Clinical determinants of the severity of Middle East respiratory syndrome (MERS): a systematic review and meta-analysis
Identifieur interne : 001342 ( Main/Exploration ); précédent : 001341; suivant : 001343Clinical determinants of the severity of Middle East respiratory syndrome (MERS): a systematic review and meta-analysis
Auteurs : Ryota Matsuyama [Japon] ; Hiroshi Nishiura [Japon] ; Satoshi Kutsuna [Japon] ; Kayoko Hayakawa [Japon] ; Norio Ohmagari [Japon]Source :
- BMC Public Health [ 1471-2458 ] ; 2016.
Descripteurs français
- KwdFr :
- MESH :
- mortalité : Infections à coronavirus.
- épidémiologie : Infections à coronavirus.
- Bases de données factuelles, Comorbidité, Facteurs de risque, Humains, Indice de gravité médicale, Odds ratio, Santé mondiale.
English descriptors
- KwdEn :
- MESH :
- epidemiology : Coronavirus Infections.
- mortality : Coronavirus Infections.
- Comorbidity, Databases, Factual, Global Health, Humans, Odds Ratio, Risk Factors, Severity of Illness Index.
Abstract
While the risk of severe complications of Middle East respiratory syndrome (MERS) and its determinants have been explored in previous studies, a systematic analysis of published articles with different designs and populations has yet to be conducted. The present study aimed to systematically review the risk of death associated with MERS as well as risk factors for associated complications.
PubMed and Web of Science databases were searched for clinical and epidemiological studies on confirmed cases of MERS. Eligible articles reported clinical outcomes, especially severe complications or death associated with MERS. Risks of admission to intensive care unit (ICU), mechanical ventilation and death were estimated. Subsequently, potential associations between MERS-associated death and age, sex, underlying medical conditions and study design were explored.
A total of 25 eligible articles were identified. The case fatality risk ranged from 14.5 to 100%, with the pooled estimate at 39.1%. The risks of ICU admission and mechanical ventilation ranged from 44.4 to 100% and from 25.0 to 100%, with pooled estimates at 78.2 and 73.0%, respectively. These risks showed a substantial heterogeneity among the identified studies, and appeared to be the highest in case studies focusing on ICU cases. We identified older age, male sex and underlying medical conditions, including diabetes mellitus, renal disease, respiratory disease, heart disease and hypertension, as clinical predictors of death associated with MERS. In ICU case studies, the expected odds ratios (OR) of death among patients with underlying heart disease or renal disease to patients without such comorbidities were 0.6 (95% Confidence Interval (CI): 0.1, 4.3) and 0.6 (95% CI: 0.0, 2.1), respectively, while the ORs were 3.8 (95% CI: 3.4, 4.2) and 2.4 (95% CI: 2.0, 2.9), respectively, in studies with other types of designs.
The heterogeneity for the risk of death and severe manifestations was substantially high among the studies, and varying study designs was one of the underlying reasons for this heterogeneity. A statistical estimation of the risk of MERS death and identification of risk factors must be conducted, particularly considering the study design and potential biases associated with case detection and diagnosis.
The online version of this article (doi:10.1186/s12889-016-3881-4) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1186/s12889-016-3881-4
PubMed: 27899100
PubMed Central: 5129628
Affiliations:
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Le document en format XML
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Hospital, 1-21-1 Toyama, Shinjuku-ku Tokyo, 162-8655 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, 1-21-1 Toyama, Shinjuku-ku Tokyo</wicri:regionArea><wicri:noRegion>Shinjuku-ku Tokyo</wicri:noRegion></affiliation></author><author><name sortKey="Hayakawa, Kayoko" sort="Hayakawa, Kayoko" uniqKey="Hayakawa K" first="Kayoko" last="Hayakawa">Kayoko Hayakawa</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, 1-21-1 Toyama, Shinjuku-ku Tokyo, 162-8655 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, 1-21-1 Toyama, Shinjuku-ku Tokyo</wicri:regionArea><wicri:noRegion>Shinjuku-ku Tokyo</wicri:noRegion></affiliation></author><author><name sortKey="Ohmagari, Norio" sort="Ohmagari, Norio" uniqKey="Ohmagari N" first="Norio" last="Ohmagari">Norio Ohmagari</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, 1-21-1 Toyama, Shinjuku-ku Tokyo, 162-8655 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, 1-21-1 Toyama, Shinjuku-ku Tokyo</wicri:regionArea><wicri:noRegion>Shinjuku-ku Tokyo</wicri:noRegion></affiliation></author></analytic><series><title level="j">BMC Public Health</title><idno type="eISSN">1471-2458</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Comorbidity</term><term>Coronavirus Infections (epidemiology)</term><term>Coronavirus Infections (mortality)</term><term>Databases, Factual</term><term>Global 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Factual</term><term>Global Health</term><term>Humans</term><term>Odds Ratio</term><term>Risk Factors</term><term>Severity of Illness Index</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Bases de données factuelles</term><term>Comorbidité</term><term>Facteurs de risque</term><term>Humains</term><term>Indice de gravité médicale</term><term>Odds ratio</term><term>Santé mondiale</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p id="Par1">While the risk of severe complications of Middle East respiratory syndrome (MERS) and its determinants have been explored in previous studies, a systematic analysis of published articles with different designs and populations has yet to be conducted. The present study aimed to systematically review the risk of death associated with MERS as well as risk factors for associated complications.</p></sec><sec><title>Methods</title><p id="Par2">PubMed and Web of Science databases were searched for clinical and epidemiological studies on confirmed cases of MERS. Eligible articles reported clinical outcomes, especially severe complications or death associated with MERS. Risks of admission to intensive care unit (ICU), mechanical ventilation and death were estimated. Subsequently, potential associations between MERS-associated death and age, sex, underlying medical conditions and study design were explored.</p></sec><sec><title>Results</title><p id="Par3">A total of 25 eligible articles were identified. The case fatality risk ranged from 14.5 to 100%, with the pooled estimate at 39.1%. The risks of ICU admission and mechanical ventilation ranged from 44.4 to 100% and from 25.0 to 100%, with pooled estimates at 78.2 and 73.0%, respectively. These risks showed a substantial heterogeneity among the identified studies, and appeared to be the highest in case studies focusing on ICU cases. We identified older age, male sex and underlying medical conditions, including diabetes mellitus, renal disease, respiratory disease, heart disease and hypertension, as clinical predictors of death associated with MERS. In ICU case studies, the expected odds ratios (OR) of death among patients with underlying heart disease or renal disease to patients without such comorbidities were 0.6 (95% Confidence Interval (CI): 0.1, 4.3) and 0.6 (95% CI: 0.0, 2.1), respectively, while the ORs were 3.8 (95% CI: 3.4, 4.2) and 2.4 (95% CI: 2.0, 2.9), respectively, in studies with other types of designs.</p></sec><sec><title>Conclusions</title><p id="Par4">The heterogeneity for the risk of death and severe manifestations was substantially high among the studies, and varying study designs was one of the underlying reasons for this heterogeneity. A statistical estimation of the risk of MERS death and identification of risk factors must be conducted, particularly considering the study design and potential biases associated with case detection and diagnosis.</p></sec><sec><title>Electronic supplementary material</title><p>The online version of this article (doi:10.1186/s12889-016-3881-4) contains supplementary material, which is available to authorized users.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Kapoor, M" uniqKey="Kapoor M">M Kapoor</name></author><author><name sortKey="Pringle, K" uniqKey="Pringle K">K Pringle</name></author><author><name sortKey="Kumar, A" uniqKey="Kumar A">A Kumar</name></author><author><name sortKey="Dearth, S" uniqKey="Dearth S">S Dearth</name></author><author><name sortKey="Liu, L" uniqKey="Liu L">L Liu</name></author><author><name sortKey="Lovchik, J" uniqKey="Lovchik J">J 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Boëlle</name></author><author><name sortKey="Colizza, V" uniqKey="Colizza V">V Colizza</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Nah, K" uniqKey="Nah K">K Nah</name></author><author><name sortKey="Otsuki, S" uniqKey="Otsuki S">S Otsuki</name></author><author><name sortKey="Chowell, G" uniqKey="Chowell G">G Chowell</name></author><author><name sortKey="Nishiura, H" uniqKey="Nishiura H">H Nishiura</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Nishiura, H" uniqKey="Nishiura H">H Nishiura</name></author><author><name sortKey="Endo, A" uniqKey="Endo A">A Endo</name></author><author><name sortKey="Saitoh, M" uniqKey="Saitoh M">M Saitoh</name></author><author><name sortKey="Kinoshita, R" uniqKey="Kinoshita R">R Kinoshita</name></author><author><name sortKey="Ueno, R" uniqKey="Ueno R">R Ueno</name></author><author><name sortKey="Nakaoka, S" uniqKey="Nakaoka S">S Nakaoka</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Japon</li></country></list><tree><country name="Japon"><noRegion><name sortKey="Matsuyama, Ryota" sort="Matsuyama, Ryota" uniqKey="Matsuyama R" first="Ryota" last="Matsuyama">Ryota Matsuyama</name></noRegion><name sortKey="Hayakawa, Kayoko" sort="Hayakawa, Kayoko" uniqKey="Hayakawa K" first="Kayoko" last="Hayakawa">Kayoko Hayakawa</name><name sortKey="Kutsuna, Satoshi" sort="Kutsuna, Satoshi" uniqKey="Kutsuna S" first="Satoshi" last="Kutsuna">Satoshi Kutsuna</name><name sortKey="Nishiura, Hiroshi" sort="Nishiura, Hiroshi" uniqKey="Nishiura H" first="Hiroshi" last="Nishiura">Hiroshi Nishiura</name><name sortKey="Ohmagari, Norio" sort="Ohmagari, Norio" uniqKey="Ohmagari N" first="Norio" last="Ohmagari">Norio Ohmagari</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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