Treatment outcomes for patients with Middle Eastern Respiratory Syndrome Coronavirus (MERS CoV) infection at a coronavirus referral center in the Kingdom of Saudi Arabia
Identifieur interne : 000F73 ( Main/Exploration ); précédent : 000F72; suivant : 000F74Treatment outcomes for patients with Middle Eastern Respiratory Syndrome Coronavirus (MERS CoV) infection at a coronavirus referral center in the Kingdom of Saudi Arabia
Auteurs : Mohammed Al Ghamdi ; Khalid M. Alghamdi ; Yasmeen Ghandoora ; Ameera Alzahrani ; Fatmah Salah ; Abdulmoatani Alsulami ; Mayada F. Bawayan ; Dhananjay Vaidya ; Trish M. Perl ; Geeta SoodSource :
- BMC Infectious Diseases [ 1471-2334 ] ; 2016.
Descripteurs français
- KwdFr :
- Acide mycophénolique (analogues et dérivés), Acide mycophénolique (usage thérapeutique), Adulte d'âge moyen, Alanine transaminase (métabolisme), Analyse multivariée, Arabie saoudite, Centres de soins tertiaires, Coronavirus du syndrome respiratoire du Moyen-Orient (génétique), Coronavirus du syndrome respiratoire du Moyen-Orient (isolement et purification), Femelle, Humains, Immunosuppresseurs (usage thérapeutique), Indice de gravité médicale, Infections à coronavirus (mortalité), Infections à coronavirus (traitement médicamenteux), Infections à coronavirus (virologie), Modèles logistiques, Mâle, Personnel de santé, Poumon (enzymologie), Poumon (virologie), Réaction de polymérisation en chaîne, Résultat thérapeutique, Sujet âgé, Études rétrospectives.
- MESH :
- analogues et dérivés : Acide mycophénolique.
- enzymologie : Poumon.
- génétique : Coronavirus du syndrome respiratoire du Moyen-Orient.
- isolement et purification : Coronavirus du syndrome respiratoire du Moyen-Orient.
- mortalité : Infections à coronavirus.
- métabolisme : Alanine transaminase.
- traitement médicamenteux : Infections à coronavirus.
- usage thérapeutique : Acide mycophénolique, Immunosuppresseurs.
- virologie : Infections à coronavirus, Poumon.
- Adulte d'âge moyen, Analyse multivariée, Arabie saoudite, Centres de soins tertiaires, Femelle, Humains, Indice de gravité médicale, Modèles logistiques, Mâle, Personnel de santé, Réaction de polymérisation en chaîne, Résultat thérapeutique, Sujet âgé, Études rétrospectives.
English descriptors
- KwdEn :
- Aged, Alanine Transaminase (metabolism), Coronavirus Infections (drug therapy), Coronavirus Infections (mortality), Coronavirus Infections (virology), Female, Health Personnel, Humans, Immunosuppressive Agents (therapeutic use), Logistic Models, Lung (enzymology), Lung (virology), Male, Middle Aged, Middle East Respiratory Syndrome Coronavirus (genetics), Middle East Respiratory Syndrome Coronavirus (isolation & purification), Multivariate Analysis, Mycophenolic Acid (analogs & derivatives), Mycophenolic Acid (therapeutic use), Polymerase Chain Reaction, Retrospective Studies, Saudi Arabia, Severity of Illness Index, Tertiary Care Centers, Treatment Outcome.
- MESH :
- chemical , analogs & derivatives : Mycophenolic Acid.
- chemical , metabolism : Alanine Transaminase.
- drug therapy : Coronavirus Infections.
- enzymology : Lung.
- genetics : Middle East Respiratory Syndrome Coronavirus.
- isolation & purification : Middle East Respiratory Syndrome Coronavirus.
- mortality : Coronavirus Infections.
- chemical , therapeutic use : Immunosuppressive Agents, Mycophenolic Acid.
- virology : Coronavirus Infections, Lung.
- Aged, Female, Health Personnel, Humans, Logistic Models, Male, Middle Aged, Multivariate Analysis, Polymerase Chain Reaction, Retrospective Studies, Saudi Arabia, Severity of Illness Index, Tertiary Care Centers, Treatment Outcome.
Abstract
Middle Eastern Respiratory Syndrome coronavirus (MERS-CoV) is a poorly understood disease with no known treatments. We describe the clinical features and treatment outcomes of patients with laboratory confirmed MERS-CoV at a regional referral center in the Kingdom of Saudi Arabia.
In 2014, a retrospective chart review was performed on patients with a laboratory confirmed diagnosis of MERS-CoV to determine clinical and treatment characteristics associated with death. Confounding was evaluated and a multivariate logistic regression was performed to assess the independent effect of treatments administered.
Fifty-one patients had an overall mortality of 37 %. Most patients were male (78 %) with a mean age of 54 years. Almost a quarter of the patients were healthcare workers (23.5 %) and 41 % had a known exposure to another person with MERS-CoV. Survival was associated with male gender, working as a healthcare worker, history of hypertension, vomiting on admission, elevated respiratory rate, abnormal lung exam, elevated alanine transaminase (ALT), clearance of MERS-CoV on repeat PCR polymerase chain reaction (PCR) testing, and mycophenolate mofetil treatment. Survival was reduced in the presence of coronary artery disease, hypotension, hypoxemia, CXR (chest X-ray) abnormalities, leukocytosis, creatinine >1 · 5 mg/dL, thrombocytopenia, anemia, and renal failure. In a multivariate analysis of treatments administered, severity of illness was the greatest predictor of reduced survival.
Care for patients with MERS-CoV remains a challenge. In this retrospective cohort, interferon beta and mycophenolate mofetil treatment were predictors of increased survival in the univariate analysis. Severity of illness was the greatest predictor of reduced survival in the multivariate analysis. Larger randomized trials are needed to better evaluate the efficacy of these treatment regimens for MERS-CoV.
Url:
DOI: 10.1186/s12879-016-1492-4
PubMed: 27097824
PubMed Central: 4839124
Affiliations:
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Reaction</term><term>Retrospective Studies</term><term>Saudi Arabia</term><term>Severity of Illness Index</term><term>Tertiary Care Centers</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Analyse multivariée</term><term>Arabie saoudite</term><term>Centres de soins tertiaires</term><term>Femelle</term><term>Humains</term><term>Indice de gravité médicale</term><term>Modèles logistiques</term><term>Mâle</term><term>Personnel de santé</term><term>Réaction de polymérisation en chaîne</term><term>Résultat thérapeutique</term><term>Sujet âgé</term><term>Études rétrospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p id="Par1">Middle Eastern Respiratory Syndrome coronavirus (MERS-CoV) is a poorly understood disease with no known treatments. We describe the clinical features and treatment outcomes of patients with laboratory confirmed MERS-CoV at a regional referral center in the Kingdom of Saudi Arabia.</p></sec><sec><title>Methods</title><p id="Par2">In 2014, a retrospective chart review was performed on patients with a laboratory confirmed diagnosis of MERS-CoV to determine clinical and treatment characteristics associated with death. Confounding was evaluated and a multivariate logistic regression was performed to assess the independent effect of treatments administered.</p></sec><sec><title>Results</title><p id="Par3">Fifty-one patients had an overall mortality of 37 %. Most patients were male (78 %) with a mean age of 54 years. Almost a quarter of the patients were healthcare workers (23.5 %) and 41 % had a known exposure to another person with MERS-CoV. Survival was associated with male gender, working as a healthcare worker, history of hypertension, vomiting on admission, elevated respiratory rate, abnormal lung exam, elevated alanine transaminase (ALT), clearance of MERS-CoV on repeat PCR polymerase chain reaction (PCR) testing, and mycophenolate mofetil treatment. Survival was reduced in the presence of coronary artery disease, hypotension, hypoxemia, CXR (chest X-ray) abnormalities, leukocytosis, creatinine >1 · 5 mg/dL, thrombocytopenia, anemia, and renal failure. In a multivariate analysis of treatments administered, severity of illness was the greatest predictor of reduced survival.</p></sec><sec><title>Conclusions</title><p id="Par4">Care for patients with MERS-CoV remains a challenge. In this retrospective cohort, interferon beta and mycophenolate mofetil treatment were predictors of increased survival in the univariate analysis. Severity of illness was the greatest predictor of reduced survival in the multivariate analysis. Larger randomized trials are needed to better evaluate the efficacy of these treatment regimens for MERS-CoV.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Peiris, Js" uniqKey="Peiris J">JS Peiris</name></author><author><name sortKey="Yuen, Ky" uniqKey="Yuen K">KY Yuen</name></author><author><name sortKey="Osterhaus, Ad" uniqKey="Osterhaus A">AD Osterhaus</name></author><author><name sortKey="Stohr, K" uniqKey="Stohr K">K Stöhr</name></author></analytic></biblStruct><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 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Memish</name></author><author><name sortKey="Albarrak, Am" uniqKey="Albarrak A">AM Albarrak</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Khalid, M" uniqKey="Khalid M">M Khalid</name></author><author><name sortKey="Al Rabiah, F" uniqKey="Al Rabiah F">F Al Rabiah</name></author><author><name sortKey="Khan, B" uniqKey="Khan B">B Khan</name></author><author><name sortKey="Al Mobeireek, A" uniqKey="Al Mobeireek A">A Al Mobeireek</name></author><author><name sortKey="Butt, Ts" uniqKey="Butt T">TS Butt</name></author><author><name sortKey="Al, Me" uniqKey="Al M">ME Al</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Al Tawfiq, Ja" uniqKey="Al Tawfiq J">JA Al-Tawfiq</name></author><author><name sortKey="Momattin, H" uniqKey="Momattin H">H Momattin</name></author><author><name sortKey="Dib, J" uniqKey="Dib J">J Dib</name></author><author><name sortKey="Memish, Za" uniqKey="Memish Z">ZA Memish</name></author></analytic></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><affiliations><list></list><tree><noCountry><name sortKey="Al Ghamdi, Mohammed" sort="Al Ghamdi, Mohammed" uniqKey="Al Ghamdi M" first="Mohammed" last="Al Ghamdi">Mohammed Al Ghamdi</name><name sortKey="Alghamdi, Khalid M" sort="Alghamdi, Khalid M" uniqKey="Alghamdi K" first="Khalid M." last="Alghamdi">Khalid M. Alghamdi</name><name sortKey="Alsulami, Abdulmoatani" sort="Alsulami, Abdulmoatani" uniqKey="Alsulami A" first="Abdulmoatani" last="Alsulami">Abdulmoatani Alsulami</name><name sortKey="Alzahrani, Ameera" sort="Alzahrani, Ameera" uniqKey="Alzahrani A" first="Ameera" last="Alzahrani">Ameera Alzahrani</name><name sortKey="Bawayan, Mayada F" sort="Bawayan, Mayada F" uniqKey="Bawayan M" first="Mayada F." last="Bawayan">Mayada F. Bawayan</name><name sortKey="Ghandoora, Yasmeen" sort="Ghandoora, Yasmeen" uniqKey="Ghandoora Y" first="Yasmeen" last="Ghandoora">Yasmeen Ghandoora</name><name sortKey="Perl, Trish M" sort="Perl, Trish M" uniqKey="Perl T" first="Trish M." last="Perl">Trish M. Perl</name><name sortKey="Salah, Fatmah" sort="Salah, Fatmah" uniqKey="Salah F" first="Fatmah" last="Salah">Fatmah Salah</name><name sortKey="Sood, Geeta" sort="Sood, Geeta" uniqKey="Sood G" first="Geeta" last="Sood">Geeta Sood</name><name sortKey="Vaidya, Dhananjay" sort="Vaidya, Dhananjay" uniqKey="Vaidya D" first="Dhananjay" last="Vaidya">Dhananjay Vaidya</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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