Quality of life reported by survivors after hospitalization for Middle East respiratory syndrome (MERS)
Identifieur interne : 000375 ( Pmc/Corpus ); précédent : 000374; suivant : 000376Quality of life reported by survivors after hospitalization for Middle East respiratory syndrome (MERS)
Auteurs : Sarah Batawi ; Nehal Tarazan ; Rajaa Al-Raddadi ; Eman Al Qasim ; Anees Sindi ; Sameera Al Johni ; Fahad M. Al-Hameed ; Yaseen M. Arabi ; Timothy M. Uyeki ; Basem M. AlraddadiSource :
- Health and Quality of Life Outcomes [ 1477-7525 ] ; 2019.
Abstract
Data are lacking on impact of Middle East Respiratory Syndrome (MERS) on health-related quality of life (HRQoL) among survivors.
We conducted a cross-sectional survey of MERS survivors who required hospitalization in Saudi Arabia during 2016–2017, approximately 1 year after diagnosis. The Short-Form General Health Survey 36 (SF-36) was administered by telephone interview to assess 8 quality of life domains for MERS survivors and a sample of survivors of severe acute respiratory infection (SARI) without MERS. We compared mean SF-36 scores of MERS and non-MERS SARI survivors using independent t-test, and compared categorical variables using chi-square test. Adjusted analyses were performed using multiple linear regression.
Of 355 MERS survivors, 83 were eligible and 78 agreed to participate. MERS survivors were younger than non-MERS SARI survivors (mean ± SD): (44.9 years ±12.9) vs (50.0 years ±13.6),
Functional scores were similar for MERS and non-MERS SARI survivors. However, MERS survivors of critical illness reported lower quality of life than survivors of less severe illness. Efforts are needed to address the long-term medical and psychological needs of MERS survivors.
Url:
DOI: 10.1186/s12955-019-1165-2
PubMed: 31186042
PubMed Central: 6560892
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PMC:6560892Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Quality of life reported by survivors after hospitalization for Middle East respiratory syndrome (MERS)</title><author><name sortKey="Batawi, Sarah" sort="Batawi, Sarah" uniqKey="Batawi S" first="Sarah" last="Batawi">Sarah Batawi</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0619 1117</institution-id><institution-id institution-id-type="GRID">grid.412125.1</institution-id><institution>King Abdulaziz University,</institution></institution-wrap>Jeddah, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Tarazan, Nehal" sort="Tarazan, Nehal" uniqKey="Tarazan N" first="Nehal" last="Tarazan">Nehal Tarazan</name><affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2191 4301</institution-id><institution-id institution-id-type="GRID">grid.415310.2</institution-id><institution>King Faisal Specialist Hospital and Research Center,</institution></institution-wrap>Jeddah, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Al Raddadi, Rajaa" sort="Al Raddadi, Rajaa" uniqKey="Al Raddadi R" first="Rajaa" last="Al-Raddadi">Rajaa Al-Raddadi</name><affiliation><nlm:aff id="Aff3"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0619 1117</institution-id><institution-id institution-id-type="GRID">grid.412125.1</institution-id><institution>Department of Community Medicine,</institution><institution>King Abdulaziz University,</institution></institution-wrap>Jeddah , Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Al Qasim, Eman" sort="Al Qasim, Eman" uniqKey="Al Qasim E" first="Eman" last="Al Qasim">Eman Al Qasim</name><affiliation><nlm:aff id="Aff4"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1790 7311</institution-id><institution-id institution-id-type="GRID">grid.415254.3</institution-id><institution>King Abdullah International Medical Research Center,</institution><institution>King Abdulaziz Medical City – National Guard Health Affairs,</institution></institution-wrap>Riyadh, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Sindi, Anees" sort="Sindi, Anees" uniqKey="Sindi A" first="Anees" last="Sindi">Anees Sindi</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0619 1117</institution-id><institution-id institution-id-type="GRID">grid.412125.1</institution-id><institution>King Abdulaziz University,</institution></institution-wrap>Jeddah, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Al Johni, Sameera" sort="Al Johni, Sameera" uniqKey="Al Johni S" first="Sameera" last="Al Johni">Sameera Al Johni</name><affiliation><nlm:aff id="Aff5"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0608 0662</institution-id><institution-id institution-id-type="GRID">grid.412149.b</institution-id><institution>King Saud Bin Abdulaziz University for Health Sciences,</institution></institution-wrap>Riyadh, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Al Hameed, Fahad M" sort="Al Hameed, Fahad M" uniqKey="Al Hameed F" first="Fahad M." last="Al-Hameed">Fahad M. Al-Hameed</name><affiliation><nlm:aff id="Aff6">King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Intensive Care Department, King Abdulaziz Medical City – National Guard Health Affairs, Jeddah , Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Arabi, Yaseen M" sort="Arabi, Yaseen M" uniqKey="Arabi Y" first="Yaseen M." last="Arabi">Yaseen M. Arabi</name><affiliation><nlm:aff id="Aff6">King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Intensive Care Department, King Abdulaziz Medical City – National Guard Health Affairs, Jeddah , Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Uyeki, Timothy M" sort="Uyeki, Timothy M" uniqKey="Uyeki T" first="Timothy M." last="Uyeki">Timothy M. Uyeki</name><affiliation><nlm:aff id="Aff7"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2163 0069</institution-id><institution-id institution-id-type="GRID">grid.416738.f</institution-id><institution>Influenza Division, National Center for Immunization and Respiratory Diseases,</institution><institution>Centers for Disease Control and Prevention,</institution></institution-wrap>Atlanta, Georgia USA</nlm:aff></affiliation></author><author><name sortKey="Alraddadi, Basem M" sort="Alraddadi, Basem M" uniqKey="Alraddadi B" first="Basem M." last="Alraddadi">Basem M. Alraddadi</name><affiliation><nlm:aff id="Aff8"><institution-wrap><institution-id institution-id-type="GRID">grid.460099.2</institution-id><institution>Department of Medicine, King Faisal Specialist Hospital and Research Center,</institution><institution>University of Jeddah,</institution></institution-wrap>P.O BOX 40047 Jeddah 21499 MBC J 46, Jeddah, Saudi Arabia</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">31186042</idno><idno type="pmc">6560892</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6560892</idno><idno type="RBID">PMC:6560892</idno><idno type="doi">10.1186/s12955-019-1165-2</idno><date when="2019">2019</date><idno type="wicri:Area/Pmc/Corpus">000375</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000375</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Quality of life reported by survivors after hospitalization for Middle East respiratory syndrome (MERS)</title><author><name sortKey="Batawi, Sarah" sort="Batawi, Sarah" uniqKey="Batawi S" first="Sarah" last="Batawi">Sarah Batawi</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0619 1117</institution-id><institution-id institution-id-type="GRID">grid.412125.1</institution-id><institution>King Abdulaziz University,</institution></institution-wrap>Jeddah, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Tarazan, Nehal" sort="Tarazan, Nehal" uniqKey="Tarazan N" first="Nehal" last="Tarazan">Nehal Tarazan</name><affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2191 4301</institution-id><institution-id institution-id-type="GRID">grid.415310.2</institution-id><institution>King Faisal Specialist Hospital and Research Center,</institution></institution-wrap>Jeddah, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Al Raddadi, Rajaa" sort="Al Raddadi, Rajaa" uniqKey="Al Raddadi R" first="Rajaa" last="Al-Raddadi">Rajaa Al-Raddadi</name><affiliation><nlm:aff id="Aff3"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0619 1117</institution-id><institution-id institution-id-type="GRID">grid.412125.1</institution-id><institution>Department of Community Medicine,</institution><institution>King Abdulaziz University,</institution></institution-wrap>Jeddah , Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Al Qasim, Eman" sort="Al Qasim, Eman" uniqKey="Al Qasim E" first="Eman" last="Al Qasim">Eman Al Qasim</name><affiliation><nlm:aff id="Aff4"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1790 7311</institution-id><institution-id institution-id-type="GRID">grid.415254.3</institution-id><institution>King Abdullah International Medical Research Center,</institution><institution>King Abdulaziz Medical City – National Guard Health Affairs,</institution></institution-wrap>Riyadh, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Sindi, Anees" sort="Sindi, Anees" uniqKey="Sindi A" first="Anees" last="Sindi">Anees Sindi</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0619 1117</institution-id><institution-id institution-id-type="GRID">grid.412125.1</institution-id><institution>King Abdulaziz University,</institution></institution-wrap>Jeddah, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Al Johni, Sameera" sort="Al Johni, Sameera" uniqKey="Al Johni S" first="Sameera" last="Al Johni">Sameera Al Johni</name><affiliation><nlm:aff id="Aff5"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0608 0662</institution-id><institution-id institution-id-type="GRID">grid.412149.b</institution-id><institution>King Saud Bin Abdulaziz University for Health Sciences,</institution></institution-wrap>Riyadh, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Al Hameed, Fahad M" sort="Al Hameed, Fahad M" uniqKey="Al Hameed F" first="Fahad M." last="Al-Hameed">Fahad M. Al-Hameed</name><affiliation><nlm:aff id="Aff6">King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Intensive Care Department, King Abdulaziz Medical City – National Guard Health Affairs, Jeddah , Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Arabi, Yaseen M" sort="Arabi, Yaseen M" uniqKey="Arabi Y" first="Yaseen M." last="Arabi">Yaseen M. Arabi</name><affiliation><nlm:aff id="Aff6">King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Intensive Care Department, King Abdulaziz Medical City – National Guard Health Affairs, Jeddah , Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Uyeki, Timothy M" sort="Uyeki, Timothy M" uniqKey="Uyeki T" first="Timothy M." last="Uyeki">Timothy M. Uyeki</name><affiliation><nlm:aff id="Aff7"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2163 0069</institution-id><institution-id institution-id-type="GRID">grid.416738.f</institution-id><institution>Influenza Division, National Center for Immunization and Respiratory Diseases,</institution><institution>Centers for Disease Control and Prevention,</institution></institution-wrap>Atlanta, Georgia USA</nlm:aff></affiliation></author><author><name sortKey="Alraddadi, Basem M" sort="Alraddadi, Basem M" uniqKey="Alraddadi B" first="Basem M." last="Alraddadi">Basem M. Alraddadi</name><affiliation><nlm:aff id="Aff8"><institution-wrap><institution-id institution-id-type="GRID">grid.460099.2</institution-id><institution>Department of Medicine, King Faisal Specialist Hospital and Research Center,</institution><institution>University of Jeddah,</institution></institution-wrap>P.O BOX 40047 Jeddah 21499 MBC J 46, Jeddah, Saudi Arabia</nlm:aff></affiliation></author></analytic><series><title level="j">Health and Quality of Life Outcomes</title><idno type="eISSN">1477-7525</idno><imprint><date when="2019">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Introduction</title><p id="Par1">Data are lacking on impact of Middle East Respiratory Syndrome (MERS) on health-related quality of life (HRQoL) among survivors.</p></sec><sec><title>Methods</title><p id="Par2">We conducted a cross-sectional survey of MERS survivors who required hospitalization in Saudi Arabia during 2016–2017, approximately 1 year after diagnosis. The Short-Form General Health Survey 36 (SF-36) was administered by telephone interview to assess 8 quality of life domains for MERS survivors and a sample of survivors of severe acute respiratory infection (SARI) without MERS. We compared mean SF-36 scores of MERS and non-MERS SARI survivors using independent t-test, and compared categorical variables using chi-square test. Adjusted analyses were performed using multiple linear regression.</p></sec><sec><title>Results</title><p id="Par3">Of 355 MERS survivors, 83 were eligible and 78 agreed to participate. MERS survivors were younger than non-MERS SARI survivors (mean ± SD): (44.9 years ±12.9) vs (50.0 years ±13.6), <italic>p</italic> = 0.031. Intensive care unit (ICU) admissions were similar for MERS and non-MERS SARI survivors (46.2% vs. 57.1%), <italic>p</italic> = 0.20. After adjusting for potential confounders, there were no significant differences between MERS and non-MERS SARI survivors in physical component or mental component summary scores. MERS ICU survivors scored lower than MERS survivors not admitted to an ICU for physical function (<italic>p</italic> = 0.05), general health (<italic>p</italic> = 0.01), vitality (<italic>p</italic> = 0.03), emotional role (<italic>p</italic> = 0.03) and physical component summary (<italic>p</italic> < 0.02).</p></sec><sec><title>Conclusions</title><p id="Par4">Functional scores were similar for MERS and non-MERS SARI survivors. However, MERS survivors of critical illness reported lower quality of life than survivors of less severe illness. Efforts are needed to address the long-term medical and psychological needs of MERS survivors.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Zaki, Am" uniqKey="Zaki A">AM Zaki</name></author><author><name sortKey="Van Boheemen, S" uniqKey="Van Boheemen S">S van Boheemen</name></author><author><name sortKey="Bestebroer, Tm" uniqKey="Bestebroer T">TM Bestebroer</name></author><author><name sortKey="Osterhaus, Ad" uniqKey="Osterhaus A">AD Osterhaus</name></author><author><name sortKey="Fouchier, Ra" uniqKey="Fouchier R">RA Fouchier</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Oboho, Ik" uniqKey="Oboho I">IK Oboho</name></author><author><name sortKey="Tomczyk, Sm" uniqKey="Tomczyk S">SM Tomczyk</name></author><author><name sortKey="Al Asmari, Am" uniqKey="Al Asmari A">AM Al-Asmari</name></author><author><name sortKey="Banjar, Aa" uniqKey="Banjar A">AA Banjar</name></author><author><name sortKey="Al Mugti, H" uniqKey="Al Mugti H">H Al-Mugti</name></author><author><name sortKey="Aloraini, Ms" uniqKey="Aloraini M">MS Aloraini</name></author><author><name sortKey="Alkhaldi, Kz" uniqKey="Alkhaldi K">KZ Alkhaldi</name></author><author><name sortKey="Almohammadi, El" uniqKey="Almohammadi E">EL Almohammadi</name></author><author><name sortKey="Alraddadi, Bm" uniqKey="Alraddadi B">BM Alraddadi</name></author><author><name sortKey="Gerber, Si" uniqKey="Gerber S">SI Gerber</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Balkhy, Hh" uniqKey="Balkhy H">HH Balkhy</name></author><author><name sortKey="Alenazi, Th" uniqKey="Alenazi T">TH Alenazi</name></author><author><name sortKey="Alshamrani, Mm" uniqKey="Alshamrani M">MM Alshamrani</name></author><author><name sortKey="Baffoe Bonnie, H" uniqKey="Baffoe Bonnie H">H Baffoe-Bonnie</name></author><author><name sortKey="Arabi, Y" uniqKey="Arabi Y">Y Arabi</name></author><author><name sortKey="Hijazi, R" uniqKey="Hijazi R">R Hijazi</name></author><author><name sortKey="Al Abdely, Hm" uniqKey="Al Abdely H">HM Al-Abdely</name></author><author><name sortKey="El Saed, A" uniqKey="El Saed A">A El-Saed</name></author><author><name sortKey="Al Johani, S" uniqKey="Al Johani S">S Al Johani</name></author><author><name sortKey="Assiri, Am" uniqKey="Assiri A">AM Assiri</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Assiri, A" uniqKey="Assiri A">A Assiri</name></author><author><name sortKey="Al Tawfiq, Ja" uniqKey="Al Tawfiq J">JA Al-Tawfiq</name></author><author><name sortKey="Al Rabeeah, Aa" uniqKey="Al Rabeeah A">AA Al-Rabeeah</name></author><author><name sortKey="Al Rabiah, Fa" uniqKey="Al Rabiah F">FA Al-Rabiah</name></author><author><name sortKey="Al Hajjar, S" uniqKey="Al Hajjar S">S Al-Hajjar</name></author><author><name sortKey="Al Barrak, A" uniqKey="Al Barrak A">A Al-Barrak</name></author><author><name sortKey="Flemban, H" uniqKey="Flemban H">H Flemban</name></author><author><name sortKey="Al Nassir, Wn" uniqKey="Al Nassir W">WN Al-Nassir</name></author><author><name sortKey="Balkhy, Hh" uniqKey="Balkhy H">HH Balkhy</name></author><author><name sortKey="Al Hakeem, Rf" uniqKey="Al Hakeem R">RF Al-Hakeem</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Arabi, Ym" uniqKey="Arabi Y">YM Arabi</name></author><author><name sortKey="Arifi, Aa" uniqKey="Arifi A">AA Arifi</name></author><author><name sortKey="Balkhy, Hh" uniqKey="Balkhy H">HH Balkhy</name></author><author><name sortKey="Najm, H" uniqKey="Najm H">H Najm</name></author><author><name sortKey="Aldawood, As" uniqKey="Aldawood A">AS Aldawood</name></author><author><name sortKey="Ghabashi, A" uniqKey="Ghabashi A">A Ghabashi</name></author><author><name sortKey="Hawa, H" uniqKey="Hawa H">H Hawa</name></author><author><name sortKey="Alothman, A" uniqKey="Alothman A">A Alothman</name></author><author><name sortKey="Khaldi, A" uniqKey="Khaldi A">A Khaldi</name></author><author><name sortKey="Al Raiy, B" uniqKey="Al Raiy B">B Al Raiy</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Arabi, Ym" uniqKey="Arabi Y">YM Arabi</name></author><author><name sortKey="Balkhy, Hh" uniqKey="Balkhy H">HH Balkhy</name></author><author><name sortKey="Hayden, Fg" uniqKey="Hayden F">FG Hayden</name></author><author><name sortKey="Bouchama, A" uniqKey="Bouchama A">A Bouchama</name></author><author><name sortKey="Luke, T" uniqKey="Luke T">T Luke</name></author><author><name sortKey="Baillie, Jk" uniqKey="Baillie J">JK Baillie</name></author><author><name sortKey="Al Omari, A" uniqKey="Al Omari A">A Al-Omari</name></author><author><name sortKey="Hajeer, Ah" uniqKey="Hajeer A">AH Hajeer</name></author><author><name sortKey="Senga, M" uniqKey="Senga M">M Senga</name></author><author><name sortKey="Denison, Mr" uniqKey="Denison M">MR Denison</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Arabi, Ym" uniqKey="Arabi Y">YM Arabi</name></author><author><name sortKey="Al Omari, A" uniqKey="Al Omari A">A Al-Omari</name></author><author><name sortKey="Mandourah, Y" uniqKey="Mandourah Y">Y Mandourah</name></author><author><name sortKey="Al Hameed, F" uniqKey="Al Hameed F">F Al-Hameed</name></author><author><name sortKey="Sindi, Aa" uniqKey="Sindi A">AA Sindi</name></author><author><name sortKey="Alraddadi, B" uniqKey="Alraddadi B">B Alraddadi</name></author><author><name sortKey="Shalhoub, S" uniqKey="Shalhoub S">S Shalhoub</name></author><author><name sortKey="Almotairi, A" uniqKey="Almotairi A">A Almotairi</name></author><author><name sortKey="Al Khatib, K" uniqKey="Al Khatib K">K Al Khatib</name></author><author><name sortKey="Abdulmomen, A" uniqKey="Abdulmomen A">A Abdulmomen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Alsaad, Ko" uniqKey="Alsaad K">KO Alsaad</name></author><author><name sortKey="Hajeer, Ah" uniqKey="Hajeer A">AH Hajeer</name></author><author><name sortKey="Al Balwi, M" uniqKey="Al Balwi M">M Al Balwi</name></author><author><name sortKey="Al Moaiqel, M" uniqKey="Al Moaiqel M">M Al Moaiqel</name></author><author><name sortKey="Al Oudah, N" uniqKey="Al Oudah N">N Al Oudah</name></author><author><name sortKey="Al Ajlan, A" uniqKey="Al Ajlan A">A Al Ajlan</name></author><author><name sortKey="Aljohani, S" uniqKey="Aljohani S">S AlJohani</name></author><author><name sortKey="Alsolamy, S" uniqKey="Alsolamy S">S Alsolamy</name></author><author><name sortKey="Gmati, Ge" uniqKey="Gmati G">GE Gmati</name></author><author><name sortKey="Balkhy, H" uniqKey="Balkhy H">H Balkhy</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ng, Dl" uniqKey="Ng D">DL Ng</name></author><author><name sortKey="Al Hosani, F" uniqKey="Al Hosani F">F Al Hosani</name></author><author><name sortKey="Keating, Mk" uniqKey="Keating M">MK Keating</name></author><author><name sortKey="Gerber, Si" uniqKey="Gerber S">SI Gerber</name></author><author><name sortKey="Jones, Tl" uniqKey="Jones T">TL Jones</name></author><author><name sortKey="Metcalfe, Mg" uniqKey="Metcalfe M">MG Metcalfe</name></author><author><name sortKey="Tong, S" uniqKey="Tong S">S Tong</name></author><author><name sortKey="Tao, Y" uniqKey="Tao Y">Y Tao</name></author><author><name sortKey="Alami, Nn" uniqKey="Alami N">NN Alami</name></author><author><name sortKey="Haynes, Lm" uniqKey="Haynes L">LM Haynes</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Payne, Dc" uniqKey="Payne D">DC Payne</name></author><author><name sortKey="Iblan, I" uniqKey="Iblan I">I Iblan</name></author><author><name sortKey="Rha, B" uniqKey="Rha B">B Rha</name></author><author><name sortKey="Alqasrawi, S" uniqKey="Alqasrawi S">S Alqasrawi</name></author><author><name sortKey="Haddadin, A" uniqKey="Haddadin A">A Haddadin</name></author><author><name sortKey="Al Nsour, M" uniqKey="Al Nsour M">M Al Nsour</name></author><author><name sortKey="Alsanouri, T" uniqKey="Alsanouri T">T Alsanouri</name></author><author><name sortKey="Ali, Ss" uniqKey="Ali S">SS Ali</name></author><author><name sortKey="Harcourt, J" uniqKey="Harcourt J">J Harcourt</name></author><author><name sortKey="Miao, C" uniqKey="Miao C">C Miao</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Zhao, Jingxian" uniqKey="Zhao J">Jingxian Zhao</name></author><author><name sortKey="Alshukairi, Abeer N" uniqKey="Alshukairi A">Abeer N. Alshukairi</name></author><author><name sortKey="Baharoon, Salim A" uniqKey="Baharoon S">Salim A. Baharoon</name></author><author><name sortKey="Ahmed, Waleed A" uniqKey="Ahmed W">Waleed A. Ahmed</name></author><author><name sortKey="Bokhari, Ahmad A" uniqKey="Bokhari A">Ahmad A. Bokhari</name></author><author><name sortKey="Nehdi, Atef M" uniqKey="Nehdi A">Atef M. Nehdi</name></author><author><name sortKey="Layqah, Laila A" uniqKey="Layqah L">Laila A. Layqah</name></author><author><name sortKey="Alghamdi, Mohammed G" uniqKey="Alghamdi M">Mohammed G. Alghamdi</name></author><author><name sortKey="Al Gethamy, Manal M" uniqKey="Al Gethamy M">Manal M. Al Gethamy</name></author><author><name sortKey="Dada, Ashraf M" uniqKey="Dada A">Ashraf M. Dada</name></author><author><name sortKey="Khalid, Imran" uniqKey="Khalid I">Imran Khalid</name></author><author><name sortKey="Boujelal, Mohamad" uniqKey="Boujelal M">Mohamad Boujelal</name></author><author><name sortKey="Al Johani, Sameera M" uniqKey="Al Johani S">Sameera M. Al Johani</name></author><author><name sortKey="Vogel, Leatrice" uniqKey="Vogel L">Leatrice Vogel</name></author><author><name sortKey="Subbarao, Kanta" uniqKey="Subbarao K">Kanta Subbarao</name></author><author><name sortKey="Mangalam, Ashutosh" uniqKey="Mangalam A">Ashutosh Mangalam</name></author><author><name sortKey="Wu, Chaorong" uniqKey="Wu C">Chaorong Wu</name></author><author><name sortKey="Ten Eyck, Patrick" uniqKey="Ten Eyck P">Patrick Ten Eyck</name></author><author><name sortKey="Perlman, Stanley" uniqKey="Perlman S">Stanley Perlman</name></author><author><name sortKey="Zhao, Jincun" uniqKey="Zhao J">Jincun Zhao</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Choe, Pg" uniqKey="Choe P">PG Choe</name></author><author><name sortKey="Perera, R" uniqKey="Perera R">R Perera</name></author><author><name sortKey="Park, Wb" uniqKey="Park W">WB Park</name></author><author><name sortKey="Song, Kh" uniqKey="Song K">KH Song</name></author><author><name sortKey="Bang, Jh" uniqKey="Bang J">JH Bang</name></author><author><name sortKey="Kim, Es" uniqKey="Kim E">ES Kim</name></author><author><name sortKey="Kim, Hb" uniqKey="Kim H">HB Kim</name></author><author><name sortKey="Ko, Lwr" uniqKey="Ko L">LWR Ko</name></author><author><name sortKey="Park, Sw" uniqKey="Park S">SW Park</name></author><author><name sortKey="Kim, Nj" uniqKey="Kim N">NJ Kim</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ko, Jh" uniqKey="Ko J">JH Ko</name></author><author><name sortKey="Muller, Ma" uniqKey="Muller M">MA Muller</name></author><author><name sortKey="Seok, H" uniqKey="Seok H">H Seok</name></author><author><name sortKey="Park, Ge" uniqKey="Park G">GE Park</name></author><author><name sortKey="Lee, Jy" uniqKey="Lee J">JY Lee</name></author><author><name sortKey="Cho, Sy" uniqKey="Cho S">SY Cho</name></author><author><name sortKey="Ha, Ye" uniqKey="Ha Y">YE Ha</name></author><author><name sortKey="Baek, Jy" uniqKey="Baek J">JY Baek</name></author><author><name sortKey="Kim, Sh" uniqKey="Kim S">SH Kim</name></author><author><name sortKey="Kang, Jm" uniqKey="Kang J">JM Kang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tansey, Cm" uniqKey="Tansey C">CM Tansey</name></author><author><name sortKey="Louie, M" uniqKey="Louie M">M Louie</name></author><author><name sortKey="Loeb, M" uniqKey="Loeb M">M Loeb</name></author><author><name sortKey="Gold, Wl" uniqKey="Gold W">WL Gold</name></author><author><name sortKey="Muller, Mp" uniqKey="Muller M">MP Muller</name></author><author><name sortKey="De Jager, J" uniqKey="De Jager J">J de Jager</name></author><author><name sortKey="Cameron, Ji" uniqKey="Cameron J">JI Cameron</name></author><author><name sortKey="Tomlinson, G" uniqKey="Tomlinson G">G Tomlinson</name></author><author><name sortKey="Mazzulli, T" uniqKey="Mazzulli T">T Mazzulli</name></author><author><name sortKey="Walmsley, Sl" uniqKey="Walmsley S">SL Walmsley</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chen, J" uniqKey="Chen J">J Chen</name></author><author><name sortKey="Wu, J" uniqKey="Wu J">J Wu</name></author><author><name sortKey="Hao, S" uniqKey="Hao S">S Hao</name></author><author><name sortKey="Yang, M" uniqKey="Yang M">M Yang</name></author><author><name sortKey="Lu, X" uniqKey="Lu X">X Lu</name></author><author><name sortKey="Chen, X" uniqKey="Chen X">X Chen</name></author><author><name sortKey="Li, L" uniqKey="Li L">L Li</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ngai, Jc" uniqKey="Ngai J">JC Ngai</name></author><author><name sortKey="Ko, Fw" uniqKey="Ko F">FW Ko</name></author><author><name sortKey="Ng, Ss" uniqKey="Ng S">SS Ng</name></author><author><name sortKey="To, Kw" uniqKey="To K">KW To</name></author><author><name sortKey="Tong, M" uniqKey="Tong M">M Tong</name></author><author><name sortKey="Hui, Ds" uniqKey="Hui D">DS Hui</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ng, Ck" uniqKey="Ng C">CK Ng</name></author><author><name sortKey="Chan, Jw" uniqKey="Chan J">JW Chan</name></author><author><name sortKey="Kwan, Tl" uniqKey="Kwan T">TL Kwan</name></author><author><name sortKey="Chan, Yh" uniqKey="Chan Y">YH Chan</name></author><author><name sortKey="Ng, Fy" uniqKey="Ng F">FY Ng</name></author><author><name sortKey="Mok, Ty" uniqKey="Mok T">TY Mok</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Madani, Ta" uniqKey="Madani T">TA Madani</name></author><author><name sortKey="Althaqafi, Ao" uniqKey="Althaqafi A">AO Althaqafi</name></author><author><name sortKey="Alraddadi, Bm" uniqKey="Alraddadi B">BM Alraddadi</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Luyt, Ce" uniqKey="Luyt C">CE Luyt</name></author><author><name sortKey="Combes, A" uniqKey="Combes A">A Combes</name></author><author><name sortKey="Becquemin, Mh" uniqKey="Becquemin M">MH Becquemin</name></author><author><name sortKey="Beigelman Aubry, C" uniqKey="Beigelman Aubry C">C Beigelman-Aubry</name></author><author><name sortKey="Hatem, S" uniqKey="Hatem S">S Hatem</name></author><author><name sortKey="Brun, Al" uniqKey="Brun A">AL Brun</name></author><author><name sortKey="Zraik, N" uniqKey="Zraik N">N Zraik</name></author><author><name sortKey="Carrat, F" uniqKey="Carrat F">F Carrat</name></author><author><name sortKey="Grenier, Pa" uniqKey="Grenier P">PA Grenier</name></author><author><name sortKey="Richard, Jm" uniqKey="Richard J">JM Richard</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mchorney, Ca" uniqKey="Mchorney C">CA McHorney</name></author><author><name sortKey="Ware, Je" uniqKey="Ware J">JE Ware</name></author><author><name sortKey="Lu, Jf" uniqKey="Lu J">JF Lu</name></author><author><name sortKey="Sherbourne, Cd" uniqKey="Sherbourne C">CD Sherbourne</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ware, Je" uniqKey="Ware J">JE Ware</name></author><author><name sortKey="Sherbourne, Cd" uniqKey="Sherbourne C">CD Sherbourne</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Coons, Sj" uniqKey="Coons S">SJ Coons</name></author><author><name sortKey="Alabdulmohsin, Sa" uniqKey="Alabdulmohsin S">SA Alabdulmohsin</name></author><author><name sortKey="Draugalis, Jr" uniqKey="Draugalis J">JR Draugalis</name></author><author><name sortKey="Hays, Rd" uniqKey="Hays R">RD Hays</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Campos, Ac" uniqKey="Campos A">AC Campos</name></author><author><name sortKey="Ferreira E Ferreira, E" uniqKey="Ferreira E Ferreira E">E Ferreira e Ferreira</name></author><author><name sortKey="Vargas, Am" uniqKey="Vargas A">AM Vargas</name></author><author><name sortKey="Albala, C" uniqKey="Albala C">C Albala</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Liu, H" uniqKey="Liu H">H Liu</name></author><author><name sortKey="Feurer, Id" uniqKey="Feurer I">ID Feurer</name></author><author><name sortKey="Dwyer, K" uniqKey="Dwyer K">K Dwyer</name></author><author><name sortKey="Speroff, T" uniqKey="Speroff T">T Speroff</name></author><author><name sortKey="Shaffer, D" uniqKey="Shaffer D">D Shaffer</name></author><author><name sortKey="Wright Pinson, C" uniqKey="Wright Pinson C">C Wright Pinson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Dowdy, Dw" uniqKey="Dowdy D">DW Dowdy</name></author><author><name sortKey="Eid, Mp" uniqKey="Eid M">MP Eid</name></author><author><name sortKey="Sedrakyan, A" uniqKey="Sedrakyan A">A Sedrakyan</name></author><author><name sortKey="Mendez Tellez, Pa" uniqKey="Mendez Tellez P">PA Mendez-Tellez</name></author><author><name sortKey="Pronovost, Pj" uniqKey="Pronovost P">PJ Pronovost</name></author><author><name sortKey="Herridge, Ms" uniqKey="Herridge M">MS Herridge</name></author><author><name sortKey="Needham, Dm" uniqKey="Needham D">DM Needham</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hui, Ds" uniqKey="Hui D">DS Hui</name></author><author><name sortKey="Wong, Kt" uniqKey="Wong K">KT Wong</name></author><author><name sortKey="Ko, Fw" uniqKey="Ko F">FW Ko</name></author><author><name sortKey="Tam, Ls" uniqKey="Tam L">LS Tam</name></author><author><name sortKey="Chan, Dp" uniqKey="Chan D">DP Chan</name></author><author><name sortKey="Woo, J" uniqKey="Woo J">J Woo</name></author><author><name sortKey="Sung, Jj" uniqKey="Sung J">JJ Sung</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Herridge, Ms" uniqKey="Herridge M">MS Herridge</name></author><author><name sortKey="Cheung, Am" uniqKey="Cheung A">AM Cheung</name></author><author><name sortKey="Tansey, Cm" uniqKey="Tansey C">CM Tansey</name></author><author><name sortKey="Matte Martyn, A" uniqKey="Matte Martyn A">A Matte-Martyn</name></author><author><name sortKey="Diaz Granados, N" uniqKey="Diaz Granados N">N Diaz-Granados</name></author><author><name sortKey="Al Saidi, F" uniqKey="Al Saidi F">F Al-Saidi</name></author><author><name sortKey="Cooper, Ab" uniqKey="Cooper A">AB Cooper</name></author><author><name sortKey="Guest, Cb" uniqKey="Guest C">CB Guest</name></author><author><name sortKey="Mazer, Cd" uniqKey="Mazer C">CD Mazer</name></author><author><name sortKey="Mehta, S" uniqKey="Mehta S">S Mehta</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lee, Am" uniqKey="Lee A">AM Lee</name></author><author><name sortKey="Wong, Jg" uniqKey="Wong J">JG Wong</name></author><author><name sortKey="Mcalonan, Gm" uniqKey="Mcalonan G">GM McAlonan</name></author><author><name sortKey="Cheung, V" uniqKey="Cheung V">V Cheung</name></author><author><name sortKey="Cheung, C" uniqKey="Cheung C">C Cheung</name></author><author><name sortKey="Sham, Pc" uniqKey="Sham P">PC Sham</name></author><author><name sortKey="Chu, Cm" uniqKey="Chu C">CM Chu</name></author><author><name sortKey="Wong, Pc" uniqKey="Wong P">PC Wong</name></author><author><name sortKey="Tsang, Kw" uniqKey="Tsang K">KW Tsang</name></author><author><name sortKey="Chua, Se" uniqKey="Chua S">SE Chua</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Watson, Ek" uniqKey="Watson E">EK Watson</name></author><author><name sortKey="Firman, Dw" uniqKey="Firman D">DW Firman</name></author><author><name sortKey="Baade, Pd" uniqKey="Baade P">PD Baade</name></author><author><name sortKey="Ring, I" uniqKey="Ring I">I Ring</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Garcia, M" uniqKey="Garcia M">M Garcia</name></author><author><name sortKey="Rohlfs, I" uniqKey="Rohlfs I">I Rohlfs</name></author><author><name sortKey="Vila, J" uniqKey="Vila J">J Vila</name></author><author><name sortKey="Sala, J" uniqKey="Sala J">J Sala</name></author><author><name sortKey="Pena, A" uniqKey="Pena A">A Pena</name></author><author><name sortKey="Masia, R" uniqKey="Masia R">R Masia</name></author><author><name sortKey="Marrugat, J" uniqKey="Marrugat J">J Marrugat</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Health Qual Life Outcomes</journal-id><journal-id journal-id-type="iso-abbrev">Health Qual Life Outcomes</journal-id><journal-title-group><journal-title>Health and Quality of Life Outcomes</journal-title></journal-title-group><issn pub-type="epub">1477-7525</issn><publisher><publisher-name>BioMed Central</publisher-name><publisher-loc>London</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">31186042</article-id><article-id pub-id-type="pmc">6560892</article-id><article-id pub-id-type="publisher-id">1165</article-id><article-id pub-id-type="doi">10.1186/s12955-019-1165-2</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research</subject></subj-group></article-categories><title-group><article-title>Quality of life reported by survivors after hospitalization for Middle East respiratory syndrome (MERS)</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Batawi</surname><given-names>Sarah</given-names></name><address><email>sabatawi@kau.edu.sa</email></address><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Tarazan</surname><given-names>Nehal</given-names></name><address><email>Nehal.tarazan@gmail.com</email></address><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Al-Raddadi</surname><given-names>Rajaa</given-names></name><address><email>saudiresearcher@yahoo.com</email></address><xref ref-type="aff" rid="Aff3">3</xref></contrib><contrib contrib-type="author"><name><surname>Al Qasim</surname><given-names>Eman</given-names></name><address><email>eman77al-qasim@hotmail.com</email></address><xref ref-type="aff" rid="Aff4">4</xref></contrib><contrib contrib-type="author"><name><surname>Sindi</surname><given-names>Anees</given-names></name><address><email>ansindi@gmail.com</email></address><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>AL Johni</surname><given-names>Sameera</given-names></name><address><email>johanis@ngha.med.sa</email></address><xref ref-type="aff" rid="Aff5">5</xref></contrib><contrib contrib-type="author"><name><surname>Al-Hameed</surname><given-names>Fahad M.</given-names></name><address><email>Hameedf@ngha.med.sa</email></address><xref ref-type="aff" rid="Aff6">6</xref></contrib><contrib contrib-type="author"><name><surname>Arabi</surname><given-names>Yaseen M.</given-names></name><address><email>arabi@ngha.med.sa</email></address><xref ref-type="aff" rid="Aff6">6</xref></contrib><contrib contrib-type="author"><name><surname>Uyeki</surname><given-names>Timothy M.</given-names></name><address><email>tmu0@cdc.gov</email></address><xref ref-type="aff" rid="Aff7">7</xref></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">http://orcid.org/0000-0003-1565-1829</contrib-id><name><surname>Alraddadi</surname><given-names>Basem M.</given-names></name><address><phone>+966-12-6677777</phone><email>balraddadi@kfshrc.edu.sa</email></address><xref ref-type="aff" rid="Aff8">8</xref></contrib><aff id="Aff1"><label>1</label><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0619 1117</institution-id><institution-id institution-id-type="GRID">grid.412125.1</institution-id><institution>King Abdulaziz University,</institution></institution-wrap>Jeddah, Saudi Arabia</aff><aff id="Aff2"><label>2</label><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2191 4301</institution-id><institution-id institution-id-type="GRID">grid.415310.2</institution-id><institution>King Faisal Specialist Hospital and Research Center,</institution></institution-wrap>Jeddah, Saudi Arabia</aff><aff id="Aff3"><label>3</label><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0619 1117</institution-id><institution-id institution-id-type="GRID">grid.412125.1</institution-id><institution>Department of Community Medicine,</institution><institution>King Abdulaziz University,</institution></institution-wrap>Jeddah , Saudi Arabia</aff><aff id="Aff4"><label>4</label><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1790 7311</institution-id><institution-id institution-id-type="GRID">grid.415254.3</institution-id><institution>King Abdullah International Medical Research Center,</institution><institution>King Abdulaziz Medical City – National Guard Health Affairs,</institution></institution-wrap>Riyadh, Saudi Arabia</aff><aff id="Aff5"><label>5</label><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0608 0662</institution-id><institution-id institution-id-type="GRID">grid.412149.b</institution-id><institution>King Saud Bin Abdulaziz University for Health Sciences,</institution></institution-wrap>Riyadh, Saudi Arabia</aff><aff id="Aff6"><label>6</label>King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Intensive Care Department, King Abdulaziz Medical City – National Guard Health Affairs, Jeddah , Saudi Arabia</aff><aff id="Aff7"><label>7</label><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2163 0069</institution-id><institution-id institution-id-type="GRID">grid.416738.f</institution-id><institution>Influenza Division, National Center for Immunization and Respiratory Diseases,</institution><institution>Centers for Disease Control and Prevention,</institution></institution-wrap>Atlanta, Georgia USA</aff><aff id="Aff8"><label>8</label><institution-wrap><institution-id institution-id-type="GRID">grid.460099.2</institution-id><institution>Department of Medicine, King Faisal Specialist Hospital and Research Center,</institution><institution>University of Jeddah,</institution></institution-wrap>P.O BOX 40047 Jeddah 21499 MBC J 46, Jeddah, Saudi Arabia</aff></contrib-group><pub-date pub-type="epub"><day>11</day><month>6</month><year>2019</year></pub-date><pub-date pub-type="pmc-release"><day>11</day><month>6</month><year>2019</year></pub-date><pub-date pub-type="collection"><year>2019</year></pub-date><volume>17</volume><elocation-id>101</elocation-id><history><date date-type="received"><day>12</day><month>2</month><year>2019</year></date><date date-type="accepted"><day>23</day><month>5</month><year>2019</year></date></history><permissions><copyright-statement>© The Author(s). 2019</copyright-statement><license license-type="OpenAccess"><license-p><bold>Open Access</bold>This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>) applies to the data made available in this article, unless otherwise stated.</license-p></license></permissions><abstract id="Abs1"><sec><title>Introduction</title><p id="Par1">Data are lacking on impact of Middle East Respiratory Syndrome (MERS) on health-related quality of life (HRQoL) among survivors.</p></sec><sec><title>Methods</title><p id="Par2">We conducted a cross-sectional survey of MERS survivors who required hospitalization in Saudi Arabia during 2016–2017, approximately 1 year after diagnosis. The Short-Form General Health Survey 36 (SF-36) was administered by telephone interview to assess 8 quality of life domains for MERS survivors and a sample of survivors of severe acute respiratory infection (SARI) without MERS. We compared mean SF-36 scores of MERS and non-MERS SARI survivors using independent t-test, and compared categorical variables using chi-square test. Adjusted analyses were performed using multiple linear regression.</p></sec><sec><title>Results</title><p id="Par3">Of 355 MERS survivors, 83 were eligible and 78 agreed to participate. MERS survivors were younger than non-MERS SARI survivors (mean ± SD): (44.9 years ±12.9) vs (50.0 years ±13.6), <italic>p</italic> = 0.031. Intensive care unit (ICU) admissions were similar for MERS and non-MERS SARI survivors (46.2% vs. 57.1%), <italic>p</italic> = 0.20. After adjusting for potential confounders, there were no significant differences between MERS and non-MERS SARI survivors in physical component or mental component summary scores. MERS ICU survivors scored lower than MERS survivors not admitted to an ICU for physical function (<italic>p</italic> = 0.05), general health (<italic>p</italic> = 0.01), vitality (<italic>p</italic> = 0.03), emotional role (<italic>p</italic> = 0.03) and physical component summary (<italic>p</italic> < 0.02).</p></sec><sec><title>Conclusions</title><p id="Par4">Functional scores were similar for MERS and non-MERS SARI survivors. However, MERS survivors of critical illness reported lower quality of life than survivors of less severe illness. Efforts are needed to address the long-term medical and psychological needs of MERS survivors.</p></sec></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>Health-related quality of life (HRQoL)</kwd><kwd>Coronavirus</kwd><kwd>Middle East respiratory syndrome (MERS)</kwd><kwd>Pneumonia</kwd><kwd>Saudi Arabia</kwd><kwd>Severe acute respiratory infection (SARI)</kwd><kwd>Long term outcome, survivors</kwd></kwd-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Author(s) 2019</meta-value></custom-meta></custom-meta-group></article-meta></front><body><sec id="Sec1"><title>Introduction</title><p id="Par24">Middle East Respiratory Syndrome (MERS) caused by a novel coronavirus (MERS-CoV) was first identified in Saudi Arabia in 2012 [<xref ref-type="bibr" rid="CR1">1</xref>]. Since then, MERS outbreaks have occurred in several hospitals [<xref ref-type="bibr" rid="CR2">2</xref>, <xref ref-type="bibr" rid="CR3">3</xref>]. As of March 31, 2019, 2399 laboratory-confirmed MERS cases, including 827 deaths (34.5%) worldwide have been reported to the World Health Organization (WHO [<xref ref-type="bibr" rid="CR4">4</xref>]. The clinical presentation of MERS is variable, ranging from asymptomatic infection to critical illness and multi-organ failure requiring intensive care unit (ICU) admission for mechanical ventilation, renal replacement therapy, and vasopressor support for refractory shock [<xref ref-type="bibr" rid="CR5">5</xref>–<xref ref-type="bibr" rid="CR8">8</xref>]. A recent post-mortem study reported detection of MERS-CoV by transmission electron microscopy in the lungs, kidney, and muscle of a fatal case [<xref ref-type="bibr" rid="CR9">9</xref>]. Lung pathology of a previous fatal case of MERS demonstrated diffuse alveolar damage without evidence of extrapulmonary spread [<xref ref-type="bibr" rid="CR10">10</xref>]. MERS-CoV infection triggers specific CD4 and CD8 T-cell responses that may last up to 18–34 months following the primary infection [<xref ref-type="bibr" rid="CR11">11</xref>, <xref ref-type="bibr" rid="CR12">12</xref>]. MERS severity and recovery has been correlated with CD4 T-cell response, levels of antibody and longevity, but not CD8 T-cell responses [<xref ref-type="bibr" rid="CR11">11</xref>–<xref ref-type="bibr" rid="CR15">15</xref>].</p><p id="Par25">Patients who survived severe acute respiratory infection (SARI) due to non-MERS etiologies have reported persistent abnormalities during prospective follow up [<xref ref-type="bibr" rid="CR16">16</xref>]. A longitudinal 2-year follow-up of survivors of severe illness from avian influenza A(H7N9) virus infection reported residual impairment in ventilation and diffusion capacity for carbon monoxide (DLCO) in more than half despite significant improvement from baseline during the first 6 months [<xref ref-type="bibr" rid="CR17">17</xref>]. Survivors of a closely related coronavirus infection, Severe Acute Respiratory Syndrome (SARS), had residual abnormalities detected with pulmonary function testing, with impairment in DLCO up to 2 years after recovery [<xref ref-type="bibr" rid="CR18">18</xref>]. In addition to air space changes reported in chest radiographs, further pulmonary abnormalities were observed using high resolution computed tomography [<xref ref-type="bibr" rid="CR19">19</xref>] and impairment in Health-related quality of life (HRQoL) was also reported in SARS survivors [<xref ref-type="bibr" rid="CR18">18</xref>].</p><p id="Par26">While the clinical course and the immunological response to MERS-CoV infection have been described, data are lacking on the impact of MERS on quality of life among survivors. We aimed to describe the long-term outcomes and quality of life among survivors of MERS who required hospitalization. In addition, we compared reported HRQoL scores between MERS patients who had severe disease and those with mild disease.</p></sec><sec id="Sec2"><title>Methods</title><sec id="Sec3"><title>Study design and setting</title><p id="Par27">During February 1, 2016 to February 14, 2017, we aimed to evaluate MERS patients reported to the Ministry of Health (MOH) of Saudi Arabia from September 2014 until November 16, 2015 and who survived. Eligible patients met the following criteria: 1) had laboratory confirmed MERS [MERS-CoV RNA was detected in upper or lower respiratory tract specimens by real-time reverse transcription polymerase chain reaction (rRT-PCR)] [<xref ref-type="bibr" rid="CR20">20</xref>]; 2) aged ≥18 years; 3) were hospitalized for MERS; 4) survived for at least 1 year from the time of MERS diagnosis; and 5) had contact information available to the MOH. A sample of SARI patients who tested negative for MERS-CoV RNA in upper or lower respiratory tract specimens by rRT-PCR (non-MERS SARI) was selected to serve as a comparative cohort. We identified potential non-MERS-SARI controls randomly from retrospective records, based on the WHO case definition of SARI; 1) Any acute respiratory infection requires hospitalization with history of fever or measured temperature ≥ 38 °C; 2) cough; 3) onset within the last 10 days [<xref ref-type="bibr" rid="CR21">21</xref>]; and 4) aged ≥18 years. Disease severity was stratified based on requirements of admission to an intensive care unit or medical ward.</p><p id="Par28">We excluded 1) subjects with incomplete information on quality of life survey and 2) patients who were not able to complete the interview. Non-MERS SARI cases were selected only from one hospital; whereas the MERS cases were from multiple hospitals in Saudi Arabia.</p><p id="Par29">Contact information and the data registry of MERS-CoV patients were provided by the MOH in Saudi Arabia and the Ministry of National Guard Health Affairs Hospitals (Jeddah and Riyadh) and a short form health survey was administered through telephone interview by a general physician. Verbal informed consent was obtained from all participants.</p></sec><sec id="Sec4"><title>Short form health survey (SF-36)</title><p id="Par30">The SF- 36 is an internationally recognized instrument that has been used in clinical trials to assess the quality of life for patients with other respiratory infections, including those caused by avian influenza A(H7N9) virus (17), influenza A(H1N1)pdm09 virus [<xref ref-type="bibr" rid="CR22">22</xref>], and SARS-CoV [<xref ref-type="bibr" rid="CR18">18</xref>]. The SF-36 consists of 36 question that evaluates eight health domains: physical functioning (PF), social functioning (SF), role limitation due to physical problems (RP), role limitation due to emotional problems (RE), mental health (MH), bodily pain (BP), vitality (VT), and general health (GH) [<xref ref-type="bibr" rid="CR23">23</xref>, <xref ref-type="bibr" rid="CR24">24</xref>]. These domains can be further represented as physical (PSC) and mental (MCS) component summary scales. Scores for each domain can range from 0 (worst) to 100 (best) with higher scores indicating better HRQoL [<xref ref-type="bibr" rid="CR24">24</xref>]. The Arabic version of SF-36 has been validated in the Saudi Arabian population, and no significant mean differences between Arabic and English SF-36 questionnaires were observed [<xref ref-type="bibr" rid="CR25">25</xref>]. Patients were interviewed using the English or Arabic version as needed of the Short-Form 36-item survey (SF-36) to assess the HRQoL.</p></sec><sec id="Sec5"><title>Statistical analysis</title><p id="Par31">Categorical data were expressed as frequencies and percentages, continuous data were reported as means ± SD for normally distributed data and medians and interquartile range (IQR) for non-normally distributed data. For comparisons of mean SF-36 scores between MERS and non-MERS SARI survivors, we used the independent t-test. Categorical variables were compared using the chi-square test. Multiple linear regression was used to adjust for the following potential confounders: Age, gender, ICU admission, healthcare worker, mean time of diagnosis to interview, presence of at least one comorbidity; and immunocompromised status.</p><p id="Par32">We included age and gender as covariates since these factors have been shown to affect the HRQoL [<xref ref-type="bibr" rid="CR26">26</xref>, <xref ref-type="bibr" rid="CR27">27</xref>]. Other covariates were included because these variables were significantly different (<italic>p</italic> < 0.05) between MERS vs non-MERS SARI patients. Analyses were performed using SPSS. <italic>P</italic>-values of < 0.05 were considered statistically significant.</p></sec><sec id="Sec6"><title>Ethics statement</title><p id="Par33">Institutional Review Board approval was obtained from the Ministry of Health and the Ministry of National Guard Health Affairs of Saudi Arabia.</p></sec></sec><sec id="Sec7"><title>Results</title><sec id="Sec8"><title>Baseline characteristics of MERS and non-MERS SARI survivors</title><p id="Par34">Throughout the recruitment period from February 1, 2016 to February 142,017, 83 MERS survivors were determined to be eligible and 78 agreed to participate and were included in the final analysis (Fig. <xref rid="Fig1" ref-type="fig">1</xref>a). Eligible patients were interviewed from four major cities in the Kingdom: Riyadh 64 (82%), Jeddah 9 (12%), Ahsa 4 (5%) and Taif 1 (1%). Fifty-seven non-MERS SARI survivors met our inclusion criteria and were included in the analysis. MERS survivors were younger when compared to non-MERS SARI survivors (mean ± SD): (44.9 years ±12.9) vs (50.0 years ±13.6), <italic>p</italic> = 0.031.. The mean time from illness onset to interview was significantly longer in the non-MERS SARI cases than MERS survivors, mean (±SD), 25.3 months (7.5) and 13.8 months (3.4) respectively (<italic>p</italic> < 0.01). Twenty (25.6%) MERS survivors were healthcare personnel, whereas only two (3.5%) of the non-MERS survivors worked in a hospital at the time of illness onset (p < 0.01). Non-MERS survivors were more likely than MERS survivors to report a pre-existing medical condition. (Table <xref rid="Tab1" ref-type="table">1</xref>).<fig id="Fig1"><label>Fig. 1</label><caption><p><bold>a</bold> MERS survivor recruitment process</p></caption><graphic xlink:href="12955_2019_1165_Fig1_HTML" id="MO1"></graphic></fig><table-wrap id="Tab1"><label>Table 1</label><caption><p>Baseline Characteristics of patients with Middle East Respiratory Syndrome (MERS) and patients with Non-MERS Severe Acute Respiratory Infection (SARI) at the time of diagnosis</p></caption><table frame="hsides" rules="groups"><thead><tr><th>Characteristic</th><th>MERS <italic>N</italic> = 78 (%)</th><th>Non-MERS SARI <italic>N</italic> = 57 (%)</th><th><italic>p</italic>-value</th></tr></thead><tbody><tr><td>Age-years (Mean ± SD)</td><td>(44.99 ± 12.95)</td><td>(50.04 ± 13.64)</td><td>0.31</td></tr><tr><td>Male gender</td><td>56 (71.8%)</td><td>34 (59.6%)</td><td>0.14</td></tr><tr><td>Nationality-Saudi</td><td>56 (71.8%)</td><td>34 (59.6%)</td><td>0.14</td></tr><tr><td>ICU admission</td><td>36 (46.2%)</td><td>32 (57.1%)</td><td>0.20</td></tr><tr><td>Mechanically ventilated</td><td>26 (33.3%)<sup>c</sup></td><td>26 (45.6%)</td><td>0.10</td></tr><tr><td>Health care worker</td><td>20 (25.6%)</td><td>2 (3.5%)</td><td>< 0.01</td></tr><tr><td>Presence of comorbidity (one or more)</td><td>45 (63.4%)</td><td>44 (91.7%)</td><td>< 0.01</td></tr><tr><td colspan="4">Comorbidities</td></tr><tr><td> Diabetes</td><td>29 (37.2%)</td><td>28 (50.9%)</td><td>0.12</td></tr><tr><td> Hypertension</td><td>29 (37.2%)</td><td>29 (51.8%)</td><td>0.09</td></tr><tr><td> Respiratory disease</td><td>2 (2.6%)</td><td>0</td><td>0.33</td></tr><tr><td> Cardiovascular disease</td><td>10 (12.8%)</td><td>19 (33.9%)</td><td>< 0.01</td></tr><tr><td> Neurological disease</td><td>4 (5.1%)</td><td>12 (21.4%)</td><td>< 0.01</td></tr><tr><td> Renal disease</td><td>9 (11.5%)</td><td>15 (26.8%)</td><td>0.02</td></tr><tr><td> Hemodialysis</td><td>3 (3.9%)</td><td>3 (5.4%)</td><td>0.70</td></tr><tr><td> Chronic liver disease</td><td>0</td><td>7 (12.5%)</td><td>< 0.01</td></tr><tr><td>Immunocompromised<sup>a</sup></td><td>6 (7.7%)</td><td>20 (35.7%)</td><td>< 0.01</td></tr><tr><td>Current smoker or history of smoking</td><td>26 (33.3%)</td><td>11 (19.6%)</td><td>0.08</td></tr><tr><td>Time to interview after illness –month (Mean ± SD)</td><td>(13.79 ± 3.43)</td><td>(25.32 ± 7.54)</td><td>< 0.01</td></tr><tr><td>Returned to original work at the time of interview</td><td>44 (88%)<sup>b</sup></td><td>17 (73.9%)</td><td>0.17</td></tr></tbody></table><table-wrap-foot><p><sup>a</sup>Immunocompromised patients were defined as follows: (Use of systemic corticosteroids or immunosuppressive medication, preexisting organ transplantation and active cancer)</p><p><sup>b</sup>Subjects who were originally not working were excluded in the analysis</p><p><sup>c</sup>Percentage from total patients with MERS (78) and Non-MERS SARI (57)</p></table-wrap-foot></table-wrap></p></sec><sec id="Sec9"><title>Main outcomes</title><p id="Par35">MERS survivors (<italic>n</italic> = 78) had significantly higher mean SF-36 scores than non-MERS SARI patients (<italic>n</italic> = 57) for the following domains (Table <xref rid="Tab2" ref-type="table">2</xref>): physical functioning [mean ± SD (72.47 ± 26.11) vs (55.26 ± 35.07), p < 0.01], physical role [(64.87 ± 39.12) vs (50.00 ± 42.52), <italic>p</italic> = 0.04], general health [(73.03 ± 22.68) vs (63.95 ± 23.52), <italic>p</italic> = 0.03], vitality [(65.96 ± 26.47) vs (53.60 ± 28.80), <italic>p</italic> = 0.01] and physical component summary (71.33 ± 22.20) vs (59.77 ± 27.00), <italic>p</italic> = 0.01]. After adjusting for potential confounders, there were no significant differences between the physical or mental component summary scores between the two groups At the time of the survey, the majority of MERS survivors (88%) had returned to their original work compared with 74% of non-MERS SARI survivors, <italic>p</italic> = 0.17.<table-wrap id="Tab2"><label>Table 2</label><caption><p>Average score of SF36 components reported by MERS survivors (<italic>n</italic> = 78) and non-MERS SARI survivors (<italic>n</italic> = 57)</p></caption><table frame="hsides" rules="groups"><thead><tr><th>SF36 component</th><th>MERS (<italic>n</italic> = 78) mean (SD)</th><th>Non-MERS SARI survivors (<italic>n</italic> = 57) mean (SD)</th><th><italic>p</italic>-value</th></tr></thead><tbody><tr><td>Physical functioning</td><td>72.47 (26.11)</td><td>55.26 (35.07)</td><td>< 0.01</td></tr><tr><td>Physical role</td><td>64.87 (39.12)</td><td>50.00 (42.52)</td><td>0.04</td></tr><tr><td>Pain</td><td>78.97 (29.84)</td><td>76.05 (33.88)</td><td>0.60</td></tr><tr><td>General health</td><td>73.03 (22.68)</td><td>63.95 (23.52)</td><td>0.03</td></tr><tr><td>Vitality</td><td>65.96 (26.47)</td><td>53.60 (28.80)</td><td>0.01</td></tr><tr><td>Social functioning</td><td>84.45 (24.36)</td><td>75.44 (32.04)</td><td>0.08</td></tr><tr><td>Emotional role</td><td>75.12 (36.39)</td><td>62.58 (42.76)</td><td>0.08</td></tr><tr><td>Mental health</td><td>79.64 (22.34)</td><td>74.74 (24.03)</td><td>0.23</td></tr><tr><td>Physical component Summary</td><td>71.33 (22.20)</td><td>59.77 (27.00)</td><td>0.01</td></tr><tr><td>Mental component Summary</td><td>79.77 (23.20)</td><td>70.92 (28.53)</td><td>0.06</td></tr></tbody></table></table-wrap></p><p id="Par36">Mean SF-36 scores reported among MERS survivors stratified by disease severity are summarized in Table <xref rid="Tab3" ref-type="table">3</xref>. SF-36 domain scores for those admitted to an intensive care unit (<italic>n</italic> = 36) were significantly lower than survivors managed in medical wards (<italic>n</italic> = 42) in the following domains, physical functioning [mean ± SD (66.94 ± 30.29) vs (78.69 ± 18.78), <italic>p</italic> < 0.05], general health [(65.94 ± 26.97) vs (79.10 ± 16.21), <italic>p</italic> = 0.01], vitality [(58.47 ± 31.60) vs (72.38 ± 19.29), <italic>p</italic> = 0.03], emotional role [(65.74 ± 38.62) vs (83.33 ± 33.13), <italic>p</italic> = 0.03], and physical component summary [(64.84 ± 25.52) vs (76.90 ± 17.35), <italic>p</italic> = 0.02] (Table <xref rid="Tab3" ref-type="table">3</xref>). After adjustment for potential confounders, MERS ICU survivors had a significantly lower mental component summary score than MERS survivors cared for on medical wards (<italic>p</italic> < 0.026), but no significant difference was found in physical component summary score.<table-wrap id="Tab3"><label>Table 3</label><caption><p>Average score of SF36 components reported by MERS-CoV survivors admitted to an ICU (<italic>n</italic> = 36) or a medical ward (non ICU) (<italic>n</italic> = 42)</p></caption><table frame="hsides" rules="groups"><thead><tr><th></th><th>MERS ICU (<italic>n</italic> = 36) mean (SD)</th><th>MERS Non ICU (<italic>n</italic> = 42) mean (SD)</th><th><italic>P</italic> value</th></tr></thead><tbody><tr><td>Physical functioning</td><td>66.94 (30.29)</td><td>78.69 (18.78)</td><td>0.05</td></tr><tr><td>Physical role</td><td>58.33 (40.53)</td><td>72.02 (36.29)</td><td>0.12</td></tr><tr><td>Pain</td><td>74.51 (33.55)</td><td>82.29 (26.34)</td><td>0.27</td></tr><tr><td>General health</td><td>65.94 (26.97)</td><td>79.10 (16.21)</td><td>0.01</td></tr><tr><td>Vitality</td><td>58.47 (31.60)</td><td>72.38 (19.29)</td><td>0.03</td></tr><tr><td>Social functioning</td><td>81.60 (28.74)</td><td>86.89 (19.90)</td><td>0.36</td></tr><tr><td>Emotional role</td><td>65.74 (38.62)</td><td>83.33 (33.13)</td><td>0.03</td></tr><tr><td>Mental health</td><td>77.11 (24.46)</td><td>81.81 (20.40)</td><td>0.36</td></tr><tr><td>Physical component Summary</td><td>64.84 (25.52)</td><td>76.90 (17.35)</td><td>0.02</td></tr><tr><td>Mental component Summary</td><td>74.82 (25.14)</td><td>84.01 (20.77)</td><td>0.09</td></tr></tbody></table><table-wrap-foot><p>Continuous data were compared using independent t-test</p></table-wrap-foot></table-wrap></p></sec></sec><sec id="Sec10"><title>Discussion</title><p id="Par37">In this study, the overall quality of life reported by MERS survivors at approximately 14 months of follow-up was lower than that reported by non-MERS SARI survivors, although the difference became insignificant when adjusted for relevant confounders. In addition, survivors who required intensive care unit admission reported significantly lower overall quality of life than MERS survivors with less severe illness who were hospitalized in general medical wards. MERS survivors also reported significantly lower quality physical health at approximately 14 months after illness onset compared to a previously published sample of healthy individuals in Saudi Arabia.</p><p id="Par38">Our findings are similar to those reported in studies of long-term follow-up of survivors of SARI due to other etiologies associated with high mortality. The overall scores of SF-36 domains (with exception for mental health and role emotion) were significantly lower in survivors of SARS-CoV at 2 years compared with the general Hong Kong population [<xref ref-type="bibr" rid="CR18">18</xref>]. Similar findings were observed at 1-year follow-up evaluation among patients who survived critical illness and the acute respiratory distress syndrome from influenza A(H1N1)pdm09 virus infection compared with a sample of the general population [<xref ref-type="bibr" rid="CR22">22</xref>]. In a recent study that assessed survivors of severe disease due to avian influenza A(H7N9) virus infection in China, quality of life reported at approximately 1.5 years was lower than a sample of the general population [<xref ref-type="bibr" rid="CR17">17</xref>].</p><p id="Par39">Longitudinal studies have documented some improvements in quality of life reported over time [<xref ref-type="bibr" rid="CR28">28</xref>]. However, the changes are not uniformly distributed across the SF36 components. In SARS-CoV survivors, the quality-of-life scores for the following domains (social functioning, role physical and role emotional) were lowest at discharge, increased substantially at 1 year [<xref ref-type="bibr" rid="CR29">29</xref>], and remained stable at 2 years [<xref ref-type="bibr" rid="CR18">18</xref>]. In another SARS-CoV survivor study, there was a significant improvements in role physical, social function, and role emotional domains at one-year evaluation [<xref ref-type="bibr" rid="CR16">16</xref>, <xref ref-type="bibr" rid="CR17">17</xref>]. However, a study of survivors who were hospitalized with avian influenza A(H7N9) virus infection did not find any significant changes in reported SF-36 domains from 3 to 24 months post-discharge follow-up [<xref ref-type="bibr" rid="CR17">17</xref>].</p><p id="Par40">MERS survivors had a similar degree of impairment identified on HRQoL compared to SARI survivors of non-MERS-CoV origin. Despite the longer interval in the assessments in non-MERS SARI survivors, reported quality of life scores were similar after adjustments of potential confounders using a linear regression model. Due to the descriptive cross-sectional study design, any temporal relationship may be undetected; MERS could have a transient effect on survivors at discharge, and it is possible we were unable to detect these dynamic changes. Corticosteroid-induced myopathy, muscle wasting and weakness have been reported in survivors of ARDS at one-year follow up [<xref ref-type="bibr" rid="CR30">30</xref>]. Since many MERS ICU patients have been treated with high-dose corticosteroids, sequelae from such therapy could contribute to reduced quality of life in survivors. Additionally, critically ill MERS survivors had impairment in the emotional role that might be attributed to psychological trauma similar to that observed in survivors of the 2003 SARS outbreak [<xref ref-type="bibr" rid="CR31">31</xref>].</p><p id="Par41">Our study is subject to several limitations. First, selection bias may be present; as the small study population may not be representative of all eligible Saudi MERS survivors -since the majority of survivors were unreachable- and our non-MERS SARI controls were enrolled from only two hospitals in Saudi Arabia. Additionally, the number of non-MERS SARI controls was lower than MERS survivors. Second, we had limited medical information on potential predictors that may alter the reported quality of life scores. Specifically, we did not have information regarding the severity of illness such as APACHE II score, number of ventilator days, length of hospital stay, or use of sedatives or neuromuscular blocking agents which have been shown to affect long term outcomes. Third, there is a potential for recall bias since there was a significant difference in time from illness onset to interview time between MERS cases and non-MERS SARI controls; to reduce bias, we performed a multiple linear regression model to adjust for confounders. Lastly, we administered the SF-36 questionnaire by telephone and not in-person. However, telephone administration has been validated in previous studies and shown to be a reliable method when compared to a self-administered survey [<xref ref-type="bibr" rid="CR32">32</xref>, <xref ref-type="bibr" rid="CR33">33</xref>].</p><p id="Par42">This cross-sectional observational study has provided preliminary information about the quality of life of MERS survivors. Assessment of functional limitation and exercise capacity is needed in MERS survivors to estimate the long-term burden of this illness. Prospective longitudinal studies measuring objective parameters such as; pulmonary function testing, 6-min walk test and detection of depression, anxiety and post-traumatic stress disorder with correlation with health status, will provide more informative data to understanding of the overall long term outcomes of MERS-CoV infection.</p></sec><sec id="Sec11"><title>Conclusions</title><p id="Par43">Approximately 14 months after onset of MERS illness, ICU survivors reported higher limitations in some measure of their quality of life than patients with less severe illness who were managed in medical wards. The long-term consequences of MERS illness on survivors may be similar to that caused by SARI of other etiologies. Further attention is needed to address the long-term medical and psychological needs of survivors of MERS and non-MERS SARI.</p></sec></body><back><glossary><title>Abbreviations</title><def-list><def-item><term>BP</term><def><p id="Par5">Bodily pain</p></def></def-item><def-item><term>DLCO</term><def><p id="Par6">Diffusion capacity for carbon monoxide</p></def></def-item><def-item><term>GH</term><def><p id="Par7">General health</p></def></def-item><def-item><term>HRQoL</term><def><p id="Par8">Health-related quality of life</p></def></def-item><def-item><term>ICU</term><def><p id="Par9">Intensive care unit</p></def></def-item><def-item><term>IQR</term><def><p id="Par10">Interquartile range</p></def></def-item><def-item><term>MCS</term><def><p id="Par11">Mental component summary scales</p></def></def-item><def-item><term>MERS</term><def><p id="Par12">Middle East Respiratory Syndrome</p></def></def-item><def-item><term>MERS-CoV</term><def><p id="Par13">Middle East Respiratory Syndrome coronavirus</p></def></def-item><def-item><term>MH</term><def><p id="Par14">Mental health</p></def></def-item><def-item><term>MOH</term><def><p id="Par15">Ministry of Health</p></def></def-item><def-item><term>PF</term><def><p id="Par16">Physical functioning</p></def></def-item><def-item><term>PSC</term><def><p id="Par17">Physical component summary scales</p></def></def-item><def-item><term>RE</term><def><p id="Par18">Role limitation due to emotional problems</p></def></def-item><def-item><term>RP</term><def><p id="Par19">Role limitation due to physical problems</p></def></def-item><def-item><term>rRT-PCR</term><def><p id="Par20">Real-time reverse transcription polymerase chain reaction</p></def></def-item><def-item><term>SF</term><def><p id="Par21">Social functioning</p></def></def-item><def-item><term>SF-36</term><def><p id="Par22">The Short-Form General Health Survey 36</p></def></def-item><def-item><term>VT</term><def><p id="Par23">Vitality (VT)</p></def></def-item></def-list></glossary><fn-group><fn><p><bold>Publisher’s Note</bold></p><p>Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.</p></fn></fn-group><ack><title>Acknowledgements</title><p>Not applicable.</p><sec id="FPar1"><title>Authors’contributions</title><p id="Par44">SB Conception and design, data acquisition, analytical plan, interpretation of data for the work, drafting of the manuscript, critical revision of the manuscript for important intellectual content, approval of the final version to be published and agreement to be accountable for all aspects of the work. NT Conception and design, data acquisition, analytical plan, interpretation of data for the work, drafting of the manuscript, critical revision of the manuscript for important intellectual content, approval of the final version to be published and agreement to be accountable for all aspects of the work. RA analytical plan, interpretation of data for the work, drafting of the manuscript, critical revision of the manuscript for important intellectual content, approval of the final version to be published and agreement to be accountable for all aspects of the work. EA data acquisition, interpretation of data for the work, drafting of the manuscript, critical revision of the manuscript for important intellectual content, approval of the final version to be published and agreement to be accountable for all aspects of the work. SA data acquisition, interpretation of data for the work, drafting of the manuscript, critical revision of the manuscript for important intellectual content, approval of the final version to be published and agreement to be accountable for all aspects of the work. FA data acquisition, interpretation of data for the work, drafting of the manuscript, critical revision of the manuscript for important intellectual content, approval of the final version to be published and agreement to be accountable for all aspects of the work. YA Conception and design, data acquisition, analytical plan, interpretation of data for the work, drafting of the manuscript, critical revision of the manuscript for important intellectual content, approval of the final version to be published and agreement to be accountable for all aspects of the work. TU Conception and design, analytical plan, interpretation of data for the work, drafting of the manuscript, critical revision of the manuscript for important intellectual content, approval of the final version to be published and agreement to be accountable for all aspects of the work. BA Conception and design, data acquisition, analytical plan, interpretation of data for the work, drafting of the manuscript, critical revision of the manuscript for important intellectual content, approval of the final version to be published and agreement to be accountable for all aspects of the work. AS data acquisition, interpretation of data for the work, drafting of the manuscript, critical revision of the manuscript for important intellectual content, approval of the final version to be published and agreement to be accountable for all aspects of the work.</p></sec><sec id="FPar2"><title>Disclaimer</title><p id="Par45">The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the U.S. Centers for Disease Control and Prevention.</p></sec></ack><notes notes-type="funding-information"><title>Funding</title><p>None.</p></notes><notes notes-type="data-availability"><title>Availability of data and materials</title><p>The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.</p></notes><notes><title>Ethics approval and consent to participate</title><p id="Par46">Institutional Review Board approval was obtained from the Ministry of Health and the Ministry of National Guard Health Affairs of Saudi Arabia.</p></notes><notes><title>Consent for publication</title><p id="Par47">Not applicable.</p></notes><notes notes-type="COI-statement"><title>Competing interests</title><p id="Par48">The authors declare that they have no competing interests.</p></notes><ref-list id="Bib1"><title>References</title><ref id="CR1"><label>1.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Zaki</surname><given-names>AM</given-names></name><name><surname>van Boheemen</surname><given-names>S</given-names></name><name><surname>Bestebroer</surname><given-names>TM</given-names></name><name><surname>Osterhaus</surname><given-names>AD</given-names></name><name><surname>Fouchier</surname><given-names>RA</given-names></name></person-group><article-title>Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia</article-title><source>N Engl J Med</source><year>2012</year><volume>367</volume><issue>19</issue><fpage>1814</fpage><lpage>1820</lpage><pub-id pub-id-type="doi">10.1056/NEJMoa1211721</pub-id><pub-id pub-id-type="pmid">23075143</pub-id></element-citation></ref><ref id="CR2"><label>2.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Oboho</surname><given-names>IK</given-names></name><name><surname>Tomczyk</surname><given-names>SM</given-names></name><name><surname>Al-Asmari</surname><given-names>AM</given-names></name><name><surname>Banjar</surname><given-names>AA</given-names></name><name><surname>Al-Mugti</surname><given-names>H</given-names></name><name><surname>Aloraini</surname><given-names>MS</given-names></name><name><surname>Alkhaldi</surname><given-names>KZ</given-names></name><name><surname>Almohammadi</surname><given-names>EL</given-names></name><name><surname>Alraddadi</surname><given-names>BM</given-names></name><name><surname>Gerber</surname><given-names>SI</given-names></name><etal></etal></person-group><article-title>2014 MERS-CoV outbreak in Jeddah--a link to health care facilities</article-title><source>N Engl J Med</source><year>2015</year><volume>372</volume><issue>9</issue><fpage>846</fpage><lpage>854</lpage><pub-id pub-id-type="doi">10.1056/NEJMoa1408636</pub-id><pub-id pub-id-type="pmid">25714162</pub-id></element-citation></ref><ref id="CR3"><label>3.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Balkhy</surname><given-names>HH</given-names></name><name><surname>Alenazi</surname><given-names>TH</given-names></name><name><surname>Alshamrani</surname><given-names>MM</given-names></name><name><surname>Baffoe-Bonnie</surname><given-names>H</given-names></name><name><surname>Arabi</surname><given-names>Y</given-names></name><name><surname>Hijazi</surname><given-names>R</given-names></name><name><surname>Al-Abdely</surname><given-names>HM</given-names></name><name><surname>El-Saed</surname><given-names>A</given-names></name><name><surname>Al Johani</surname><given-names>S</given-names></name><name><surname>Assiri</surname><given-names>AM</given-names></name><etal></etal></person-group><article-title>Description of a hospital outbreak of Middle East respiratory syndrome in a large tertiary Care Hospital in Saudi Arabia</article-title><source>Infect Control Hosp Epidemiol</source><year>2016</year><volume>37</volume><issue>10</issue><fpage>1147</fpage><lpage>1155</lpage><pub-id pub-id-type="doi">10.1017/ice.2016.132</pub-id><pub-id pub-id-type="pmid">27426423</pub-id></element-citation></ref><ref id="CR4"><label>4.</label><mixed-citation publication-type="other">Update WHOMErscM-CTKoSADON, 24 April 2019. Accessed on May 6 ahwwicd-A--m-s-ae.</mixed-citation></ref><ref id="CR5"><label>5.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Assiri</surname><given-names>A</given-names></name><name><surname>Al-Tawfiq</surname><given-names>JA</given-names></name><name><surname>Al-Rabeeah</surname><given-names>AA</given-names></name><name><surname>Al-Rabiah</surname><given-names>FA</given-names></name><name><surname>Al-Hajjar</surname><given-names>S</given-names></name><name><surname>Al-Barrak</surname><given-names>A</given-names></name><name><surname>Flemban</surname><given-names>H</given-names></name><name><surname>Al-Nassir</surname><given-names>WN</given-names></name><name><surname>Balkhy</surname><given-names>HH</given-names></name><name><surname>Al-Hakeem</surname><given-names>RF</given-names></name><etal></etal></person-group><article-title>Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study</article-title><source>Lancet Infect Dis</source><year>2013</year><volume>13</volume><issue>9</issue><fpage>752</fpage><lpage>761</lpage><pub-id pub-id-type="doi">10.1016/S1473-3099(13)70204-4</pub-id><pub-id pub-id-type="pmid">23891402</pub-id></element-citation></ref><ref id="CR6"><label>6.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Arabi</surname><given-names>YM</given-names></name><name><surname>Arifi</surname><given-names>AA</given-names></name><name><surname>Balkhy</surname><given-names>HH</given-names></name><name><surname>Najm</surname><given-names>H</given-names></name><name><surname>Aldawood</surname><given-names>AS</given-names></name><name><surname>Ghabashi</surname><given-names>A</given-names></name><name><surname>Hawa</surname><given-names>H</given-names></name><name><surname>Alothman</surname><given-names>A</given-names></name><name><surname>Khaldi</surname><given-names>A</given-names></name><name><surname>Al Raiy</surname><given-names>B</given-names></name></person-group><article-title>Clinical course and outcomes of critically ill patients with Middle East respiratory syndrome coronavirus infection</article-title><source>Ann Intern Med</source><year>2014</year><volume>160</volume><issue>6</issue><fpage>389</fpage><lpage>397</lpage><pub-id pub-id-type="doi">10.7326/M13-2486</pub-id><pub-id pub-id-type="pmid">24474051</pub-id></element-citation></ref><ref id="CR7"><label>7.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Arabi</surname><given-names>YM</given-names></name><name><surname>Balkhy</surname><given-names>HH</given-names></name><name><surname>Hayden</surname><given-names>FG</given-names></name><name><surname>Bouchama</surname><given-names>A</given-names></name><name><surname>Luke</surname><given-names>T</given-names></name><name><surname>Baillie</surname><given-names>JK</given-names></name><name><surname>Al-Omari</surname><given-names>A</given-names></name><name><surname>Hajeer</surname><given-names>AH</given-names></name><name><surname>Senga</surname><given-names>M</given-names></name><name><surname>Denison</surname><given-names>MR</given-names></name><etal></etal></person-group><article-title>Middle East respiratory syndrome</article-title><source>N Engl J Med</source><year>2017</year><volume>376</volume><issue>6</issue><fpage>584</fpage><lpage>594</lpage><pub-id pub-id-type="doi">10.1056/NEJMsr1408795</pub-id><pub-id pub-id-type="pmid">28177862</pub-id></element-citation></ref><ref id="CR8"><label>8.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Arabi</surname><given-names>YM</given-names></name><name><surname>Al-Omari</surname><given-names>A</given-names></name><name><surname>Mandourah</surname><given-names>Y</given-names></name><name><surname>Al-Hameed</surname><given-names>F</given-names></name><name><surname>Sindi</surname><given-names>AA</given-names></name><name><surname>Alraddadi</surname><given-names>B</given-names></name><name><surname>Shalhoub</surname><given-names>S</given-names></name><name><surname>Almotairi</surname><given-names>A</given-names></name><name><surname>Al Khatib</surname><given-names>K</given-names></name><name><surname>Abdulmomen</surname><given-names>A</given-names></name><etal></etal></person-group><article-title>Critically ill patients with the Middle East respiratory syndrome: a multicenter retrospective cohort study</article-title><source>Crit Care Med</source><year>2017</year><volume>45</volume><issue>10</issue><fpage>1683</fpage><lpage>1695</lpage><pub-id pub-id-type="doi">10.1097/CCM.0000000000002621</pub-id><pub-id pub-id-type="pmid">28787295</pub-id></element-citation></ref><ref id="CR9"><label>9.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Alsaad</surname><given-names>KO</given-names></name><name><surname>Hajeer</surname><given-names>AH</given-names></name><name><surname>Al Balwi</surname><given-names>M</given-names></name><name><surname>Al Moaiqel</surname><given-names>M</given-names></name><name><surname>Al Oudah</surname><given-names>N</given-names></name><name><surname>Al Ajlan</surname><given-names>A</given-names></name><name><surname>AlJohani</surname><given-names>S</given-names></name><name><surname>Alsolamy</surname><given-names>S</given-names></name><name><surname>Gmati</surname><given-names>GE</given-names></name><name><surname>Balkhy</surname><given-names>H</given-names></name><etal></etal></person-group><article-title>Histopathology of Middle East respiratory syndrome coronovirus (MERS-CoV) infection - clinicopathological and ultrastructural study</article-title><source>Histopathology</source><year>2018</year><volume>72</volume><issue>3</issue><fpage>516</fpage><lpage>524</lpage><pub-id pub-id-type="doi">10.1111/his.13379</pub-id><pub-id pub-id-type="pmid">28858401</pub-id></element-citation></ref><ref id="CR10"><label>10.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ng</surname><given-names>DL</given-names></name><name><surname>Al Hosani</surname><given-names>F</given-names></name><name><surname>Keating</surname><given-names>MK</given-names></name><name><surname>Gerber</surname><given-names>SI</given-names></name><name><surname>Jones</surname><given-names>TL</given-names></name><name><surname>Metcalfe</surname><given-names>MG</given-names></name><name><surname>Tong</surname><given-names>S</given-names></name><name><surname>Tao</surname><given-names>Y</given-names></name><name><surname>Alami</surname><given-names>NN</given-names></name><name><surname>Haynes</surname><given-names>LM</given-names></name><etal></etal></person-group><article-title>Clinicopathologic, Immunohistochemical, and ultrastructural findings of a fatal case of Middle East respiratory syndrome coronavirus infection in the United Arab Emirates, April 2014</article-title><source>Am J Pathol</source><year>2016</year><volume>186</volume><issue>3</issue><fpage>652</fpage><lpage>658</lpage><pub-id pub-id-type="doi">10.1016/j.ajpath.2015.10.024</pub-id><pub-id pub-id-type="pmid">26857507</pub-id></element-citation></ref><ref id="CR11"><label>11.</label><mixed-citation publication-type="other">Alshukairi AN, Khalid I, Ahmed WA, Dada AM, Bayumi DT, Malic LS, Althawadi S, Ignacio K, Alsalmi HS, Al-Abdely HM, et al. Antibody response and disease severity in healthcare worker MERS survivors. Emerg Infect Dis. 2016;22(6). <ext-link ext-link-type="uri" xlink:href="http://www.cdc.gov/eid">www.cdc.gov/eid</ext-link>.</mixed-citation></ref><ref id="CR12"><label>12.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Payne</surname><given-names>DC</given-names></name><name><surname>Iblan</surname><given-names>I</given-names></name><name><surname>Rha</surname><given-names>B</given-names></name><name><surname>Alqasrawi</surname><given-names>S</given-names></name><name><surname>Haddadin</surname><given-names>A</given-names></name><name><surname>Al Nsour</surname><given-names>M</given-names></name><name><surname>Alsanouri</surname><given-names>T</given-names></name><name><surname>Ali</surname><given-names>SS</given-names></name><name><surname>Harcourt</surname><given-names>J</given-names></name><name><surname>Miao</surname><given-names>C</given-names></name><etal></etal></person-group><article-title>Persistence of antibodies against Middle East respiratory syndrome coronavirus</article-title><source>Emerg Infect Dis</source><year>2016</year><volume>22</volume><issue>10</issue><fpage>1824</fpage><lpage>1826</lpage><pub-id pub-id-type="doi">10.3201/eid2210.160706</pub-id><pub-id pub-id-type="pmid">27332149</pub-id></element-citation></ref><ref id="CR13"><label>13.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Zhao</surname><given-names>Jingxian</given-names></name><name><surname>Alshukairi</surname><given-names>Abeer N.</given-names></name><name><surname>Baharoon</surname><given-names>Salim A.</given-names></name><name><surname>Ahmed</surname><given-names>Waleed A.</given-names></name><name><surname>Bokhari</surname><given-names>Ahmad A.</given-names></name><name><surname>Nehdi</surname><given-names>Atef M.</given-names></name><name><surname>Layqah</surname><given-names>Laila A.</given-names></name><name><surname>Alghamdi</surname><given-names>Mohammed G.</given-names></name><name><surname>Al Gethamy</surname><given-names>Manal M.</given-names></name><name><surname>Dada</surname><given-names>Ashraf M.</given-names></name><name><surname>Khalid</surname><given-names>Imran</given-names></name><name><surname>Boujelal</surname><given-names>Mohamad</given-names></name><name><surname>Al Johani</surname><given-names>Sameera M.</given-names></name><name><surname>Vogel</surname><given-names>Leatrice</given-names></name><name><surname>Subbarao</surname><given-names>Kanta</given-names></name><name><surname>Mangalam</surname><given-names>Ashutosh</given-names></name><name><surname>Wu</surname><given-names>Chaorong</given-names></name><name><surname>Ten Eyck</surname><given-names>Patrick</given-names></name><name><surname>Perlman</surname><given-names>Stanley</given-names></name><name><surname>Zhao</surname><given-names>Jincun</given-names></name></person-group><article-title>Recovery from the Middle East respiratory syndrome is associated with antibody and T-cell responses</article-title><source>Science Immunology</source><year>2017</year><volume>2</volume><issue>14</issue><fpage>eaan5393</fpage><pub-id pub-id-type="doi">10.1126/sciimmunol.aan5393</pub-id><pub-id pub-id-type="pmid">28778905</pub-id></element-citation></ref><ref id="CR14"><label>14.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Choe</surname><given-names>PG</given-names></name><name><surname>Perera</surname><given-names>R</given-names></name><name><surname>Park</surname><given-names>WB</given-names></name><name><surname>Song</surname><given-names>KH</given-names></name><name><surname>Bang</surname><given-names>JH</given-names></name><name><surname>Kim</surname><given-names>ES</given-names></name><name><surname>Kim</surname><given-names>HB</given-names></name><name><surname>Ko</surname><given-names>LWR</given-names></name><name><surname>Park</surname><given-names>SW</given-names></name><name><surname>Kim</surname><given-names>NJ</given-names></name><etal></etal></person-group><article-title>MERS-CoV antibody responses 1 year after symptom onset, South Korea, 2015</article-title><source>Emerg Infect Dis</source><year>2017</year><volume>23</volume><issue>7</issue><fpage>1079</fpage><lpage>1084</lpage><pub-id pub-id-type="doi">10.3201/eid2307.170310</pub-id></element-citation></ref><ref id="CR15"><label>15.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ko</surname><given-names>JH</given-names></name><name><surname>Muller</surname><given-names>MA</given-names></name><name><surname>Seok</surname><given-names>H</given-names></name><name><surname>Park</surname><given-names>GE</given-names></name><name><surname>Lee</surname><given-names>JY</given-names></name><name><surname>Cho</surname><given-names>SY</given-names></name><name><surname>Ha</surname><given-names>YE</given-names></name><name><surname>Baek</surname><given-names>JY</given-names></name><name><surname>Kim</surname><given-names>SH</given-names></name><name><surname>Kang</surname><given-names>JM</given-names></name><etal></etal></person-group><article-title>Serologic responses of 42 MERS-coronavirus-infected patients according to the disease severity</article-title><source>Diagn Microbiol Infect Dis</source><year>2017</year><volume>89</volume><issue>2</issue><fpage>106</fpage><lpage>111</lpage><pub-id pub-id-type="doi">10.1016/j.diagmicrobio.2017.07.006</pub-id><pub-id pub-id-type="pmid">28821364</pub-id></element-citation></ref><ref id="CR16"><label>16.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Tansey</surname><given-names>CM</given-names></name><name><surname>Louie</surname><given-names>M</given-names></name><name><surname>Loeb</surname><given-names>M</given-names></name><name><surname>Gold</surname><given-names>WL</given-names></name><name><surname>Muller</surname><given-names>MP</given-names></name><name><surname>de Jager</surname><given-names>J</given-names></name><name><surname>Cameron</surname><given-names>JI</given-names></name><name><surname>Tomlinson</surname><given-names>G</given-names></name><name><surname>Mazzulli</surname><given-names>T</given-names></name><name><surname>Walmsley</surname><given-names>SL</given-names></name><etal></etal></person-group><article-title>One-year outcomes and health care utilization in survivors of severe acute respiratory syndrome</article-title><source>Arch Intern Med</source><year>2007</year><volume>167</volume><issue>12</issue><fpage>1312</fpage><lpage>1320</lpage><pub-id pub-id-type="doi">10.1001/archinte.167.12.1312</pub-id><pub-id pub-id-type="pmid">17592106</pub-id></element-citation></ref><ref id="CR17"><label>17.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Chen</surname><given-names>J</given-names></name><name><surname>Wu</surname><given-names>J</given-names></name><name><surname>Hao</surname><given-names>S</given-names></name><name><surname>Yang</surname><given-names>M</given-names></name><name><surname>Lu</surname><given-names>X</given-names></name><name><surname>Chen</surname><given-names>X</given-names></name><name><surname>Li</surname><given-names>L</given-names></name></person-group><article-title>Long term outcomes in survivors of epidemic influenza a (H7N9) virus infection</article-title><source>Sci Rep</source><year>2017</year><volume>7</volume><issue>1</issue><fpage>17275</fpage><pub-id pub-id-type="doi">10.1038/s41598-017-17497-6</pub-id><pub-id pub-id-type="pmid">29222500</pub-id></element-citation></ref><ref id="CR18"><label>18.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ngai</surname><given-names>JC</given-names></name><name><surname>Ko</surname><given-names>FW</given-names></name><name><surname>Ng</surname><given-names>SS</given-names></name><name><surname>To</surname><given-names>KW</given-names></name><name><surname>Tong</surname><given-names>M</given-names></name><name><surname>Hui</surname><given-names>DS</given-names></name></person-group><article-title>The long-term impact of severe acute respiratory syndrome on pulmonary function, exercise capacity and health status</article-title><source>Respirology</source><year>2010</year><volume>15</volume><issue>3</issue><fpage>543</fpage><lpage>550</lpage><pub-id pub-id-type="doi">10.1111/j.1440-1843.2010.01720.x</pub-id><pub-id pub-id-type="pmid">20337995</pub-id></element-citation></ref><ref id="CR19"><label>19.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ng</surname><given-names>CK</given-names></name><name><surname>Chan</surname><given-names>JW</given-names></name><name><surname>Kwan</surname><given-names>TL</given-names></name><collab>To TS</collab><name><surname>Chan</surname><given-names>YH</given-names></name><name><surname>Ng</surname><given-names>FY</given-names></name><name><surname>Mok</surname><given-names>TY</given-names></name></person-group><article-title>Six month radiological and physiological outcomes in severe acute respiratory syndrome (SARS) survivors</article-title><source>Thorax</source><year>2004</year><volume>59</volume><issue>10</issue><fpage>889</fpage><lpage>891</lpage><pub-id pub-id-type="doi">10.1136/thx.2004.023762</pub-id><pub-id pub-id-type="pmid">15454656</pub-id></element-citation></ref><ref id="CR20"><label>20.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Madani</surname><given-names>TA</given-names></name><name><surname>Althaqafi</surname><given-names>AO</given-names></name><name><surname>Alraddadi</surname><given-names>BM</given-names></name></person-group><article-title>Infection prevention and control guidelines for patients with Middle East respiratory syndrome coronavirus (MERS-CoV) infection</article-title><source>Saudi Med J</source><year>2014</year><volume>35</volume><issue>8</issue><fpage>897</fpage><lpage>913</lpage><pub-id pub-id-type="pmid">25129197</pub-id></element-citation></ref><ref id="CR21"><label>21.</label><mixed-citation publication-type="other">WHO surveillance case definitions for ILI and SARI <ext-link ext-link-type="uri" xlink:href="https://www.who.int/influenza/surveillance_monitoring/ili_sari_surveillance_case_definition/en/">https://www.who.int/influenza/surveillance_monitoring/ili_sari_surveillance_case_definition/en/</ext-link>. Accessed 31 May 2019.</mixed-citation></ref><ref id="CR22"><label>22.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Luyt</surname><given-names>CE</given-names></name><name><surname>Combes</surname><given-names>A</given-names></name><name><surname>Becquemin</surname><given-names>MH</given-names></name><name><surname>Beigelman-Aubry</surname><given-names>C</given-names></name><name><surname>Hatem</surname><given-names>S</given-names></name><name><surname>Brun</surname><given-names>AL</given-names></name><name><surname>Zraik</surname><given-names>N</given-names></name><name><surname>Carrat</surname><given-names>F</given-names></name><name><surname>Grenier</surname><given-names>PA</given-names></name><name><surname>Richard</surname><given-names>JM</given-names></name><etal></etal></person-group><article-title>Long-term outcomes of pandemic 2009 influenza a(H1N1)-associated severe ARDS</article-title><source>Chest</source><year>2012</year><volume>142</volume><issue>3</issue><fpage>583</fpage><lpage>592</lpage><pub-id pub-id-type="doi">10.1378/chest.11-2196</pub-id><pub-id pub-id-type="pmid">22948576</pub-id></element-citation></ref><ref id="CR23"><label>23.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>McHorney</surname><given-names>CA</given-names></name><name><surname>Ware</surname><given-names>JE</given-names><suffix>Jr</suffix></name><name><surname>Lu</surname><given-names>JF</given-names></name><name><surname>Sherbourne</surname><given-names>CD</given-names></name></person-group><article-title>The MOS 36-item short-form health survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups</article-title><source>Med Care</source><year>1994</year><volume>32</volume><issue>1</issue><fpage>40</fpage><lpage>66</lpage><pub-id pub-id-type="doi">10.1097/00005650-199401000-00004</pub-id><pub-id pub-id-type="pmid">8277801</pub-id></element-citation></ref><ref id="CR24"><label>24.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ware</surname><given-names>JE</given-names><suffix>Jr</suffix></name><name><surname>Sherbourne</surname><given-names>CD</given-names></name></person-group><article-title>The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection</article-title><source>Med Care</source><year>1992</year><volume>30</volume><issue>6</issue><fpage>473</fpage><lpage>483</lpage><pub-id pub-id-type="doi">10.1097/00005650-199206000-00002</pub-id><pub-id pub-id-type="pmid">1593914</pub-id></element-citation></ref><ref id="CR25"><label>25.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Coons</surname><given-names>SJ</given-names></name><name><surname>Alabdulmohsin</surname><given-names>SA</given-names></name><name><surname>Draugalis</surname><given-names>JR</given-names></name><name><surname>Hays</surname><given-names>RD</given-names></name></person-group><article-title>Reliability of an Arabic version of the RAND-36 health survey and its equivalence to the US-English version</article-title><source>Med Care</source><year>1998</year><volume>36</volume><issue>3</issue><fpage>428</fpage><lpage>432</lpage><pub-id pub-id-type="doi">10.1097/00005650-199803000-00018</pub-id><pub-id pub-id-type="pmid">9520966</pub-id></element-citation></ref><ref id="CR26"><label>26.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Campos</surname><given-names>AC</given-names></name><name><surname>Ferreira e Ferreira</surname><given-names>E</given-names></name><name><surname>Vargas</surname><given-names>AM</given-names></name><name><surname>Albala</surname><given-names>C</given-names></name></person-group><article-title>Aging, gender and quality of life (AGEQOL) study: factors associated with good quality of life in older Brazilian community-dwelling adults</article-title><source>Health Qual Life Outcomes</source><year>2014</year><volume>12</volume><fpage>166</fpage><pub-id pub-id-type="doi">10.1186/s12955-014-0166-4</pub-id><pub-id pub-id-type="pmid">25433521</pub-id></element-citation></ref><ref id="CR27"><label>27.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Liu</surname><given-names>H</given-names></name><name><surname>Feurer</surname><given-names>ID</given-names></name><name><surname>Dwyer</surname><given-names>K</given-names></name><name><surname>Speroff</surname><given-names>T</given-names></name><name><surname>Shaffer</surname><given-names>D</given-names></name><name><surname>Wright Pinson</surname><given-names>C</given-names></name></person-group><article-title>The effects of gender and age on health-related quality of life following kidney transplantation</article-title><source>J Clin Nurs</source><year>2008</year><volume>17</volume><issue>1</issue><fpage>82</fpage><lpage>89</lpage><pub-id pub-id-type="pmid">18088260</pub-id></element-citation></ref><ref id="CR28"><label>28.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Dowdy</surname><given-names>DW</given-names></name><name><surname>Eid</surname><given-names>MP</given-names></name><name><surname>Sedrakyan</surname><given-names>A</given-names></name><name><surname>Mendez-Tellez</surname><given-names>PA</given-names></name><name><surname>Pronovost</surname><given-names>PJ</given-names></name><name><surname>Herridge</surname><given-names>MS</given-names></name><name><surname>Needham</surname><given-names>DM</given-names></name></person-group><article-title>Quality of life in adult survivors of critical illness: a systematic review of the literature</article-title><source>Intensive Care Med</source><year>2005</year><volume>31</volume><issue>5</issue><fpage>611</fpage><lpage>620</lpage><pub-id pub-id-type="doi">10.1007/s00134-005-2592-6</pub-id><pub-id pub-id-type="pmid">15803303</pub-id></element-citation></ref><ref id="CR29"><label>29.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Hui</surname><given-names>DS</given-names></name><name><surname>Wong</surname><given-names>KT</given-names></name><name><surname>Ko</surname><given-names>FW</given-names></name><name><surname>Tam</surname><given-names>LS</given-names></name><name><surname>Chan</surname><given-names>DP</given-names></name><name><surname>Woo</surname><given-names>J</given-names></name><name><surname>Sung</surname><given-names>JJ</given-names></name></person-group><article-title>The 1-year impact of severe acute respiratory syndrome on pulmonary function, exercise capacity, and quality of life in a cohort of survivors</article-title><source>Chest</source><year>2005</year><volume>128</volume><issue>4</issue><fpage>2247</fpage><lpage>2261</lpage><pub-id pub-id-type="doi">10.1378/chest.128.4.2247</pub-id><pub-id pub-id-type="pmid">16236881</pub-id></element-citation></ref><ref id="CR30"><label>30.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Herridge</surname><given-names>MS</given-names></name><name><surname>Cheung</surname><given-names>AM</given-names></name><name><surname>Tansey</surname><given-names>CM</given-names></name><name><surname>Matte-Martyn</surname><given-names>A</given-names></name><name><surname>Diaz-Granados</surname><given-names>N</given-names></name><name><surname>Al-Saidi</surname><given-names>F</given-names></name><name><surname>Cooper</surname><given-names>AB</given-names></name><name><surname>Guest</surname><given-names>CB</given-names></name><name><surname>Mazer</surname><given-names>CD</given-names></name><name><surname>Mehta</surname><given-names>S</given-names></name><etal></etal></person-group><article-title>One-year outcomes in survivors of the acute respiratory distress syndrome</article-title><source>N Engl J Med</source><year>2003</year><volume>348</volume><issue>8</issue><fpage>683</fpage><lpage>693</lpage><pub-id pub-id-type="doi">10.1056/NEJMoa022450</pub-id><pub-id pub-id-type="pmid">12594312</pub-id></element-citation></ref><ref id="CR31"><label>31.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lee</surname><given-names>AM</given-names></name><name><surname>Wong</surname><given-names>JG</given-names></name><name><surname>McAlonan</surname><given-names>GM</given-names></name><name><surname>Cheung</surname><given-names>V</given-names></name><name><surname>Cheung</surname><given-names>C</given-names></name><name><surname>Sham</surname><given-names>PC</given-names></name><name><surname>Chu</surname><given-names>CM</given-names></name><name><surname>Wong</surname><given-names>PC</given-names></name><name><surname>Tsang</surname><given-names>KW</given-names></name><name><surname>Chua</surname><given-names>SE</given-names></name></person-group><article-title>Stress and psychological distress among SARS survivors 1 year after the outbreak</article-title><source>Can J Psychiatry</source><year>2007</year><volume>52</volume><issue>4</issue><fpage>233</fpage><lpage>240</lpage><pub-id pub-id-type="doi">10.1177/070674370705200405</pub-id><pub-id pub-id-type="pmid">17500304</pub-id></element-citation></ref><ref id="CR32"><label>32.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Watson</surname><given-names>EK</given-names></name><name><surname>Firman</surname><given-names>DW</given-names></name><name><surname>Baade</surname><given-names>PD</given-names></name><name><surname>Ring</surname><given-names>I</given-names></name></person-group><article-title>Telephone administration of the SF-36 health survey: validation studies and population norms for adults in Queensland</article-title><source>Aust N Z J Public Health</source><year>1996</year><volume>20</volume><issue>4</issue><fpage>359</fpage><lpage>363</lpage><pub-id pub-id-type="doi">10.1111/j.1467-842X.1996.tb01046.x</pub-id><pub-id pub-id-type="pmid">8908757</pub-id></element-citation></ref><ref id="CR33"><label>33.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Garcia</surname><given-names>M</given-names></name><name><surname>Rohlfs</surname><given-names>I</given-names></name><name><surname>Vila</surname><given-names>J</given-names></name><name><surname>Sala</surname><given-names>J</given-names></name><name><surname>Pena</surname><given-names>A</given-names></name><name><surname>Masia</surname><given-names>R</given-names></name><name><surname>Marrugat</surname><given-names>J</given-names></name></person-group><article-title>Comparison between telephone and self-administration of short form health survey questionnaire (SF-36)</article-title><source>Gac Sanit</source><year>2005</year><volume>19</volume><issue>6</issue><fpage>433</fpage><lpage>439</lpage><pub-id pub-id-type="doi">10.1016/S0213-9111(05)71393-5</pub-id><pub-id pub-id-type="pmid">16483520</pub-id></element-citation></ref></ref-list></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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