Diagnostic delays in 537 symptomatic cases of Middle East respiratory syndrome coronavirus infection in Saudi Arabia
Identifieur interne : 000885 ( Pmc/Checkpoint ); précédent : 000884; suivant : 000886Diagnostic delays in 537 symptomatic cases of Middle East respiratory syndrome coronavirus infection in Saudi Arabia
Auteurs : Anwar E. AhmedSource :
- International Journal of Infectious Diseases [ 1201-9712 ] ; 2017.
Abstract
Although the literature indicates that patient delays in seeking medical support for Middle East respiratory syndrome coronavirus (MERS-CoV) infections are associated with poor clinical outcomes, delays in the diagnosis itself remain poorly understood in these patients. This study aimed to determine the median time interval from symptom onset to a confirmed diagnosis and to identify the potential predictors of this interval in Saudi Arabian MERS patients.
This was a retrospective study of patients with confirmed MERS who were publicly reported by the World Health Organization (WHO).
Five hundred and thirty-seven symptomatic cases of MERS-CoV infection were included. The median time interval between symptom onset and confirmation of the MERS diagnosis was 4 days (interquartile range 2–7 days), ranging from 0 to 36 days. According to the negative binomial model, the unadjusted rate ratio (RR) of delays in the diagnosis was significantly higher in older patients (>65 years) (RR 1.42), non-healthcare workers (RR 1.74), patients with severe illness (RR 1.22), those with an unknown source of infection (RR 1.84), and those who had been in close contact with camels (RR 1.74). After accounting for confounders, the adjusted rate ratio (aRR) of delays in the diagnosis was independently associated with unknown source of infection (aRR 1.68) and close contact with camels (aRR 1.58).
The time interval from symptom onset to diagnosis was greater in older patients, non-healthcare workers, patients with severe illness, patients with an unknown source of infection, and patients who had been in close contact with camels. The findings warrant educational interventions to raise general public awareness of the importance of early symptom notification.
Url:
DOI: 10.1016/j.ijid.2017.07.008
PubMed: 28728926
PubMed Central: 7110630
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Diagnostic delays in 537 symptomatic cases of Middle East respiratory syndrome coronavirus infection in Saudi Arabia</title><author><name sortKey="Ahmed, Anwar E" sort="Ahmed, Anwar E" uniqKey="Ahmed A" first="Anwar E." last="Ahmed">Anwar E. Ahmed</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">28728926</idno><idno type="pmc">7110630</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7110630</idno><idno type="RBID">PMC:7110630</idno><idno type="doi">10.1016/j.ijid.2017.07.008</idno><date when="2017">2017</date><idno type="wicri:Area/Pmc/Corpus">000D53</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000D53</idno><idno type="wicri:Area/Pmc/Curation">000D53</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000D53</idno><idno type="wicri:Area/Pmc/Checkpoint">000885</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000885</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Diagnostic delays in 537 symptomatic cases of Middle East respiratory syndrome coronavirus infection in Saudi Arabia</title><author><name sortKey="Ahmed, Anwar E" sort="Ahmed, Anwar E" uniqKey="Ahmed A" first="Anwar E." last="Ahmed">Anwar E. Ahmed</name></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>Background</title><p>Although the literature indicates that patient delays in seeking medical support for Middle East respiratory syndrome coronavirus (MERS-CoV) infections are associated with poor clinical outcomes, delays in the diagnosis itself remain poorly understood in these patients. This study aimed to determine the median time interval from symptom onset to a confirmed diagnosis and to identify the potential predictors of this interval in Saudi Arabian MERS patients.</p></sec><sec><title>Methods</title><p>This was a retrospective study of patients with confirmed MERS who were publicly reported by the World Health Organization (WHO).</p></sec><sec><title>Results</title><p>Five hundred and thirty-seven symptomatic cases of MERS-CoV infection were included. The median time interval between symptom onset and confirmation of the MERS diagnosis was 4 days (interquartile range 2–7 days), ranging from 0 to 36 days. According to the negative binomial model, the unadjusted rate ratio (RR) of delays in the diagnosis was significantly higher in older patients (>65 years) (RR 1.42), non-healthcare workers (RR 1.74), patients with severe illness (RR 1.22), those with an unknown source of infection (RR 1.84), and those who had been in close contact with camels (RR 1.74). After accounting for confounders, the adjusted rate ratio (aRR) of delays in the diagnosis was independently associated with unknown source of infection (aRR 1.68) and close contact with camels (aRR 1.58).</p></sec><sec><title>Conclusions</title><p>The time interval from symptom onset to diagnosis was greater in older patients, non-healthcare workers, patients with severe illness, patients with an unknown source of infection, and patients who had been in close contact with camels. The findings warrant educational interventions to raise general public awareness of the importance of early symptom notification.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Al Dorzi, H M" uniqKey="Al Dorzi H">H.M. Al-Dorzi</name></author><author><name sortKey="Aldawood, A S" uniqKey="Aldawood A">A.S. Aldawood</name></author><author><name sortKey="Khan, R" uniqKey="Khan R">R. 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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">28728926</article-id><article-id pub-id-type="pmc">7110630</article-id><article-id pub-id-type="publisher-id">S1201-9712(17)30186-8</article-id><article-id pub-id-type="doi">10.1016/j.ijid.2017.07.008</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Diagnostic delays in 537 symptomatic cases of Middle East respiratory syndrome coronavirus infection in Saudi Arabia</article-title></title-group><contrib-group><contrib contrib-type="author" id="aut0005"><name><surname>Ahmed</surname><given-names>Anwar E.</given-names></name><email>ahmeda5@vcu.edu</email><xref rid="cor0005" ref-type="corresp">⁎</xref></contrib></contrib-group><aff id="aff0005">College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia</aff><author-notes><corresp id="cor0005"><label>⁎</label>Corresponding author at: Department of Epidemiology and Biostatistics, College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, MC 2350, PO Box 22490, Riyadh, 11426, KSA. <email>ahmeda5@vcu.edu</email></corresp></author-notes><pub-date pub-type="pmc-release"><day>17</day><month>7</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>9</month><year>2017</year></pub-date><pub-date pub-type="epub"><day>17</day><month>7</month><year>2017</year></pub-date><volume>62</volume><fpage>47</fpage><lpage>51</lpage><history><date date-type="received"><day>2</day><month>5</month><year>2017</year></date><date date-type="rev-recd"><day>28</day><month>5</month><year>2017</year></date><date date-type="accepted"><day>8</day><month>7</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>Background</title><p>Although the literature indicates that patient delays in seeking medical support for Middle East respiratory syndrome coronavirus (MERS-CoV) infections are associated with poor clinical outcomes, delays in the diagnosis itself remain poorly understood in these patients. This study aimed to determine the median time interval from symptom onset to a confirmed diagnosis and to identify the potential predictors of this interval in Saudi Arabian MERS patients.</p></sec><sec><title>Methods</title><p>This was a retrospective study of patients with confirmed MERS who were publicly reported by the World Health Organization (WHO).</p></sec><sec><title>Results</title><p>Five hundred and thirty-seven symptomatic cases of MERS-CoV infection were included. The median time interval between symptom onset and confirmation of the MERS diagnosis was 4 days (interquartile range 2–7 days), ranging from 0 to 36 days. According to the negative binomial model, the unadjusted rate ratio (RR) of delays in the diagnosis was significantly higher in older patients (>65 years) (RR 1.42), non-healthcare workers (RR 1.74), patients with severe illness (RR 1.22), those with an unknown source of infection (RR 1.84), and those who had been in close contact with camels (RR 1.74). After accounting for confounders, the adjusted rate ratio (aRR) of delays in the diagnosis was independently associated with unknown source of infection (aRR 1.68) and close contact with camels (aRR 1.58).</p></sec><sec><title>Conclusions</title><p>The time interval from symptom onset to diagnosis was greater in older patients, non-healthcare workers, patients with severe illness, patients with an unknown source of infection, and patients who had been in close contact with camels. The findings warrant educational interventions to raise general public awareness of the importance of early symptom notification.</p></sec></abstract><kwd-group id="kwd0005"><title>Keywords</title><kwd>MERS-CoV</kwd><kwd>Symptom onset</kwd><kwd>Early diagnosis</kwd><kwd>Camel contact</kwd><kwd>Saudi Arabia</kwd></kwd-group></article-meta><notes><p id="misc0005">Corresponding Editor: Eskild Petersen, Aarhus, Denmark</p></notes></front></pmc><affiliations><list></list><tree><noCountry><name sortKey="Ahmed, Anwar E" sort="Ahmed, Anwar E" uniqKey="Ahmed A" first="Anwar E." last="Ahmed">Anwar E. Ahmed</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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