609</idno>
<affiliation ref="#struct-247341"></affiliation>
<affiliation ref="#struct-300156"></affiliation>
</author>
<author role="aut"> <persName> <forename type="first">J.</forename>
<surname>Delemazure</surname>
</persName>
<idno type="halauthorid">11259795</idno>
<affiliation ref="#struct-353778"></affiliation>
</author>
<author role="aut"> <persName> <forename type="first">M.</forename>
<surname>Jaspard</surname>
</persName>
<idno type="halauthorid">525210</idno>
<affiliation ref="#struct-17930"></affiliation>
</author>
<author role="aut"> <persName> <forename type="first">F.</forename>
<surname>Lescure</surname>
</persName>
<idno type="halauthorid">814380</idno>
<affiliation ref="#struct-34554"></affiliation>
<affiliation ref="#struct-247341"></affiliation>
</author>
<author role="aut"> <persName> <forename type="first">C.</forename>
<surname>Rioux</surname>
</persName>
<idno type="halauthorid">37055</idno>
<affiliation ref="#struct-34554"></affiliation>
</author>
<author role="aut"> <persName> <forename type="first">E.</forename>
<surname>Caumes</surname>
</persName>
<idno type="halauthorid">901266</idno>
<affiliation ref="#struct-17930"></affiliation>
</author>
<author role="aut"> <persName> <forename type="first">Y.</forename>
<surname>Yazdanapanah</surname>
</persName>
<idno type="halauthorid">11259796</idno>
<affiliation ref="#struct-34554"></affiliation>
<affiliation ref="#struct-247341"></affiliation>
</author>
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<idno type="issn">1471-2334</idno>
<idno type="eissn">1471-2334</idno>
<title level="j">BMC Infectious Diseases</title>
<imprint> <publisher>BioMed Central</publisher>
<biblScope unit="volume">18</biblScope>
<biblScope unit="issue">1</biblScope>
<biblScope unit="pp">331</biblScope>
<date type="datePub">2018-07-16</date>
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<idno type="doi">10.1186/s12879-018-3223-5</idno>
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</langUsage>
<textClass> <keywords scheme="author"> <term xml:lang="en"> Respiratory tract infection</term>
<term xml:lang="en"> Saudi Arabia</term>
<term xml:lang="en">Isolation ward</term>
<term xml:lang="en"> Legionella</term>
<term xml:lang="en"> Middle East respiratory syndrome coronavirus (MERS-CoV)</term>
<term xml:lang="en"> Pilgrims</term>
</keywords>
<classCode scheme="halDomain" n="sdv.mhep.mi">Life Sciences [q-bio]/Human health and pathology/Infectious diseases</classCode>
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<abstract xml:lang="en"> <p>Background: Patients with suspected Middle East respiratory syndrome coronavirus (MERS-CoV) infection should be hospitalized in isolation wards to avoid transmission. This suspicion can also lead to medical confusion and inappropriate management of acute respiratory syndrome due to causes other than MERS-CoV. Methods: We studied the characteristics and outcome of patients hospitalized for suspected MERS-CoV infection in the isolation wards of two referral infectious disease departments in the Paris area between January 2013 and December 2016. Results: Of 93 adult patients (49 male (52.6%), median age 63.4 years) hospitalized, 82 out of 93 adult patients had returned from Saudi Arabia, and 74 of them were pilgrims (Hajj). Chest X-ray findings were abnormal in 72 (77%) patients. The 93 patients were negative for MERS-CoV RT-PCR, and 70 (75.2%) patients had documented infection, 47 (50.5%) viral, 22 (23.6%) bacterial and one Plasmodium falciparum malaria. Microbiological analysis identified Rhinovirus (27.9%), Influenza virus (26.8%), Legionella pneumophila (7.5%), Streptococcus pneumoniae (7.5%), and non-MERS-coronavirus (6.4%). Antibiotics were initiated in 81 (87%) cases, with two antibiotics in 63 patients (67.7%). The median duration of hospitalization and isolation was 3 days (1–33) and 24 h (8–92), respectively. Time of isolation decreased over time (P < 0.01). Two patients (2%) died. Conclusion: The management of patients with possible MERS-CoV infection requires medical facilities with trained personnel, and rapid access to virological results. Empirical treatment with neuraminidase inhibitors and an association of antibiotics effective against S. pneumoniae and L. pneumophila are the cornerstones of the management of patients hospitalized for suspected MERS-CoV infection.</p>
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