Risks of Death and Severe Disease in Patients With Middle East Respiratory Syndrome Coronavirus, 2012–2015
Identifieur interne : 000A33 ( Pmc/Curation ); précédent : 000A32; suivant : 000A34Risks of Death and Severe Disease in Patients With Middle East Respiratory Syndrome Coronavirus, 2012–2015
Auteurs : Caitlin M. Rivers ; Maimuna S. Majumder ; Eric T. LofgrenSource :
- American Journal of Epidemiology [ 0002-9262 ] ; 2016.
Abstract
Middle East respiratory syndrome coronavirus (MERS-CoV) is an emerging pathogen, first recognized in 2012, with a high case fatality risk, no vaccine, and no treatment beyond supportive care. We estimated the relative risks of death and severe disease among MERS-CoV patients in the Middle East between 2012 and 2015 for several risk factors, using Poisson regression with robust variance and a bootstrap-based expectation maximization algorithm to handle extensive missing data. Increased age and underlying comorbidity were risk factors for both death and severe disease, while cases arising in Saudi Arabia were more likely to be severe. Cases occurring later in the emergence of MERS-CoV and among health-care workers were less serious. This study represents an attempt to estimate risk factors for an emerging infectious disease using open data and to address some of the uncertainty surrounding MERS-CoV epidemiology.
Url:
DOI: 10.1093/aje/kww013
PubMed: 27608662
PubMed Central: 5023790
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<author><name sortKey="Rivers, Caitlin M" sort="Rivers, Caitlin M" uniqKey="Rivers C" first="Caitlin M." last="Rivers">Caitlin M. Rivers</name>
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<author><name sortKey="Majumder, Maimuna S" sort="Majumder, Maimuna S" uniqKey="Majumder M" first="Maimuna S." last="Majumder">Maimuna S. Majumder</name>
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<p>Middle East respiratory syndrome coronavirus (MERS-CoV) is an emerging pathogen, first recognized in 2012, with a high case fatality risk, no vaccine, and no treatment beyond supportive care. We estimated the relative risks of death and severe disease among MERS-CoV patients in the Middle East between 2012 and 2015 for several risk factors, using Poisson regression with robust variance and a bootstrap-based expectation maximization algorithm to handle extensive missing data. Increased age and underlying comorbidity were risk factors for both death and severe disease, while cases arising in Saudi Arabia were more likely to be severe. Cases occurring later in the emergence of MERS-CoV and among health-care workers were less serious. This study represents an attempt to estimate risk factors for an emerging infectious disease using open data and to address some of the uncertainty surrounding MERS-CoV epidemiology.</p>
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<front><journal-meta><journal-id journal-id-type="nlm-ta">Am J Epidemiol</journal-id>
<journal-id journal-id-type="iso-abbrev">Am. J. Epidemiol</journal-id>
<journal-id journal-id-type="publisher-id">aje</journal-id>
<journal-id journal-id-type="hwp">amjepid</journal-id>
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<issn pub-type="ppub">0002-9262</issn>
<issn pub-type="epub">1476-6256</issn>
<publisher><publisher-name>Oxford University Press</publisher-name>
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<article-id pub-id-type="doi">10.1093/aje/kww013</article-id>
<article-id pub-id-type="publisher-id">kww013</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>ORIGINAL CONTRIBUTIONS</subject>
<subj-group subj-group-type="category-toc-heading"><subject>Middle East Respiratory Syndrome and risk of death</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group><article-title>Risks of Death and Severe Disease in Patients With Middle East Respiratory Syndrome Coronavirus, 2012–2015</article-title>
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<contrib-group><contrib contrib-type="author"><name><surname>Rivers</surname>
<given-names>Caitlin M.</given-names>
</name>
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<contrib contrib-type="author"><name><surname>Majumder</surname>
<given-names>Maimuna S.</given-names>
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<contrib contrib-type="author"><name><surname>Lofgren</surname>
<given-names>Eric T.</given-names>
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<xref ref-type="corresp" rid="cor1">*</xref>
<pmc-comment>Eric.Lofgren@wsu.edu </pmc-comment>
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<author-notes><corresp id="cor1"><label>*</label>
Correspondence to Dr. Eric T. Lofgren, Paul G. Allen School for Global Animal Health, Washington State University, 240 SE Ott Road, Pullman, WA 99164 (e-mail: <email>Eric.Lofgren@wsu.edu</email>
).</corresp>
<fn id="AN1" fn-type="con"><p>Abbreviation: MERS-CoV, Middle East respiratory syndrome coronavirus.</p>
</fn>
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<pub-date pub-type="ppub"><day>15</day>
<month>9</month>
<year>2016</year>
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<pub-date pub-type="epub" iso-8601-date="2016-09-08"><day>08</day>
<month>9</month>
<year>2016</year>
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<volume>184</volume>
<issue>6</issue>
<fpage>460</fpage>
<lpage>464</lpage>
<history><date date-type="received"><day>14</day>
<month>4</month>
<year>2015</year>
</date>
<date date-type="accepted"><day>13</day>
<month>1</month>
<year>2016</year>
</date>
</history>
<permissions><copyright-statement>© The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</copyright-statement>
<copyright-year>2016</copyright-year>
<license><license-p>This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.</license-p>
</license>
</permissions>
<self-uri xlink:href="kww013.pdf"></self-uri>
<abstract><title>Abstract</title>
<p>Middle East respiratory syndrome coronavirus (MERS-CoV) is an emerging pathogen, first recognized in 2012, with a high case fatality risk, no vaccine, and no treatment beyond supportive care. We estimated the relative risks of death and severe disease among MERS-CoV patients in the Middle East between 2012 and 2015 for several risk factors, using Poisson regression with robust variance and a bootstrap-based expectation maximization algorithm to handle extensive missing data. Increased age and underlying comorbidity were risk factors for both death and severe disease, while cases arising in Saudi Arabia were more likely to be severe. Cases occurring later in the emergence of MERS-CoV and among health-care workers were less serious. This study represents an attempt to estimate risk factors for an emerging infectious disease using open data and to address some of the uncertainty surrounding MERS-CoV epidemiology.</p>
</abstract>
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