High fatality rates and associated factors in two hospital outbreaks of MERS in Daejeon, the Republic of Korea
Identifieur interne : 000844 ( Pmc/Checkpoint ); précédent : 000843; suivant : 000845High 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.
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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<record><TEI><teiHeader><fileDesc><titleStmt><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><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></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">28223175</idno><idno type="pmc">7110480</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7110480</idno><idno type="RBID">PMC:7110480</idno><idno type="doi">10.1016/j.ijid.2017.02.008</idno><date when="2017">2017</date><idno type="wicri:Area/Pmc/Corpus">000D52</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000D52</idno><idno 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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></biblStruct></sourceDesc></fileDesc><profileDesc><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. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Int J Infect Dis</journal-id><journal-id journal-id-type="iso-abbrev">Int. J. Infect. Dis</journal-id><journal-title-group><journal-title>International Journal of Infectious Diseases</journal-title></journal-title-group><issn pub-type="ppub">1201-9712</issn><issn pub-type="epub">1878-3511</issn><publisher><publisher-name>The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">28223175</article-id><article-id pub-id-type="pmc">7110480</article-id><article-id pub-id-type="publisher-id">S1201-9712(17)30054-1</article-id><article-id pub-id-type="doi">10.1016/j.ijid.2017.02.008</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>High fatality rates and associated factors in two hospital outbreaks of MERS in Daejeon, the Republic of Korea</article-title></title-group><contrib-group><contrib contrib-type="author" id="aut0005"><name><surname>Nam</surname><given-names>Hae-Sung</given-names></name><email>hsnam@cnu.ac.kr</email><xref rid="aff0005" ref-type="aff">a</xref><xref rid="fn0005" ref-type="fn">1</xref><xref rid="cor0005" ref-type="corresp">⁎</xref></contrib><contrib contrib-type="author" id="aut0010"><name><surname>Park</surname><given-names>Jung Wan</given-names></name><xref rid="aff0010" ref-type="aff">b</xref><xref rid="fn0005" ref-type="fn">1</xref></contrib><contrib contrib-type="author" id="aut0015"><name><surname>Ki</surname><given-names>Moran</given-names></name><xref rid="aff0015" ref-type="aff">c</xref></contrib><contrib contrib-type="author" id="aut0020"><name><surname>Yeon</surname><given-names>Mi-Yeon</given-names></name><xref rid="aff0005" ref-type="aff">a</xref></contrib><contrib contrib-type="author" id="aut0025"><name><surname>Kim</surname><given-names>Jin</given-names></name><xref rid="aff0020" ref-type="aff">d</xref></contrib><contrib contrib-type="author" id="aut0030"><name><surname>Kim</surname><given-names>Seung Woo</given-names></name><xref rid="aff0010" ref-type="aff">b</xref></contrib></contrib-group><aff id="aff0005"><label>a</label>Department of Preventive Medicine and Public Health, Chungnam National University School of Medicine, Daejeon, Republic of Korea</aff><aff id="aff0010"><label>b</label>Division of Infectious Disease Surveillance, Korea Centers for Disease Control and Prevention, Cheongju, Republic of Korea</aff><aff id="aff0015"><label>c</label>Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea</aff><aff id="aff0020"><label>d</label>Department of Nursing, Graduate School, Chungnam National University, Daejeon, Republic of Korea</aff><author-notes><corresp id="cor0005"><label>⁎</label>Corresponding author at: Department of Preventive Medicine and Public Health, Chungnam National University School of Medicine, 266 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea. Tel: +82 42 580 8266. Fax: +82 42 583 7561. <email>hsnam@cnu.ac.kr</email></corresp><fn id="fn0005"><label>1</label><p id="npar0030">These authors contributed equally.</p></fn></author-notes><pub-date pub-type="pmc-release"><day>20</day><month>2</month><year>2017</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="ppub"><month>5</month><year>2017</year></pub-date><pub-date pub-type="epub"><day>20</day><month>2</month><year>2017</year></pub-date><volume>58</volume><fpage>37</fpage><lpage>42</lpage><history><date date-type="received"><day>18</day><month>8</month><year>2016</year></date><date date-type="rev-recd"><day>9</day><month>2</month><year>2017</year></date><date date-type="accepted"><day>10</day><month>2</month><year>2017</year></date></history><permissions><copyright-statement>© 2017 The Author(s)</copyright-statement><copyright-year>2017</copyright-year><license><license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p></license></permissions><abstract id="abs0005"><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></abstract><kwd-group id="kwd0005"><title>Keywords</title><kwd>Middle East respiratory syndrome coronavirus</kwd><kwd>Hospital</kwd><kwd>Outbreak</kwd><kwd>Mortality</kwd><kwd>Korea</kwd></kwd-group></article-meta><notes><p id="misc0005"><bold>Corresponding Editor:</bold> Eskild Petersen, Aarhus, Denmark</p></notes></front></pmc><affiliations><list><country><li>Corée du Sud</li></country></list><tree><country name="Corée du Sud"><noRegion><name sortKey="Nam, Hae Sung" sort="Nam, Hae Sung" uniqKey="Nam H" first="Hae-Sung" last="Nam">Hae-Sung Nam</name></noRegion><name sortKey="Ki, Moran" sort="Ki, Moran" uniqKey="Ki M" first="Moran" last="Ki">Moran Ki</name><name sortKey="Kim, Jin" sort="Kim, Jin" uniqKey="Kim J" first="Jin" last="Kim">Jin Kim</name><name sortKey="Kim, Seung Woo" sort="Kim, Seung Woo" uniqKey="Kim S" first="Seung Woo" last="Kim">Seung Woo Kim</name><name sortKey="Park, Jung Wan" sort="Park, Jung Wan" uniqKey="Park J" first="Jung Wan" last="Park">Jung Wan Park</name><name sortKey="Yeon, Mi Yeon" sort="Yeon, Mi Yeon" uniqKey="Yeon M" first="Mi-Yeon" last="Yeon">Mi-Yeon Yeon</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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