Critically ill healthcare workers with the middle east respiratory syndrome (MERS): A multicenter study
Identifieur interne : 000A19 ( Main/Exploration ); précédent : 000A18; suivant : 000A20Critically ill healthcare workers with the middle east respiratory syndrome (MERS): A multicenter study
Auteurs : Sarah Shalhoub [Arabie saoudite] ; Fahad Al-Hameed [Arabie saoudite] ; Yasser Mandourah [Arabie saoudite] ; Hanan H. Balkhy [Arabie saoudite] ; Awad Al-Omari [Arabie saoudite] ; Ghaleb. A. Al Mekhlafi [Arabie saoudite] ; Ayman Kharaba [Arabie saoudite] ; Basem Alraddadi [Arabie saoudite] ; Abdullah Almotairi [Arabie saoudite] ; Kasim Al Khatib [Arabie saoudite] ; Ahmed Abdulmomen [Arabie saoudite] ; Ismael Qushmaq [Arabie saoudite] ; Ahmed Mady [Arabie saoudite] ; Othman Solaiman [Arabie saoudite] ; Abdulsalam M. Al-Aithan [Arabie saoudite] ; Rajaa Al-Raddadi [Arabie saoudite] ; Ahmed Ragab [Arabie saoudite] ; Abdulrahman Al Harthy [Arabie saoudite] ; Eman Al Qasim [Arabie saoudite] ; Jesna Jose [Arabie saoudite] ; Ghassan Al-Ghamdi [Arabie saoudite] ; Laura Merson [Royaume-Uni] ; Robert Fowler [Canada] ; Frederick G. Hayden [États-Unis] ; Yaseen M. Arabi [Arabie saoudite]Source :
- PLoS ONE [ 1932-6203 ] ; 2018.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Arabie saoudite (épidémiologie), Comorbidité, Coronavirus du syndrome respiratoire du Moyen-Orient (isolement et purification), Femelle, Flambées de maladies, Humains, Infection croisée (), Infection croisée (diagnostic), Infection croisée (virologie), Infection croisée (épidémiologie), Infections à coronavirus (), Infections à coronavirus (diagnostic), Infections à coronavirus (virologie), Infections à coronavirus (épidémiologie), Maladie grave (), Maladie grave (épidémiologie), Maladies professionnelles (), Maladies professionnelles (diagnostic), Maladies professionnelles (virologie), Maladies professionnelles (épidémiologie), Mortalité hospitalière, Mâle, Niveau de performance de Karnofsky, Oxygénation extracorporelle sur oxygénateur à membrane (), Personnel de santé (), Taux de survie, Études rétrospectives.
- MESH :
- diagnostic : Infection croisée, Infections à coronavirus, Maladies professionnelles.
- isolement et purification : Coronavirus du syndrome respiratoire du Moyen-Orient.
- virologie : Infection croisée, Infections à coronavirus, Maladies professionnelles.
- épidémiologie : Arabie saoudite, Infection croisée, Infections à coronavirus, Maladie grave, Maladies professionnelles.
- Adulte, Adulte d'âge moyen, Comorbidité, Femelle, Flambées de maladies, Humains, Infection croisée, Infections à coronavirus, Maladie grave, Maladies professionnelles, Mortalité hospitalière, Mâle, Niveau de performance de Karnofsky, Oxygénation extracorporelle sur oxygénateur à membrane, Personnel de santé, Taux de survie, Études rétrospectives.
- Wicri :
- geographic : Arabie saoudite.
English descriptors
- KwdEn :
- Adult, Comorbidity, Coronavirus Infections (diagnosis), Coronavirus Infections (epidemiology), Coronavirus Infections (therapy), Coronavirus Infections (virology), Critical Illness (epidemiology), Critical Illness (therapy), Cross Infection (diagnosis), Cross Infection (epidemiology), Cross Infection (therapy), Cross Infection (virology), Disease Outbreaks, Extracorporeal Membrane Oxygenation (statistics & numerical data), Female, Health Personnel (statistics & numerical data), Hospital Mortality, Humans, Karnofsky Performance Status, Male, Middle Aged, Middle East Respiratory Syndrome Coronavirus (isolation & purification), Occupational Diseases (diagnosis), Occupational Diseases (epidemiology), Occupational Diseases (therapy), Occupational Diseases (virology), Retrospective Studies, Saudi Arabia (epidemiology), Survival Rate.
- MESH :
- geographic , epidemiology : Saudi Arabia.
- diagnosis : Coronavirus Infections, Cross Infection, Occupational Diseases.
- epidemiology : Coronavirus Infections, Critical Illness, Cross Infection, Occupational Diseases.
- isolation & purification : Middle East Respiratory Syndrome Coronavirus.
- statistics & numerical data : Extracorporeal Membrane Oxygenation, Health Personnel.
- therapy : Coronavirus Infections, Critical Illness, Cross Infection, Occupational Diseases.
- virology : Coronavirus Infections, Cross Infection, Occupational Diseases.
- Adult, Comorbidity, Disease Outbreaks, Female, Hospital Mortality, Humans, Karnofsky Performance Status, Male, Middle Aged, Retrospective Studies, Survival Rate.
Abstract
Middle East Respiratory Syndrome Coronavirus (MERS-CoV) leads to healthcare-associated transmission to patients and healthcare workers with potentially fatal outcomes.
We aimed to describe the clinical course and functional outcomes of critically ill healthcare workers (HCWs) with MERS.
Data on HCWs was extracted from a multi-center retrospective cohort study on 330 critically ill patients with MERS admitted between (9/2012–9/2015). Baseline demographics, interventions and outcomes were recorded and compared between survivors and non-survivors. Survivors were approached with questionnaires to elucidate their functional outcomes using Karnofsky Performance Status Scale.
Thirty-Two HCWs met the inclusion criteria. Comorbidities were recorded in 34% (11/32) HCW. Death resulted in 8/32 (25%) HCWs including all 5 HCWs with chronic renal impairment at baseline. Non-surviving HCW had lower PaO2/FiO2 ratios 63.5 (57, 116.2) vs 148 (84, 194.3), p = 0.043, and received more ECMO therapy compared to survivors, 9/32 (28%) vs 4/24 (16.7%) respectively (p = 0.02).Thirteen of the surviving (13/24) HCWs responded to the questionnaire. Two HCWs confirmed functional limitations. Median number of days from hospital discharge until the questionnaires were filled was 580 (95% CI 568, 723.5) days.
Approximately 10% of critically ill patients with MERS were HCWs. Hospital mortality rate was substantial (25%). Patients with chronic renal impairment represented a particularly high-risk group that should receive extra caution during suspected or confirmed MERS cases clinical care assignment and during outbreaks. Long-term repercussions of critical illness due to MERS on HCWs in particular, and patients in general, remain unknown and should be investigated in larger studies.
Url:
DOI: 10.1371/journal.pone.0206831
PubMed: 30439974
PubMed Central: 6237307
Affiliations:
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sortKey="Ragab, Ahmed" sort="Ragab, Ahmed" uniqKey="Ragab A" first="Ahmed" last="Ragab">Ahmed Ragab</name><affiliation wicri:level="1"><nlm:aff id="aff015"><addr-line>Intensive Care Department, King Fahd Hospital, Jeddah, Saudi Arabia</addr-line></nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Intensive Care Department, King Fahd Hospital, Jeddah</wicri:regionArea><wicri:noRegion>Jeddah</wicri:noRegion></affiliation></author><author><name sortKey="Al Harthy, Abdulrahman" sort="Al Harthy, Abdulrahman" uniqKey="Al Harthy A" first="Abdulrahman" last="Al Harthy">Abdulrahman Al Harthy</name><affiliation wicri:level="1"><nlm:aff id="aff011"><addr-line>Intensive Care Department, King Saud Medical City, Riyadh, Saudi Arabia</addr-line></nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Intensive Care Department, King Saud Medical City, Riyadh</wicri:regionArea><wicri:noRegion>Riyadh</wicri:noRegion></affiliation></author><author><name sortKey="Al Qasim, Eman" sort="Al Qasim, Eman" uniqKey="Al Qasim E" first="Eman" last="Al Qasim">Eman Al Qasim</name><affiliation wicri:level="1"><nlm:aff id="aff016"><addr-line>Department of intensive care, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Riyadh, Saudi Arabia</addr-line></nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Department of intensive care, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Riyadh</wicri:regionArea><wicri:noRegion>Riyadh</wicri:noRegion></affiliation></author><author><name sortKey="Jose, Jesna" sort="Jose, Jesna" uniqKey="Jose J" first="Jesna" last="Jose">Jesna Jose</name><affiliation wicri:level="1"><nlm:aff id="aff016"><addr-line>Department of intensive care, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Riyadh, Saudi Arabia</addr-line></nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Department of intensive care, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Riyadh</wicri:regionArea><wicri:noRegion>Riyadh</wicri:noRegion></affiliation></author><author><name sortKey="Al Ghamdi, Ghassan" sort="Al Ghamdi, Ghassan" uniqKey="Al Ghamdi G" first="Ghassan" last="Al-Ghamdi">Ghassan Al-Ghamdi</name><affiliation wicri:level="1"><nlm:aff id="aff016"><addr-line>Department of intensive care, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Riyadh, Saudi Arabia</addr-line></nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Department of intensive care, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Riyadh</wicri:regionArea><wicri:noRegion>Riyadh</wicri:noRegion></affiliation></author><author><name sortKey="Merson, Laura" sort="Merson, Laura" uniqKey="Merson L" first="Laura" last="Merson">Laura Merson</name><affiliation wicri:level="1"><nlm:aff id="aff017"><addr-line>Infectious Diseases Data Observatory, Oxford University, Headiington, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Infectious Diseases Data Observatory, Oxford University, Headiington</wicri:regionArea><wicri:noRegion>Headiington</wicri:noRegion></affiliation></author><author><name sortKey="Fowler, Robert" sort="Fowler, Robert" uniqKey="Fowler R" first="Robert" last="Fowler">Robert Fowler</name><affiliation wicri:level="4"><nlm:aff id="aff018"><addr-line>Department of Critical Care Medicine and Department of Medicine, Sunnybrook Hospital, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Critical Care Medicine and Department of Medicine, Sunnybrook Hospital, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Hayden, Frederick G" sort="Hayden, Frederick G" uniqKey="Hayden F" first="Frederick G." last="Hayden">Frederick G. Hayden</name><affiliation wicri:level="2"><nlm:aff id="aff019"><addr-line>Department of Medicine, Division of Infectious Diseases and International Health University of Virginia School of Medicine, Charlottesville, Virginia, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Medicine, Division of Infectious Diseases and International Health University of Virginia School of Medicine, Charlottesville, Virginia</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Arabi, Yaseen M" sort="Arabi, Yaseen M" uniqKey="Arabi Y" first="Yaseen M." last="Arabi">Yaseen M. Arabi</name><affiliation wicri:level="1"><nlm:aff id="aff016"><addr-line>Department of intensive care, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Riyadh, Saudi Arabia</addr-line></nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Department of intensive care, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Riyadh</wicri:regionArea><wicri:noRegion>Riyadh</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">30439974</idno><idno type="pmc">6237307</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6237307</idno><idno type="RBID">PMC:6237307</idno><idno type="doi">10.1371/journal.pone.0206831</idno><date when="2018">2018</date><idno type="wicri:Area/Pmc/Corpus">001046</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001046</idno><idno type="wicri:Area/Pmc/Curation">001046</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">001046</idno><idno type="wicri:Area/Pmc/Checkpoint">000608</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000608</idno><idno type="wicri:source">PubMed</idno><idno type="RBID">pubmed:30439974</idno><idno type="wicri:Area/PubMed/Corpus">000730</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000730</idno><idno type="wicri:Area/PubMed/Curation">000730</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">000730</idno><idno type="wicri:Area/PubMed/Checkpoint">000965</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">000965</idno><idno type="wicri:Area/Ncbi/Merge">002017</idno><idno type="wicri:Area/Ncbi/Curation">002017</idno><idno type="wicri:Area/Ncbi/Checkpoint">002017</idno><idno type="wicri:Area/Main/Merge">000A22</idno><idno type="wicri:Area/Main/Curation">000A19</idno><idno type="wicri:Area/Main/Exploration">000A19</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Critically ill healthcare workers with the middle east respiratory syndrome (MERS): A multicenter study</title><author><name sortKey="Shalhoub, Sarah" sort="Shalhoub, Sarah" uniqKey="Shalhoub S" first="Sarah" last="Shalhoub">Sarah Shalhoub</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Department of Medicine, Division of Infectious Diseases, University of Western Ontario, London, Canada, Department of Medicine, Division of Infectious Diseases, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia</addr-line></nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Department of Medicine, Division of Infectious Diseases, University of Western Ontario, London, Canada, Department of Medicine, Division of Infectious Diseases, King Fahad Armed Forces Hospital, Jeddah</wicri:regionArea><wicri:noRegion>Jeddah</wicri:noRegion></affiliation></author><author><name sortKey="Al Hameed, Fahad" sort="Al Hameed, Fahad" uniqKey="Al Hameed F" first="Fahad" last="Al-Hameed">Fahad Al-Hameed</name><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Department of Intensive Care, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Jeddah, Saudi Arabia</addr-line></nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Department of Intensive Care, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Jeddah</wicri:regionArea><wicri:noRegion>Jeddah</wicri:noRegion></affiliation></author><author><name sortKey="Mandourah, Yasser" sort="Mandourah, Yasser" uniqKey="Mandourah Y" first="Yasser" last="Mandourah">Yasser Mandourah</name><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>Department of Intensive Care Services, Prince Sultan Military Medical City, Riyadh, Saudi Arabia</addr-line></nlm:aff><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></affiliation></author><author><name sortKey="Balkhy, Hanan H" sort="Balkhy, Hanan H" uniqKey="Balkhy H" first="Hanan H." last="Balkhy">Hanan H. Balkhy</name><affiliation wicri:level="1"><nlm:aff id="aff004"><addr-line>Department of Infection Prevention and Control, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Riyadh, Saudi Arabia</addr-line></nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Department of Infection Prevention and Control, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Riyadh</wicri:regionArea><wicri:noRegion>Riyadh</wicri:noRegion></affiliation></author><author><name sortKey="Al Omari, Awad" sort="Al Omari, Awad" uniqKey="Al Omari A" first="Awad" last="Al-Omari">Awad Al-Omari</name><affiliation wicri:level="1"><nlm:aff id="aff005"><addr-line>Department of Intensive Care, Alfaisal University, Dr Sulaiman Al-Habib Group Hospitals, Riyadh, Saudi Arabia</addr-line></nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Department of Intensive Care, Alfaisal University, Dr Sulaiman Al-Habib Group Hospitals, Riyadh</wicri:regionArea><wicri:noRegion>Riyadh</wicri:noRegion></affiliation></author><author><name sortKey="Al Mekhlafi, Ghaleb A" sort="Al Mekhlafi, Ghaleb A" uniqKey="Al Mekhlafi G" first="Ghaleb. A." last="Al Mekhlafi">Ghaleb. A. Al Mekhlafi</name><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>Department of Intensive Care Services, Prince Sultan Military Medical City, Riyadh, Saudi Arabia</addr-line></nlm:aff><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></affiliation></author><author><name sortKey="Kharaba, Ayman" sort="Kharaba, Ayman" uniqKey="Kharaba A" first="Ayman" last="Kharaba">Ayman Kharaba</name><affiliation wicri:level="1"><nlm:aff id="aff006"><addr-line>Department of Critical Care, King Fahad Hospital, Ohoud Hospital, Al-Madinah Al-Monawarah, Saudi Arabia</addr-line></nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Department of Critical Care, King Fahad Hospital, Ohoud Hospital, Al-Madinah Al-Monawarah</wicri:regionArea><wicri:noRegion>Al-Madinah Al-Monawarah</wicri:noRegion></affiliation></author><author><name sortKey="Alraddadi, Basem" sort="Alraddadi, Basem" uniqKey="Alraddadi B" first="Basem" last="Alraddadi">Basem Alraddadi</name><affiliation wicri:level="1"><nlm:aff id="aff007"><addr-line>Department of Medicine, Alfaisal University, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia</addr-line></nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Department of Medicine, Alfaisal University, King Faisal Specialist Hospital and Research Center, Jeddah</wicri:regionArea><wicri:noRegion>Jeddah</wicri:noRegion></affiliation></author><author><name sortKey="Almotairi, Abdullah" sort="Almotairi, Abdullah" uniqKey="Almotairi A" first="Abdullah" last="Almotairi">Abdullah Almotairi</name><affiliation wicri:level="1"><nlm:aff id="aff008"><addr-line>Department of Critical Care Medicine, King Fahad Medical City, Riyadh, Saudi Arabia</addr-line></nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Department of Critical Care Medicine, King Fahad Medical City, Riyadh</wicri:regionArea><wicri:noRegion>Riyadh</wicri:noRegion></affiliation></author><author><name sortKey="Al Khatib, Kasim" sort="Al Khatib, Kasim" uniqKey="Al Khatib K" first="Kasim" last="Al Khatib">Kasim Al Khatib</name><affiliation wicri:level="1"><nlm:aff id="aff009"><addr-line>Intensive Care Department, Al-Noor Specialist Hospital, Makkah, Saudi Arabia</addr-line></nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Intensive Care Department, Al-Noor Specialist Hospital, Makkah</wicri:regionArea><wicri:noRegion>Makkah</wicri:noRegion></affiliation></author><author><name sortKey="Abdulmomen, Ahmed" sort="Abdulmomen, Ahmed" uniqKey="Abdulmomen A" first="Ahmed" last="Abdulmomen">Ahmed Abdulmomen</name><affiliation wicri:level="1"><nlm:aff id="aff010"><addr-line>Department of Critical Care Medicine, King Saud University, Riyadh, Saudi Arabia</addr-line></nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Department of Critical Care Medicine, King Saud University, Riyadh</wicri:regionArea><wicri:noRegion>Riyadh</wicri:noRegion></affiliation></author><author><name sortKey="Qushmaq, Ismael" sort="Qushmaq, Ismael" uniqKey="Qushmaq I" first="Ismael" last="Qushmaq">Ismael Qushmaq</name><affiliation wicri:level="1"><nlm:aff id="aff007"><addr-line>Department of Medicine, Alfaisal University, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia</addr-line></nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Department of Medicine, Alfaisal University, King Faisal Specialist Hospital and Research Center, Jeddah</wicri:regionArea><wicri:noRegion>Jeddah</wicri:noRegion></affiliation></author><author><name sortKey="Mady, Ahmed" sort="Mady, Ahmed" uniqKey="Mady A" first="Ahmed" last="Mady">Ahmed Mady</name><affiliation wicri:level="1"><nlm:aff id="aff011"><addr-line>Intensive Care Department, King Saud Medical City, Riyadh, Saudi Arabia</addr-line></nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Intensive Care Department, King Saud Medical City, Riyadh</wicri:regionArea><wicri:noRegion>Riyadh</wicri:noRegion></affiliation></author><author><name sortKey="Solaiman, Othman" sort="Solaiman, Othman" uniqKey="Solaiman O" first="Othman" last="Solaiman">Othman Solaiman</name><affiliation wicri:level="1"><nlm:aff id="aff012"><addr-line>Intensive Care Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia</addr-line></nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Intensive Care Department, King Faisal Specialist Hospital and Research Center, Riyadh</wicri:regionArea><wicri:noRegion>Riyadh</wicri:noRegion></affiliation></author><author><name sortKey="Al Aithan, Abdulsalam M" sort="Al Aithan, Abdulsalam M" uniqKey="Al Aithan A" first="Abdulsalam M." last="Al-Aithan">Abdulsalam M. Al-Aithan</name><affiliation wicri:level="1"><nlm:aff id="aff013"><addr-line>Intensive Care Department, King Abdulaziz Hospital, Al Ahsa, Saudi Arabia</addr-line></nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Intensive Care Department, King Abdulaziz Hospital, Al Ahsa</wicri:regionArea><wicri:noRegion>Al Ahsa</wicri:noRegion></affiliation></author><author><name sortKey="Al Raddadi, Rajaa" sort="Al Raddadi, Rajaa" uniqKey="Al Raddadi R" first="Rajaa" last="Al-Raddadi">Rajaa Al-Raddadi</name><affiliation wicri:level="1"><nlm:aff id="aff014"><addr-line>Department of Family and Community Medicine, King Abdulaziz University Hospital, Ministry of Health, Jeddah, Saudi Arabia</addr-line></nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Department of Family and Community Medicine, King Abdulaziz University Hospital, Ministry of Health, Jeddah</wicri:regionArea><wicri:noRegion>Jeddah</wicri:noRegion></affiliation></author><author><name sortKey="Ragab, Ahmed" sort="Ragab, Ahmed" uniqKey="Ragab A" first="Ahmed" last="Ragab">Ahmed Ragab</name><affiliation wicri:level="1"><nlm:aff id="aff015"><addr-line>Intensive Care Department, King Fahd Hospital, Jeddah, Saudi Arabia</addr-line></nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Intensive Care Department, King Fahd Hospital, Jeddah</wicri:regionArea><wicri:noRegion>Jeddah</wicri:noRegion></affiliation></author><author><name sortKey="Al Harthy, Abdulrahman" sort="Al Harthy, Abdulrahman" uniqKey="Al Harthy A" first="Abdulrahman" last="Al Harthy">Abdulrahman Al Harthy</name><affiliation wicri:level="1"><nlm:aff id="aff011"><addr-line>Intensive Care Department, King Saud Medical City, Riyadh, Saudi Arabia</addr-line></nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Intensive Care Department, King Saud Medical City, Riyadh</wicri:regionArea><wicri:noRegion>Riyadh</wicri:noRegion></affiliation></author><author><name sortKey="Al Qasim, Eman" sort="Al Qasim, Eman" uniqKey="Al Qasim E" first="Eman" last="Al Qasim">Eman Al Qasim</name><affiliation wicri:level="1"><nlm:aff id="aff016"><addr-line>Department of intensive care, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Riyadh, Saudi Arabia</addr-line></nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Department of intensive care, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Riyadh</wicri:regionArea><wicri:noRegion>Riyadh</wicri:noRegion></affiliation></author><author><name sortKey="Jose, Jesna" sort="Jose, Jesna" uniqKey="Jose J" first="Jesna" last="Jose">Jesna Jose</name><affiliation wicri:level="1"><nlm:aff id="aff016"><addr-line>Department of intensive care, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Riyadh, Saudi Arabia</addr-line></nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Department of intensive care, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Riyadh</wicri:regionArea><wicri:noRegion>Riyadh</wicri:noRegion></affiliation></author><author><name sortKey="Al Ghamdi, Ghassan" sort="Al Ghamdi, Ghassan" uniqKey="Al Ghamdi G" first="Ghassan" last="Al-Ghamdi">Ghassan Al-Ghamdi</name><affiliation wicri:level="1"><nlm:aff id="aff016"><addr-line>Department of intensive care, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Riyadh, Saudi Arabia</addr-line></nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Department of intensive care, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Riyadh</wicri:regionArea><wicri:noRegion>Riyadh</wicri:noRegion></affiliation></author><author><name sortKey="Merson, Laura" sort="Merson, Laura" uniqKey="Merson L" first="Laura" last="Merson">Laura Merson</name><affiliation wicri:level="1"><nlm:aff id="aff017"><addr-line>Infectious Diseases Data Observatory, Oxford University, Headiington, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Infectious Diseases Data Observatory, Oxford University, Headiington</wicri:regionArea><wicri:noRegion>Headiington</wicri:noRegion></affiliation></author><author><name sortKey="Fowler, Robert" sort="Fowler, Robert" uniqKey="Fowler R" first="Robert" last="Fowler">Robert Fowler</name><affiliation wicri:level="4"><nlm:aff id="aff018"><addr-line>Department of Critical Care Medicine and Department of Medicine, Sunnybrook Hospital, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Critical Care Medicine and Department of Medicine, Sunnybrook Hospital, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Hayden, Frederick G" sort="Hayden, Frederick G" uniqKey="Hayden F" first="Frederick G." last="Hayden">Frederick G. Hayden</name><affiliation wicri:level="2"><nlm:aff id="aff019"><addr-line>Department of Medicine, Division of Infectious Diseases and International Health University of Virginia School of Medicine, Charlottesville, Virginia, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Medicine, Division of Infectious Diseases and International Health University of Virginia School of Medicine, Charlottesville, Virginia</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Arabi, Yaseen M" sort="Arabi, Yaseen M" uniqKey="Arabi Y" first="Yaseen M." last="Arabi">Yaseen M. Arabi</name><affiliation wicri:level="1"><nlm:aff id="aff016"><addr-line>Department of intensive care, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Riyadh, Saudi Arabia</addr-line></nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Department of intensive care, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Riyadh</wicri:regionArea><wicri:noRegion>Riyadh</wicri:noRegion></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2018">2018</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Comorbidity</term><term>Coronavirus Infections (diagnosis)</term><term>Coronavirus Infections (epidemiology)</term><term>Coronavirus Infections (therapy)</term><term>Coronavirus Infections (virology)</term><term>Critical Illness (epidemiology)</term><term>Critical Illness (therapy)</term><term>Cross Infection (diagnosis)</term><term>Cross Infection (epidemiology)</term><term>Cross Infection (therapy)</term><term>Cross Infection (virology)</term><term>Disease Outbreaks</term><term>Extracorporeal Membrane Oxygenation (statistics & numerical data)</term><term>Female</term><term>Health Personnel (statistics & numerical data)</term><term>Hospital Mortality</term><term>Humans</term><term>Karnofsky Performance Status</term><term>Male</term><term>Middle Aged</term><term>Middle East Respiratory Syndrome Coronavirus (isolation & purification)</term><term>Occupational Diseases (diagnosis)</term><term>Occupational Diseases (epidemiology)</term><term>Occupational Diseases (therapy)</term><term>Occupational Diseases (virology)</term><term>Retrospective Studies</term><term>Saudi Arabia (epidemiology)</term><term>Survival Rate</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Arabie saoudite (épidémiologie)</term><term>Comorbidité</term><term>Coronavirus du syndrome respiratoire du Moyen-Orient (isolement et purification)</term><term>Femelle</term><term>Flambées de maladies</term><term>Humains</term><term>Infection croisée ()</term><term>Infection croisée (diagnostic)</term><term>Infection croisée (virologie)</term><term>Infection croisée (épidémiologie)</term><term>Infections à coronavirus ()</term><term>Infections à coronavirus (diagnostic)</term><term>Infections à coronavirus (virologie)</term><term>Infections à coronavirus (épidémiologie)</term><term>Maladie grave ()</term><term>Maladie grave (épidémiologie)</term><term>Maladies professionnelles ()</term><term>Maladies professionnelles (diagnostic)</term><term>Maladies professionnelles (virologie)</term><term>Maladies professionnelles (épidémiologie)</term><term>Mortalité hospitalière</term><term>Mâle</term><term>Niveau de performance de Karnofsky</term><term>Oxygénation extracorporelle sur oxygénateur à membrane ()</term><term>Personnel de santé ()</term><term>Taux de survie</term><term>Études rétrospectives</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Saudi Arabia</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Coronavirus Infections</term><term>Cross Infection</term><term>Occupational Diseases</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Infection croisée</term><term>Infections à coronavirus</term><term>Maladies professionnelles</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Coronavirus Infections</term><term>Critical Illness</term><term>Cross Infection</term><term>Occupational Diseases</term></keywords><keywords scheme="MESH" qualifier="isolation & purification" xml:lang="en"><term>Middle East Respiratory Syndrome Coronavirus</term></keywords><keywords scheme="MESH" qualifier="isolement et purification" xml:lang="fr"><term>Coronavirus du syndrome respiratoire du Moyen-Orient</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Extracorporeal Membrane Oxygenation</term><term>Health Personnel</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Coronavirus Infections</term><term>Critical Illness</term><term>Cross Infection</term><term>Occupational Diseases</term></keywords><keywords scheme="MESH" qualifier="virologie" xml:lang="fr"><term>Infection croisée</term><term>Infections à coronavirus</term><term>Maladies professionnelles</term></keywords><keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Coronavirus Infections</term><term>Cross Infection</term><term>Occupational Diseases</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Arabie saoudite</term><term>Infection croisée</term><term>Infections à coronavirus</term><term>Maladie grave</term><term>Maladies professionnelles</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Comorbidity</term><term>Disease Outbreaks</term><term>Female</term><term>Hospital Mortality</term><term>Humans</term><term>Karnofsky Performance Status</term><term>Male</term><term>Middle Aged</term><term>Retrospective Studies</term><term>Survival Rate</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Comorbidité</term><term>Femelle</term><term>Flambées de maladies</term><term>Humains</term><term>Infection croisée</term><term>Infections à coronavirus</term><term>Maladie grave</term><term>Maladies professionnelles</term><term>Mortalité hospitalière</term><term>Mâle</term><term>Niveau de performance de Karnofsky</term><term>Oxygénation extracorporelle sur oxygénateur à membrane</term><term>Personnel de santé</term><term>Taux de survie</term><term>Études rétrospectives</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Arabie saoudite</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Background</title><p>Middle East Respiratory Syndrome Coronavirus (MERS-CoV) leads to healthcare-associated transmission to patients and healthcare workers with potentially fatal outcomes.</p></sec><sec id="sec002"><title>Aim</title><p>We aimed to describe the clinical course and functional outcomes of critically ill healthcare workers (HCWs) with MERS.</p></sec><sec id="sec003"><title>Methods</title><p>Data on HCWs was extracted from a multi-center retrospective cohort study on 330 critically ill patients with MERS admitted between (9/2012–9/2015). Baseline demographics, interventions and outcomes were recorded and compared between survivors and non-survivors. Survivors were approached with questionnaires to elucidate their functional outcomes using Karnofsky Performance Status Scale.</p></sec><sec id="sec004"><title>Findings</title><p>Thirty-Two HCWs met the inclusion criteria. Comorbidities were recorded in 34% (11/32) HCW. Death resulted in 8/32 (25%) HCWs including all 5 HCWs with chronic renal impairment at baseline. Non-surviving HCW had lower PaO2/FiO2 ratios 63.5 (57, 116.2) vs 148 (84, 194.3), p = 0.043, and received more ECMO therapy compared to survivors, 9/32 (28%) vs 4/24 (16.7%) respectively (p = 0.02).Thirteen of the surviving (13/24) HCWs responded to the questionnaire. Two HCWs confirmed functional limitations. Median number of days from hospital discharge until the questionnaires were filled was 580 (95% CI 568, 723.5) days.</p></sec><sec id="sec005"><title>Conclusion</title><p>Approximately 10% of critically ill patients with MERS were HCWs. Hospital mortality rate was substantial (25%). Patients with chronic renal impairment represented a particularly high-risk group that should receive extra caution during suspected or confirmed MERS cases clinical care assignment and during outbreaks. Long-term repercussions of critical illness due to MERS on HCWs in particular, and patients in general, remain unknown and should be investigated in larger studies.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Zaki, Am" uniqKey="Zaki A">AM Zaki</name></author><author><name sortKey="Van Boheemen, S" uniqKey="Van Boheemen S">S van Boheemen</name></author><author><name sortKey="Bestebroer, Tm" uniqKey="Bestebroer T">TM Bestebroer</name></author><author><name sortKey="Osterhaus, Ad" uniqKey="Osterhaus A">AD Osterhaus</name></author><author><name sortKey="Fouchier, Ra" uniqKey="Fouchier R">RA Fouchier</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Arabi, Ym" uniqKey="Arabi Y">YM Arabi</name></author><author><name sortKey="Balkhy, Hh" uniqKey="Balkhy H">HH Balkhy</name></author><author><name sortKey="Hayden, Fg" uniqKey="Hayden F">FG Hayden</name></author><author><name sortKey="Bouchama, A" 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last="Shalhoub">Sarah Shalhoub</name></noRegion><name sortKey="Abdulmomen, Ahmed" sort="Abdulmomen, Ahmed" uniqKey="Abdulmomen A" first="Ahmed" last="Abdulmomen">Ahmed Abdulmomen</name><name sortKey="Al Aithan, Abdulsalam M" sort="Al Aithan, Abdulsalam M" uniqKey="Al Aithan A" first="Abdulsalam M." last="Al-Aithan">Abdulsalam M. Al-Aithan</name><name sortKey="Al Ghamdi, Ghassan" sort="Al Ghamdi, Ghassan" uniqKey="Al Ghamdi G" first="Ghassan" last="Al-Ghamdi">Ghassan Al-Ghamdi</name><name sortKey="Al Hameed, Fahad" sort="Al Hameed, Fahad" uniqKey="Al Hameed F" first="Fahad" last="Al-Hameed">Fahad Al-Hameed</name><name sortKey="Al Harthy, Abdulrahman" sort="Al Harthy, Abdulrahman" uniqKey="Al Harthy A" first="Abdulrahman" last="Al Harthy">Abdulrahman Al Harthy</name><name sortKey="Al Khatib, Kasim" sort="Al Khatib, Kasim" uniqKey="Al Khatib K" first="Kasim" last="Al Khatib">Kasim Al Khatib</name><name sortKey="Al Mekhlafi, Ghaleb A" sort="Al Mekhlafi, Ghaleb A" uniqKey="Al Mekhlafi G" first="Ghaleb. A." last="Al Mekhlafi">Ghaleb. A. Al Mekhlafi</name><name sortKey="Al Omari, Awad" sort="Al Omari, Awad" uniqKey="Al Omari A" first="Awad" last="Al-Omari">Awad Al-Omari</name><name sortKey="Al Qasim, Eman" sort="Al Qasim, Eman" uniqKey="Al Qasim E" first="Eman" last="Al Qasim">Eman Al Qasim</name><name sortKey="Al Raddadi, Rajaa" sort="Al Raddadi, Rajaa" uniqKey="Al Raddadi R" first="Rajaa" last="Al-Raddadi">Rajaa Al-Raddadi</name><name sortKey="Almotairi, Abdullah" sort="Almotairi, Abdullah" uniqKey="Almotairi A" first="Abdullah" last="Almotairi">Abdullah Almotairi</name><name sortKey="Alraddadi, Basem" sort="Alraddadi, Basem" uniqKey="Alraddadi B" first="Basem" last="Alraddadi">Basem Alraddadi</name><name sortKey="Arabi, Yaseen M" sort="Arabi, Yaseen M" uniqKey="Arabi Y" first="Yaseen M." last="Arabi">Yaseen M. Arabi</name><name sortKey="Balkhy, Hanan H" sort="Balkhy, Hanan H" uniqKey="Balkhy H" first="Hanan H." last="Balkhy">Hanan H. Balkhy</name><name sortKey="Jose, Jesna" sort="Jose, Jesna" uniqKey="Jose J" first="Jesna" last="Jose">Jesna Jose</name><name sortKey="Kharaba, Ayman" sort="Kharaba, Ayman" uniqKey="Kharaba A" first="Ayman" last="Kharaba">Ayman Kharaba</name><name sortKey="Mady, Ahmed" sort="Mady, Ahmed" uniqKey="Mady A" first="Ahmed" last="Mady">Ahmed Mady</name><name sortKey="Mandourah, Yasser" sort="Mandourah, Yasser" uniqKey="Mandourah Y" first="Yasser" last="Mandourah">Yasser Mandourah</name><name sortKey="Qushmaq, Ismael" sort="Qushmaq, Ismael" uniqKey="Qushmaq I" first="Ismael" last="Qushmaq">Ismael Qushmaq</name><name sortKey="Ragab, Ahmed" sort="Ragab, Ahmed" uniqKey="Ragab A" first="Ahmed" last="Ragab">Ahmed Ragab</name><name sortKey="Solaiman, Othman" sort="Solaiman, Othman" uniqKey="Solaiman O" first="Othman" last="Solaiman">Othman Solaiman</name></country><country name="Royaume-Uni"><noRegion><name sortKey="Merson, Laura" sort="Merson, Laura" uniqKey="Merson L" first="Laura" last="Merson">Laura Merson</name></noRegion></country><country name="Canada"><region name="Ontario"><name sortKey="Fowler, Robert" sort="Fowler, Robert" uniqKey="Fowler R" first="Robert" last="Fowler">Robert Fowler</name></region></country><country name="États-Unis"><region name="Virginie"><name sortKey="Hayden, Frederick G" sort="Hayden, Frederick G" uniqKey="Hayden F" first="Frederick G." last="Hayden">Frederick G. 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