Presentation and outcome of Middle East respiratory syndrome in Saudi intensive care unit patients
Identifieur interne : 000353 ( Pmc/Curation ); précédent : 000352; suivant : 000354Presentation and outcome of Middle East respiratory syndrome in Saudi intensive care unit patients
Auteurs : Ghaleb A. Almekhlafi [Arabie saoudite] ; Mohammed M. Albarrak [Arabie saoudite] ; Yasser Mandourah [Arabie saoudite] ; Sahar Hassan [Arabie saoudite] ; Abid Alwan [Arabie saoudite] ; Abdullah Abudayah [Arabie saoudite] ; Sultan Altayyar [Arabie saoudite] ; Mohamed Mustafa [Arabie saoudite] ; Tareef Aldaghestani [Arabie saoudite] ; Adnan Alghamedi [Arabie saoudite] ; Ali Talag [Arabie saoudite] ; Muhammad K. Malik [Arabie saoudite] ; Ali S. Omrani [Arabie saoudite] ; Yasser Sakr [Allemagne]Source :
- Critical Care [ 1364-8535 ] ; 2016.
Abstract
Middle East respiratory syndrome coronavirus infection is associated with high mortality rates but limited clinical data have been reported. We describe the clinical features and outcomes of patients admitted to an intensive care unit (ICU) with Middle East respiratory syndrome coronavirus (MERS-CoV) infection.
Retrospective analysis of data from all adult (>18 years old) patients admitted to our 20-bed mixed ICU with Middle East respiratory syndrome coronavirus infection between October 1, 2012 and May 31, 2014. Diagnosis was confirmed in all patients using real-time reverse transcription polymerase chain reaction on respiratory samples.
During the observation period, 31 patients were admitted with MERS-CoV infection (mean age 59 ± 20 years, 22 [71 %] males). Cough and tachypnea were reported in all patients; 22 (77.4 %) patients had bilateral pulmonary infiltrates. Invasive mechanical ventilation was applied in 27 (87.1 %) and vasopressor therapy in 25 (80.6 %) patients during the intensive care unit stay. Twenty-three (74.2 %) patients died in the ICU. Nonsurvivors were older, had greater APACHE II and SOFA scores on admission, and were more likely to have received invasive mechanical ventilation and vasopressor therapy. After adjustment for the severity of illness and the degree of organ dysfunction, the need for vasopressors was an independent risk factor for death in the ICU (odds ratio = 18.33, 95 % confidence interval: 1.11–302.1,
MERS-CoV infection requiring admission to the ICU is associated with high morbidity and mortality. The need for vasopressor therapy is the main risk factor for death in these patients.
The online version of this article (doi:10.1186/s13054-016-1303-8) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1186/s13054-016-1303-8
PubMed: 27153800
PubMed Central: 4859954
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Almekhlafi</name><affiliation wicri:level="1"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.415989.8</institution-id><institution-id institution-id-type="ISNI">0000000097598141</institution-id><institution>Department of Intensive Care Services,</institution><institution>Prince Sultan Military Medical City,</institution></institution-wrap>Riyadh, 11159 Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Albarrak, Mohammed M" sort="Albarrak, Mohammed M" uniqKey="Albarrak M" first="Mohammed M." last="Albarrak">Mohammed M. Albarrak</name><affiliation wicri:level="1"><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.415989.8</institution-id><institution-id institution-id-type="ISNI">0000000097598141</institution-id><institution>Intensive Care Unit,</institution><institution>Prince Sultan Cardiac Center,</institution></institution-wrap>Riyadh, 11159 Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Mandourah, Yasser" sort="Mandourah, Yasser" uniqKey="Mandourah Y" first="Yasser" last="Mandourah">Yasser Mandourah</name><affiliation wicri:level="1"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.415989.8</institution-id><institution-id institution-id-type="ISNI">0000000097598141</institution-id><institution>Department of Intensive Care Services,</institution><institution>Prince Sultan Military Medical 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id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.415989.8</institution-id><institution-id institution-id-type="ISNI">0000000097598141</institution-id><institution>Department of Intensive Care Services,</institution><institution>Prince Sultan Military Medical City,</institution></institution-wrap>Riyadh, 11159 Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Abudayah, Abdullah" sort="Abudayah, Abdullah" uniqKey="Abudayah A" first="Abdullah" last="Abudayah">Abdullah Abudayah</name><affiliation wicri:level="1"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.415989.8</institution-id><institution-id institution-id-type="ISNI">0000000097598141</institution-id><institution>Department of Intensive Care Services,</institution><institution>Prince Sultan Military Medical City,</institution></institution-wrap>Riyadh, 11159 Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Altayyar, Sultan" sort="Altayyar, Sultan" uniqKey="Altayyar S" first="Sultan" last="Altayyar">Sultan Altayyar</name><affiliation wicri:level="1"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.415989.8</institution-id><institution-id institution-id-type="ISNI">0000000097598141</institution-id><institution>Department of Intensive Care Services,</institution><institution>Prince Sultan Military Medical City,</institution></institution-wrap>Riyadh, 11159 Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Mustafa, Mohamed" sort="Mustafa, Mohamed" uniqKey="Mustafa M" first="Mohamed" last="Mustafa">Mohamed Mustafa</name><affiliation wicri:level="1"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.415989.8</institution-id><institution-id institution-id-type="ISNI">0000000097598141</institution-id><institution>Department of Intensive Care Services,</institution><institution>Prince Sultan Military Medical City,</institution></institution-wrap>Riyadh, 11159 Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Aldaghestani, Tareef" sort="Aldaghestani, Tareef" uniqKey="Aldaghestani T" first="Tareef" last="Aldaghestani">Tareef Aldaghestani</name><affiliation wicri:level="1"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.415989.8</institution-id><institution-id institution-id-type="ISNI">0000000097598141</institution-id><institution>Department of Intensive Care Services,</institution><institution>Prince Sultan Military Medical City,</institution></institution-wrap>Riyadh, 11159 Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Alghamedi, Adnan" sort="Alghamedi, Adnan" uniqKey="Alghamedi A" first="Adnan" last="Alghamedi">Adnan Alghamedi</name><affiliation wicri:level="1"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.415989.8</institution-id><institution-id institution-id-type="ISNI">0000000097598141</institution-id><institution>Department of Intensive Care Services,</institution><institution>Prince Sultan Military Medical City,</institution></institution-wrap>Riyadh, 11159 Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Talag, Ali" sort="Talag, Ali" uniqKey="Talag A" first="Ali" last="Talag">Ali Talag</name><affiliation wicri:level="1"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.415989.8</institution-id><institution-id institution-id-type="ISNI">0000000097598141</institution-id><institution>Department of Intensive Care Services,</institution><institution>Prince Sultan Military Medical City,</institution></institution-wrap>Riyadh, 11159 Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Malik, Muhammad K" sort="Malik, Muhammad K" uniqKey="Malik M" first="Muhammad K." last="Malik">Muhammad K. Malik</name><affiliation wicri:level="1"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.415989.8</institution-id><institution-id institution-id-type="ISNI">0000000097598141</institution-id><institution>Department of Intensive Care Services,</institution><institution>Prince Sultan Military Medical City,</institution></institution-wrap>Riyadh, 11159 Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Omrani, Ali S" sort="Omrani, Ali S" uniqKey="Omrani A" first="Ali S." last="Omrani">Ali S. Omrani</name><affiliation wicri:level="1"><nlm:aff id="Aff3"><institution-wrap><institution-id institution-id-type="GRID">grid.415310.2</institution-id><institution-id institution-id-type="ISNI">0000000121914301</institution-id><institution>Department of Medicine, King Faisal Specialist Hospital and Research Centre,</institution></institution-wrap>Riyadh, 11211 Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Sakr, Yasser" sort="Sakr, Yasser" uniqKey="Sakr Y" first="Yasser" last="Sakr">Yasser Sakr</name><affiliation wicri:level="1"><nlm:aff id="Aff4"><institution-wrap><institution-id institution-id-type="GRID">grid.275559.9</institution-id><institution-id institution-id-type="ISNI">0000 0000 8517 6224</institution-id><institution>Department of Anesthesiology and Intensive Care,</institution><institution>Uniklinikum Jena,</institution></institution-wrap>07743 Jena, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>07743 Jena</wicri:regionArea></affiliation></author></analytic><series><title level="j">Critical Care</title><idno type="ISSN">1364-8535</idno><idno type="eISSN">1466-609X</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p id="Par1">Middle East respiratory syndrome coronavirus infection is associated with high mortality rates but limited clinical data have been reported. We describe the clinical features and outcomes of patients admitted to an intensive care unit (ICU) with Middle East respiratory syndrome coronavirus (MERS-CoV) infection.</p></sec><sec><title>Methods</title><p id="Par2">Retrospective analysis of data from all adult (>18 years old) patients admitted to our 20-bed mixed ICU with Middle East respiratory syndrome coronavirus infection between October 1, 2012 and May 31, 2014. Diagnosis was confirmed in all patients using real-time reverse transcription polymerase chain reaction on respiratory samples.</p></sec><sec><title>Results</title><p id="Par3">During the observation period, 31 patients were admitted with MERS-CoV infection (mean age 59 ± 20 years, 22 [71 %] males). Cough and tachypnea were reported in all patients; 22 (77.4 %) patients had bilateral pulmonary infiltrates. Invasive mechanical ventilation was applied in 27 (87.1 %) and vasopressor therapy in 25 (80.6 %) patients during the intensive care unit stay. Twenty-three (74.2 %) patients died in the ICU. Nonsurvivors were older, had greater APACHE II and SOFA scores on admission, and were more likely to have received invasive mechanical ventilation and vasopressor therapy. After adjustment for the severity of illness and the degree of organ dysfunction, the need for vasopressors was an independent risk factor for death in the ICU (odds ratio = 18.33, 95 % confidence interval: 1.11–302.1, <italic>P</italic> = 0.04).</p></sec><sec><title>Conclusions</title><p id="Par4">MERS-CoV infection requiring admission to the ICU is associated with high morbidity and mortality. The need for vasopressor therapy is the main risk factor for death in these patients.</p></sec><sec><title>Electronic supplementary material</title><p>The online version of this article (doi:10.1186/s13054-016-1303-8) contains supplementary material, which is available to authorized users.</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, Adme" uniqKey="Osterhaus A">ADME Osterhaus</name></author><author><name sortKey="Fouchier, Ram" uniqKey="Fouchier R">RAM Fouchier</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Omrani, As" uniqKey="Omrani A">AS 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Crit Care</journal-id><journal-title-group><journal-title>Critical Care</journal-title></journal-title-group><issn pub-type="ppub">1364-8535</issn><issn pub-type="epub">1466-609X</issn><publisher><publisher-name>BioMed Central</publisher-name><publisher-loc>London</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">27153800</article-id><article-id pub-id-type="pmc">4859954</article-id><article-id pub-id-type="publisher-id">1303</article-id><article-id pub-id-type="doi">10.1186/s13054-016-1303-8</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research</subject></subj-group></article-categories><title-group><article-title>Presentation and outcome of Middle East respiratory syndrome in Saudi intensive care unit patients</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Almekhlafi</surname><given-names>Ghaleb A.</given-names></name><address><phone>00966114777714</phone><email>gmekhlafi@yahoo.com</email></address><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Albarrak</surname><given-names>Mohammed M.</given-names></name><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Mandourah</surname><given-names>Yasser</given-names></name><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Hassan</surname><given-names>Sahar</given-names></name><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Alwan</surname><given-names>Abid</given-names></name><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Abudayah</surname><given-names>Abdullah</given-names></name><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Altayyar</surname><given-names>Sultan</given-names></name><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Mustafa</surname><given-names>Mohamed</given-names></name><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Aldaghestani</surname><given-names>Tareef</given-names></name><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Alghamedi</surname><given-names>Adnan</given-names></name><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Talag</surname><given-names>Ali</given-names></name><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Malik</surname><given-names>Muhammad K.</given-names></name><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Omrani</surname><given-names>Ali S.</given-names></name><xref ref-type="aff" rid="Aff3">3</xref></contrib><contrib contrib-type="author"><name><surname>Sakr</surname><given-names>Yasser</given-names></name><xref ref-type="aff" rid="Aff4">4</xref></contrib><aff id="Aff1"><label>1</label><institution-wrap><institution-id institution-id-type="GRID">grid.415989.8</institution-id><institution-id institution-id-type="ISNI">0000000097598141</institution-id><institution>Department of Intensive Care Services,</institution><institution>Prince Sultan Military Medical City,</institution></institution-wrap>Riyadh, 11159 Saudi Arabia</aff><aff id="Aff2"><label>2</label><institution-wrap><institution-id institution-id-type="GRID">grid.415989.8</institution-id><institution-id institution-id-type="ISNI">0000000097598141</institution-id><institution>Intensive Care Unit,</institution><institution>Prince Sultan Cardiac Center,</institution></institution-wrap>Riyadh, 11159 Saudi Arabia</aff><aff id="Aff3"><label>3</label><institution-wrap><institution-id institution-id-type="GRID">grid.415310.2</institution-id><institution-id institution-id-type="ISNI">0000000121914301</institution-id><institution>Department of Medicine, King Faisal Specialist Hospital and Research Centre,</institution></institution-wrap>Riyadh, 11211 Saudi Arabia</aff><aff id="Aff4"><label>4</label><institution-wrap><institution-id institution-id-type="GRID">grid.275559.9</institution-id><institution-id institution-id-type="ISNI">0000 0000 8517 6224</institution-id><institution>Department of Anesthesiology and Intensive Care,</institution><institution>Uniklinikum Jena,</institution></institution-wrap>07743 Jena, Germany</aff></contrib-group><pub-date pub-type="epub"><day>7</day><month>5</month><year>2016</year></pub-date><pub-date pub-type="pmc-release"><day>7</day><month>5</month><year>2016</year></pub-date><pub-date pub-type="collection"><year>2016</year></pub-date><volume>20</volume><elocation-id>123</elocation-id><history><date date-type="received"><day>26</day><month>1</month><year>2016</year></date><date date-type="accepted"><day>19</day><month>4</month><year>2016</year></date></history><permissions><copyright-statement>© Almekhlafi et al. 2016</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>Background</title><p id="Par1">Middle East respiratory syndrome coronavirus infection is associated with high mortality rates but limited clinical data have been reported. We describe the clinical features and outcomes of patients admitted to an intensive care unit (ICU) with Middle East respiratory syndrome coronavirus (MERS-CoV) infection.</p></sec><sec><title>Methods</title><p id="Par2">Retrospective analysis of data from all adult (>18 years old) patients admitted to our 20-bed mixed ICU with Middle East respiratory syndrome coronavirus infection between October 1, 2012 and May 31, 2014. Diagnosis was confirmed in all patients using real-time reverse transcription polymerase chain reaction on respiratory samples.</p></sec><sec><title>Results</title><p id="Par3">During the observation period, 31 patients were admitted with MERS-CoV infection (mean age 59 ± 20 years, 22 [71 %] males). Cough and tachypnea were reported in all patients; 22 (77.4 %) patients had bilateral pulmonary infiltrates. Invasive mechanical ventilation was applied in 27 (87.1 %) and vasopressor therapy in 25 (80.6 %) patients during the intensive care unit stay. Twenty-three (74.2 %) patients died in the ICU. Nonsurvivors were older, had greater APACHE II and SOFA scores on admission, and were more likely to have received invasive mechanical ventilation and vasopressor therapy. After adjustment for the severity of illness and the degree of organ dysfunction, the need for vasopressors was an independent risk factor for death in the ICU (odds ratio = 18.33, 95 % confidence interval: 1.11–302.1, <italic>P</italic> = 0.04).</p></sec><sec><title>Conclusions</title><p id="Par4">MERS-CoV infection requiring admission to the ICU is associated with high morbidity and mortality. The need for vasopressor therapy is the main risk factor for death in these patients.</p></sec><sec><title>Electronic supplementary material</title><p>The online version of this article (doi:10.1186/s13054-016-1303-8) contains supplementary material, which is available to authorized users.</p></sec></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>Coronavirus</kwd><kwd>MERS-CoV</kwd><kwd>Respiratory failure</kwd><kwd>Epidemic</kwd><kwd>Saudi Arabia</kwd></kwd-group><funding-group><award-group><funding-source><institution>Institutional funding</institution></funding-source></award-group></funding-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Author(s) 2016</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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