High fatality rates and associated factors in two hospital outbreaks of MERS in Daejeon, the Republic of Korea
Identifieur interne : 001962 ( Ncbi/Curation ); précédent : 001961; suivant : 001963High fatality rates and associated factors in two hospital outbreaks of MERS in Daejeon, the Republic of Korea
Auteurs : Hae-Sung Nam [Corée du Sud] ; Jung Wan Park [Corée du Sud] ; Moran Ki [Corée du Sud] ; Mi-Yeon Yeon [Corée du Sud] ; Jin Kim [Corée du Sud] ; Seung Woo Kim [Corée du Sud]Source :
- International Journal of Infectious Diseases [ 1201-9712 ] ; 2017.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Coronavirus du syndrome respiratoire du Moyen-Orient, Facteurs de risque, Femelle, Flambées de maladies, Humains, Infection croisée (mortalité), Infection croisée (épidémiologie), Infections à coronavirus (mortalité), Infections à coronavirus (épidémiologie), Mâle, République de Corée (épidémiologie), Sujet âgé.
- MESH :
English descriptors
- KwdEn :
- MESH :
- epidemiology : Coronavirus Infections, Cross Infection, Republic of Korea.
- mortality : Coronavirus Infections, Cross Infection.
- Adult, Aged, Disease Outbreaks, Female, Humans, Male, Middle Aged, Middle East Respiratory Syndrome Coronavirus, Risk Factors.
Abstract
To explore the epidemiological and clinical factors predictive of the case fatality rate (CFR) of Middle East respiratory syndrome-coronavirus (MERS-CoV) infection in an outbreak in Daejeon, the Republic of Korea.
We reviewed the outbreak investigation reports and medical records of 1 index case and 25 additional MERS cases in hospitals A (14 cases) and B (11 cases), and conducted an in-depth interview with the index case.
The CFR in hospital B was higher than that in hospital A (63.6% vs. 28.6%, respectively). Higher MERS-CoV exposure conditions were also found in hospital B, including aggravated pneumonia in the index case and nebulizer use in a six-bed admission room. The host factors associated with high CFR were pre-existing pneumonia, smoking history, an incubation period of less than 5 days, leukocytosis, abnormal renal function at diagnosis, and respiratory symptoms such as sputum and dyspnea.
The conditions surrounding MERS-CoV exposure and the underlying poor pulmonary function due to a smoking history or pre-existing pneumonia may explain the high CFR in hospital B. The clinical features described above may enable prediction of the prognosis of MERS cases.
Url:
DOI: 10.1016/j.ijid.2017.02.008
PubMed: 28223175
PubMed Central: 7110480
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PMC:7110480Le document en format XML
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<series><title level="j">International Journal of Infectious Diseases</title>
<idno type="ISSN">1201-9712</idno>
<idno type="eISSN">1878-3511</idno>
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<term>Aged</term>
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<term>Coronavirus Infections (mortality)</term>
<term>Cross Infection (epidemiology)</term>
<term>Cross Infection (mortality)</term>
<term>Disease Outbreaks</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Middle East Respiratory Syndrome Coronavirus</term>
<term>Republic of Korea (epidemiology)</term>
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<term>Adulte d'âge moyen</term>
<term>Coronavirus du syndrome respiratoire du Moyen-Orient</term>
<term>Facteurs de risque</term>
<term>Femelle</term>
<term>Flambées de maladies</term>
<term>Humains</term>
<term>Infection croisée (mortalité)</term>
<term>Infection croisée (épidémiologie)</term>
<term>Infections à coronavirus (mortalité)</term>
<term>Infections à coronavirus (épidémiologie)</term>
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<term>République de Corée (épidémiologie)</term>
<term>Sujet âgé</term>
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<term>Cross Infection</term>
<term>Republic of Korea</term>
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<term>Cross Infection</term>
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<keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Infection croisée</term>
<term>Infections à coronavirus</term>
</keywords>
<keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Infection croisée</term>
<term>Infections à coronavirus</term>
<term>République de Corée</term>
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<front><div type="abstract" xml:lang="en"><sec><title>Objectives</title>
<p>To explore the epidemiological and clinical factors predictive of the case fatality rate (CFR) of Middle East respiratory syndrome-coronavirus (MERS-CoV) infection in an outbreak in Daejeon, the Republic of Korea.</p>
</sec>
<sec><title>Methods</title>
<p>We reviewed the outbreak investigation reports and medical records of 1 index case and 25 additional MERS cases in hospitals A (14 cases) and B (11 cases), and conducted an in-depth interview with the index case.</p>
</sec>
<sec><title>Results</title>
<p>The CFR in hospital B was higher than that in hospital A (63.6% vs. 28.6%, respectively). Higher MERS-CoV exposure conditions were also found in hospital B, including aggravated pneumonia in the index case and nebulizer use in a six-bed admission room. The host factors associated with high CFR were pre-existing pneumonia, smoking history, an incubation period of less than 5 days, leukocytosis, abnormal renal function at diagnosis, and respiratory symptoms such as sputum and dyspnea.</p>
</sec>
<sec><title>Conclusions</title>
<p>The conditions surrounding MERS-CoV exposure and the underlying poor pulmonary function due to a smoking history or pre-existing pneumonia may explain the high CFR in hospital B. The clinical features described above may enable prediction of the prognosis of MERS cases.</p>
</sec>
</div>
</front>
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