Serveur d'exploration MERS

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High fatality rates and associated factors in two hospital outbreaks of MERS in Daejeon, the Republic of Korea

Identifieur interne : 001962 ( Ncbi/Merge ); précédent : 001961; suivant : 001963

High 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 :

RBID : PMC:7110480

Descripteurs français

English descriptors

Abstract

Objectives

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.

Methods

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.

Results

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.

Conclusions

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:7110480

Le document en format XML

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<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>
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<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>
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<title xml:lang="en">High fatality rates and associated factors in two hospital outbreaks of MERS in Daejeon, the Republic of Korea</title>
<author>
<name sortKey="Nam, Hae Sung" sort="Nam, Hae Sung" uniqKey="Nam H" first="Hae-Sung" last="Nam">Hae-Sung Nam</name>
<affiliation wicri:level="1">
<nlm:aff id="aff0005">Department of Preventive Medicine and Public Health, Chungnam National University School of Medicine, Daejeon, Republic of Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Department of Preventive Medicine and Public Health, Chungnam National University School of Medicine, Daejeon</wicri:regionArea>
<wicri:noRegion>Daejeon</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Park, Jung Wan" sort="Park, Jung Wan" uniqKey="Park J" first="Jung Wan" last="Park">Jung Wan Park</name>
<affiliation wicri:level="1">
<nlm:aff id="aff0010">Division of Infectious Disease Surveillance, Korea Centers for Disease Control and Prevention, Cheongju, Republic of Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Division of Infectious Disease Surveillance, Korea Centers for Disease Control and Prevention, Cheongju</wicri:regionArea>
<wicri:noRegion>Cheongju</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Ki, Moran" sort="Ki, Moran" uniqKey="Ki M" first="Moran" last="Ki">Moran Ki</name>
<affiliation wicri:level="1">
<nlm:aff id="aff0015">Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang</wicri:regionArea>
<wicri:noRegion>Goyang</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Yeon, Mi Yeon" sort="Yeon, Mi Yeon" uniqKey="Yeon M" first="Mi-Yeon" last="Yeon">Mi-Yeon Yeon</name>
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<nlm:aff id="aff0005">Department of Preventive Medicine and Public Health, Chungnam National University School of Medicine, Daejeon, Republic of Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Department of Preventive Medicine and Public Health, Chungnam National University School of Medicine, Daejeon</wicri:regionArea>
<wicri:noRegion>Daejeon</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Kim, Jin" sort="Kim, Jin" uniqKey="Kim J" first="Jin" last="Kim">Jin Kim</name>
<affiliation wicri:level="1">
<nlm:aff id="aff0020">Department of Nursing, Graduate School, Chungnam National University, Daejeon, Republic of Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Department of Nursing, Graduate School, Chungnam National University, Daejeon</wicri:regionArea>
<wicri:noRegion>Daejeon</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Kim, Seung Woo" sort="Kim, Seung Woo" uniqKey="Kim S" first="Seung Woo" last="Kim">Seung Woo Kim</name>
<affiliation wicri:level="1">
<nlm:aff id="aff0010">Division of Infectious Disease Surveillance, Korea Centers for Disease Control and Prevention, Cheongju, Republic of Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Division of Infectious Disease Surveillance, Korea Centers for Disease Control and Prevention, Cheongju</wicri:regionArea>
<wicri:noRegion>Cheongju</wicri:noRegion>
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<idno type="RBID">PMC:7110480</idno>
<idno type="doi">10.1016/j.ijid.2017.02.008</idno>
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<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000844</idno>
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<title xml:lang="en" level="a" type="main">High fatality rates and associated factors in two hospital outbreaks of MERS in Daejeon, the Republic of Korea</title>
<author>
<name sortKey="Nam, Hae Sung" sort="Nam, Hae Sung" uniqKey="Nam H" first="Hae-Sung" last="Nam">Hae-Sung Nam</name>
<affiliation wicri:level="1">
<nlm:aff id="aff0005">Department of Preventive Medicine and Public Health, Chungnam National University School of Medicine, Daejeon, Republic of Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Department of Preventive Medicine and Public Health, Chungnam National University School of Medicine, Daejeon</wicri:regionArea>
<wicri:noRegion>Daejeon</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Park, Jung Wan" sort="Park, Jung Wan" uniqKey="Park J" first="Jung Wan" last="Park">Jung Wan Park</name>
<affiliation wicri:level="1">
<nlm:aff id="aff0010">Division of Infectious Disease Surveillance, Korea Centers for Disease Control and Prevention, Cheongju, Republic of Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Division of Infectious Disease Surveillance, Korea Centers for Disease Control and Prevention, Cheongju</wicri:regionArea>
<wicri:noRegion>Cheongju</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Ki, Moran" sort="Ki, Moran" uniqKey="Ki M" first="Moran" last="Ki">Moran Ki</name>
<affiliation wicri:level="1">
<nlm:aff id="aff0015">Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang</wicri:regionArea>
<wicri:noRegion>Goyang</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Yeon, Mi Yeon" sort="Yeon, Mi Yeon" uniqKey="Yeon M" first="Mi-Yeon" last="Yeon">Mi-Yeon Yeon</name>
<affiliation wicri:level="1">
<nlm:aff id="aff0005">Department of Preventive Medicine and Public Health, Chungnam National University School of Medicine, Daejeon, Republic of Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Department of Preventive Medicine and Public Health, Chungnam National University School of Medicine, Daejeon</wicri:regionArea>
<wicri:noRegion>Daejeon</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Kim, Jin" sort="Kim, Jin" uniqKey="Kim J" first="Jin" last="Kim">Jin Kim</name>
<affiliation wicri:level="1">
<nlm:aff id="aff0020">Department of Nursing, Graduate School, Chungnam National University, Daejeon, Republic of Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Department of Nursing, Graduate School, Chungnam National University, Daejeon</wicri:regionArea>
<wicri:noRegion>Daejeon</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Kim, Seung Woo" sort="Kim, Seung Woo" uniqKey="Kim S" first="Seung Woo" last="Kim">Seung Woo Kim</name>
<affiliation wicri:level="1">
<nlm:aff id="aff0010">Division of Infectious Disease Surveillance, Korea Centers for Disease Control and Prevention, Cheongju, Republic of Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Division of Infectious Disease Surveillance, Korea Centers for Disease Control and Prevention, Cheongju</wicri:regionArea>
<wicri:noRegion>Cheongju</wicri:noRegion>
</affiliation>
</author>
</analytic>
<series>
<title level="j">International Journal of Infectious Diseases</title>
<idno type="ISSN">1201-9712</idno>
<idno type="eISSN">1878-3511</idno>
<imprint>
<date when="2017">2017</date>
</imprint>
</series>
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<textClass></textClass>
</profileDesc>
</teiHeader>
<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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<term>Adult</term>
<term>Aged</term>
<term>Coronavirus Infections (epidemiology)</term>
<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>
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<term>Republic of Korea (epidemiology)</term>
<term>Risk Factors</term>
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<keywords scheme="KwdFr" xml:lang="fr">
<term>Adulte</term>
<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>
<term>Mâle</term>
<term>République de Corée (épidémiologie)</term>
<term>Sujet âgé</term>
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<term>Cross Infection</term>
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<term>Coronavirus Infections</term>
<term>Cross Infection</term>
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<term>Infection croisée</term>
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<front>
<div type="abstract" xml:lang="en">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.</div>
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