Middle Eastern Respiratory Syndrome Corona Virus (MERS CoV): case reports from a tertiary care hospital in Saudi Arabia
Identifieur interne : 000A53 ( Pmc/Curation ); précédent : 000A52; suivant : 000A54Middle Eastern Respiratory Syndrome Corona Virus (MERS CoV): case reports from a tertiary care hospital in Saudi Arabia
Auteurs : Mohammad Khalid ; Basha Khan ; Fahad Al Rabiah ; Ruwaida Alismaili ; Sarfraz Saleemi ; Agha Muhammad Rehan-Khaliq ; Ihab Weheba ; Hail Al Abdely ; Magid Halim ; Quaid Johar Nadri ; Abdullah Mohsin Al Dalaan ; Mohamed Zeitouni ; Taimur Butt ; Eid Al MutairySource :
- Annals of Saudi Medicine [ 0256-4947 ] ; 2014.
Abstract
Middle Eastern respiratory syndrome caused by novel coronavirus (MERS CoV) has been a major public health challenge since it was first described in 2012 in Saudi Arabia. So far, there is no effective treatment for this serious illness, which features a high mortality rate. We report an initial experience of the use of ribavirin and interferon (IFN)-α2b in the management of MERS CoV at a tertiary care hospital.
A case series of 6 patients admitted with a confirmed diagnosis of MERS CoV were treated with ribavirin and IFN-α2b in addition to supportive management. The patients’ demographics, clinical parameters, and outcomes were recorded. Fifty-four close contacts of these patients were screened for MERS CoV.
Six patients with MERS CoV infection were included in this study. Four cases featured symptomatic disease, including pneumonia and respiratory failure, while 2 were asymptomatic close contacts of the MERS CoV patients. The MERS CoV infection was confirmed by reverse transcription–polymerase chain reaction detection of the consensus viral RNA targets upstream of the E gene (UPE) and open reading frame (ORF1b) on a sputum sample. The patients’ demographics, comorbid conditions, time to diagnosis and initiation of treatment, and clinical outcomes were recorded.
Three out of 6 patients who had comorbid conditions died during the study period, while 3 had successful outcomes. The diagnosis and treatment was delayed by an average of 15 days in those patients who died. Only 2 close contacts out of the 54 screened (3.7%) were positive for MERS CoV.
Treatment with ribavirin and IFN-α2b may be effective in patients infected with MERS CoV. There appears to be a low infectivity rate among close contacts of MERS CoV patients.
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DOI: 10.5144/0256-4947.2014.396
PubMed: 25827696
PubMed Central: 6074560
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Middle Eastern Respiratory Syndrome Corona Virus (MERS CoV): case reports from a tertiary care hospital in Saudi Arabia</title><author><name sortKey="Khalid, Mohammad" sort="Khalid, Mohammad" uniqKey="Khalid M" first="Mohammad" last="Khalid">Mohammad Khalid</name></author><author><name sortKey="Khan, Basha" sort="Khan, Basha" uniqKey="Khan B" first="Basha" last="Khan">Basha Khan</name></author><author><name sortKey="Al Rabiah, Fahad" sort="Al Rabiah, Fahad" uniqKey="Al Rabiah F" first="Fahad" last="Al Rabiah">Fahad Al Rabiah</name></author><author><name sortKey="Alismaili, Ruwaida" sort="Alismaili, Ruwaida" uniqKey="Alismaili R" first="Ruwaida" last="Alismaili">Ruwaida Alismaili</name></author><author><name sortKey="Saleemi, Sarfraz" sort="Saleemi, Sarfraz" uniqKey="Saleemi S" first="Sarfraz" last="Saleemi">Sarfraz Saleemi</name></author><author><name sortKey="Rehan Khaliq, Agha Muhammad" sort="Rehan Khaliq, Agha Muhammad" uniqKey="Rehan Khaliq A" first="Agha Muhammad" last="Rehan-Khaliq">Agha Muhammad Rehan-Khaliq</name></author><author><name sortKey="Weheba, Ihab" sort="Weheba, Ihab" uniqKey="Weheba I" first="Ihab" last="Weheba">Ihab Weheba</name></author><author><name sortKey="Al Abdely, Hail" sort="Al Abdely, Hail" uniqKey="Al Abdely H" first="Hail" last="Al Abdely">Hail Al Abdely</name></author><author><name sortKey="Halim, Magid" sort="Halim, Magid" uniqKey="Halim M" first="Magid" last="Halim">Magid Halim</name></author><author><name sortKey="Nadri, Quaid Johar" sort="Nadri, Quaid Johar" uniqKey="Nadri Q" first="Quaid Johar" last="Nadri">Quaid Johar Nadri</name></author><author><name sortKey="Al Dalaan, Abdullah Mohsin" sort="Al Dalaan, Abdullah Mohsin" uniqKey="Al Dalaan A" first="Abdullah Mohsin" last="Al Dalaan">Abdullah Mohsin Al Dalaan</name></author><author><name sortKey="Zeitouni, Mohamed" sort="Zeitouni, Mohamed" uniqKey="Zeitouni M" first="Mohamed" last="Zeitouni">Mohamed Zeitouni</name></author><author><name sortKey="Butt, Taimur" sort="Butt, Taimur" uniqKey="Butt T" first="Taimur" last="Butt">Taimur Butt</name></author><author><name sortKey="Al Mutairy, Eid" sort="Al Mutairy, Eid" uniqKey="Al Mutairy E" first="Eid" last="Al Mutairy">Eid Al Mutairy</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25827696</idno><idno type="pmc">6074560</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6074560</idno><idno type="RBID">PMC:6074560</idno><idno type="doi">10.5144/0256-4947.2014.396</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">000A53</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000A53</idno><idno type="wicri:Area/Pmc/Curation">000A53</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000A53</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Middle Eastern Respiratory Syndrome Corona Virus (MERS CoV): case reports from a tertiary care hospital in Saudi Arabia</title><author><name sortKey="Khalid, Mohammad" sort="Khalid, Mohammad" uniqKey="Khalid M" first="Mohammad" last="Khalid">Mohammad Khalid</name></author><author><name sortKey="Khan, Basha" sort="Khan, Basha" uniqKey="Khan B" first="Basha" last="Khan">Basha Khan</name></author><author><name sortKey="Al Rabiah, Fahad" sort="Al Rabiah, Fahad" uniqKey="Al Rabiah F" first="Fahad" last="Al Rabiah">Fahad Al Rabiah</name></author><author><name sortKey="Alismaili, Ruwaida" sort="Alismaili, Ruwaida" uniqKey="Alismaili R" first="Ruwaida" last="Alismaili">Ruwaida Alismaili</name></author><author><name sortKey="Saleemi, Sarfraz" sort="Saleemi, Sarfraz" uniqKey="Saleemi S" first="Sarfraz" last="Saleemi">Sarfraz Saleemi</name></author><author><name sortKey="Rehan Khaliq, Agha Muhammad" sort="Rehan Khaliq, Agha Muhammad" uniqKey="Rehan Khaliq A" first="Agha Muhammad" last="Rehan-Khaliq">Agha Muhammad Rehan-Khaliq</name></author><author><name sortKey="Weheba, Ihab" sort="Weheba, Ihab" uniqKey="Weheba I" first="Ihab" last="Weheba">Ihab Weheba</name></author><author><name sortKey="Al Abdely, Hail" sort="Al Abdely, Hail" uniqKey="Al Abdely H" first="Hail" last="Al Abdely">Hail Al Abdely</name></author><author><name sortKey="Halim, Magid" sort="Halim, Magid" uniqKey="Halim M" first="Magid" last="Halim">Magid Halim</name></author><author><name sortKey="Nadri, Quaid Johar" sort="Nadri, Quaid Johar" uniqKey="Nadri Q" first="Quaid Johar" last="Nadri">Quaid Johar Nadri</name></author><author><name sortKey="Al Dalaan, Abdullah Mohsin" sort="Al Dalaan, Abdullah Mohsin" uniqKey="Al Dalaan A" first="Abdullah Mohsin" last="Al Dalaan">Abdullah Mohsin Al Dalaan</name></author><author><name sortKey="Zeitouni, Mohamed" sort="Zeitouni, Mohamed" uniqKey="Zeitouni M" first="Mohamed" last="Zeitouni">Mohamed Zeitouni</name></author><author><name sortKey="Butt, Taimur" sort="Butt, Taimur" uniqKey="Butt T" first="Taimur" last="Butt">Taimur Butt</name></author><author><name sortKey="Al Mutairy, Eid" sort="Al Mutairy, Eid" uniqKey="Al Mutairy E" first="Eid" last="Al Mutairy">Eid Al Mutairy</name></author></analytic><series><title level="j">Annals of Saudi Medicine</title><idno type="ISSN">0256-4947</idno><idno type="eISSN">0975-4466</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>BACKGROUND AND OBJECTIVES</title><p>Middle Eastern respiratory syndrome caused by novel coronavirus (MERS CoV) has been a major public health challenge since it was first described in 2012 in Saudi Arabia. So far, there is no effective treatment for this serious illness, which features a high mortality rate. We report an initial experience of the use of ribavirin and interferon (IFN)-α2b in the management of MERS CoV at a tertiary care hospital.</p></sec><sec><title>DESIGN AND SETTINGS</title><p>A case series of 6 patients admitted with a confirmed diagnosis of MERS CoV were treated with ribavirin and IFN-α2b in addition to supportive management. The patients’ demographics, clinical parameters, and outcomes were recorded. Fifty-four close contacts of these patients were screened for MERS CoV.</p></sec><sec><title>METHODS</title><p>Six patients with MERS CoV infection were included in this study. Four cases featured symptomatic disease, including pneumonia and respiratory failure, while 2 were asymptomatic close contacts of the MERS CoV patients. The MERS CoV infection was confirmed by reverse transcription–polymerase chain reaction detection of the consensus viral RNA targets upstream of the E gene (UPE) and open reading frame (ORF1b) on a sputum sample. The patients’ demographics, comorbid conditions, time to diagnosis and initiation of treatment, and clinical outcomes were recorded.</p></sec><sec><title>RESULTS</title><p>Three out of 6 patients who had comorbid conditions died during the study period, while 3 had successful outcomes. The diagnosis and treatment was delayed by an average of 15 days in those patients who died. Only 2 close contacts out of the 54 screened (3.7%) were positive for MERS CoV.</p></sec><sec><title>CONCLUSION</title><p>Treatment with ribavirin and IFN-α2b may be effective in patients infected with MERS CoV. There appears to be a low infectivity rate among close contacts of MERS CoV patients.</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></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Falzarano, D" uniqKey="Falzarano D">D Falzarano</name></author><author><name sortKey="De Wit, E" uniqKey="De Wit E">E de Wit</name></author><author><name sortKey="Martellaro, C" uniqKey="Martellaro C">C Martellaro</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Khan, K" uniqKey="Khan K">K Khan</name></author><author><name sortKey="Sears, J" uniqKey="Sears J">J Sears</name></author><author><name sortKey="Hu, Vw" uniqKey="Hu V">VW Hu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Alagaili, An" uniqKey="Alagaili A">AN Alagaili</name></author><author><name sortKey="Briese, T" uniqKey="Briese T">T Briese</name></author><author><name sortKey="Mishra, N" uniqKey="Mishra N">N Mishra</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Saey, Th" uniqKey="Saey T">TH Saey</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Briese, T" uniqKey="Briese T">T Briese</name></author><author><name sortKey="Mishra, N" uniqKey="Mishra N">N Mishra</name></author><author><name sortKey="Jain, K" uniqKey="Jain K">K Jain</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Azhar, Ei" uniqKey="Azhar E">EI Azhar</name></author><author><name sortKey="El Kafrawy, Sa" uniqKey="El Kafrawy S">SA El-Kafrawy</name></author><author><name sortKey="Farraj, Sa" uniqKey="Farraj S">SA Farraj</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Falzarano, D" uniqKey="Falzarano D">D Falzarano</name></author><author><name sortKey="De Wit, E" uniqKey="De Wit E">E de Wit</name></author><author><name sortKey="Rasmussen, Al" uniqKey="Rasmussen A">AL Rasmussen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Al Tawfiq, Ja" uniqKey="Al Tawfiq J">JA Al-Tawfiq</name></author><author><name sortKey="Momattin, H" uniqKey="Momattin H">H Momattin</name></author><author><name sortKey="Dib, J" uniqKey="Dib J">J Dib</name></author><author><name sortKey="Memish, Za" uniqKey="Memish Z">ZA Memish</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Omrani, As" uniqKey="Omrani A">AS Omrani</name></author><author><name sortKey="Saad, Mm" uniqKey="Saad M">MM Saad</name></author><author><name sortKey="Baig, K" uniqKey="Baig K">K Baig</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Guery, B" uniqKey="Guery B">B Guery</name></author><author><name sortKey="Van Der Werf, S" uniqKey="Van Der Werf S">S van der Werf</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Falzarano, D" uniqKey="Falzarano D">D Falzarano</name></author><author><name sortKey="De Wit, E" uniqKey="De Wit E">E de Wit</name></author><author><name sortKey="Martellaro, C" uniqKey="Martellaro C">C Martellaro</name></author><author><name sortKey="Callison, J" uniqKey="Callison J">J Callison</name></author><author><name sortKey="Munster, Vj" uniqKey="Munster V">VJ Munster</name></author><author><name sortKey="Feldmann, H" uniqKey="Feldmann H">H Feldmann</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Momattin, H" uniqKey="Momattin H">H Momattin</name></author><author><name sortKey="Mohammed, K" uniqKey="Mohammed K">K Mohammed</name></author><author><name sortKey="Zumla, A" uniqKey="Zumla A">A Zumla</name></author><author><name sortKey="Memish, Za" uniqKey="Memish Z">ZA Memish</name></author><author><name sortKey="Al Tawfiq, Ja" uniqKey="Al Tawfiq J">JA Al-Tawfiq</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">Ann Saudi Med</journal-id><journal-id journal-id-type="iso-abbrev">Ann Saudi Med</journal-id><journal-title-group><journal-title>Annals of Saudi Medicine</journal-title></journal-title-group><issn pub-type="ppub">0256-4947</issn><issn pub-type="epub">0975-4466</issn><publisher><publisher-name>King Faisal Specialist Hospital and Research Centre</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">25827696</article-id><article-id pub-id-type="pmc">6074560</article-id><article-id pub-id-type="doi">10.5144/0256-4947.2014.396</article-id><article-id pub-id-type="publisher-id">asm-5-396</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject></subj-group></article-categories><title-group><article-title>Middle Eastern Respiratory Syndrome Corona Virus (MERS CoV): case reports from a tertiary care hospital in Saudi Arabia</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Khalid</surname><given-names>Mohammad</given-names></name></contrib><contrib contrib-type="author"><name><surname>Khan</surname><given-names>Basha</given-names></name></contrib><contrib contrib-type="author"><name><surname>Al Rabiah</surname><given-names>Fahad</given-names></name></contrib><contrib contrib-type="author"><name><surname>Alismaili</surname><given-names>Ruwaida</given-names></name></contrib><contrib contrib-type="author"><name><surname>Saleemi</surname><given-names>Sarfraz</given-names></name></contrib><contrib contrib-type="author"><name><surname>Rehan-Khaliq</surname><given-names>Agha Muhammad</given-names></name></contrib><contrib contrib-type="author"><name><surname>Weheba</surname><given-names>Ihab</given-names></name></contrib><contrib contrib-type="author"><name><surname>Al Abdely</surname><given-names>Hail</given-names></name></contrib><contrib contrib-type="author"><name><surname>Halim</surname><given-names>Magid</given-names></name></contrib><contrib contrib-type="author"><name><surname>Nadri</surname><given-names>Quaid Johar</given-names></name></contrib><contrib contrib-type="author"><name><surname>Al Dalaan</surname><given-names>Abdullah Mohsin</given-names></name></contrib><contrib contrib-type="author"><name><surname>Zeitouni</surname><given-names>Mohamed</given-names></name></contrib><contrib contrib-type="author"><name><surname>Butt</surname><given-names>Taimur</given-names></name></contrib><contrib contrib-type="author"><name><surname>Al Mutairy</surname><given-names>Eid</given-names></name></contrib><aff id="af1-asm-5-396">From the Department of Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia</aff></contrib-group><author-notes><corresp id="c1-asm-5-396">Correspondence: Dr. Mohammad Khalid, Department of Medicine, King Faisal Specialist Hospital & Research Center PO Box 3354 Riyadh 11211 Saudi Arabia, <email>mkhalid@kfshrc.edu.sa</email></corresp></author-notes><pub-date pub-type="ppub"><season>Sep-Oct</season><year>2014</year></pub-date><volume>34</volume><issue>5</issue><fpage>396</fpage><lpage>400</lpage><permissions><copyright-statement>Copyright © 2014, Annals of Saudi Medicine</copyright-statement><copyright-year>2014</copyright-year><license><license-p>This work is licensed under a <ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by-nc-nd/4.0/">Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</ext-link>.</license-p></license></permissions><abstract><sec><title>BACKGROUND AND OBJECTIVES</title><p>Middle Eastern respiratory syndrome caused by novel coronavirus (MERS CoV) has been a major public health challenge since it was first described in 2012 in Saudi Arabia. So far, there is no effective treatment for this serious illness, which features a high mortality rate. We report an initial experience of the use of ribavirin and interferon (IFN)-α2b in the management of MERS CoV at a tertiary care hospital.</p></sec><sec><title>DESIGN AND SETTINGS</title><p>A case series of 6 patients admitted with a confirmed diagnosis of MERS CoV were treated with ribavirin and IFN-α2b in addition to supportive management. The patients’ demographics, clinical parameters, and outcomes were recorded. Fifty-four close contacts of these patients were screened for MERS CoV.</p></sec><sec><title>METHODS</title><p>Six patients with MERS CoV infection were included in this study. Four cases featured symptomatic disease, including pneumonia and respiratory failure, while 2 were asymptomatic close contacts of the MERS CoV patients. The MERS CoV infection was confirmed by reverse transcription–polymerase chain reaction detection of the consensus viral RNA targets upstream of the E gene (UPE) and open reading frame (ORF1b) on a sputum sample. The patients’ demographics, comorbid conditions, time to diagnosis and initiation of treatment, and clinical outcomes were recorded.</p></sec><sec><title>RESULTS</title><p>Three out of 6 patients who had comorbid conditions died during the study period, while 3 had successful outcomes. The diagnosis and treatment was delayed by an average of 15 days in those patients who died. Only 2 close contacts out of the 54 screened (3.7%) were positive for MERS CoV.</p></sec><sec><title>CONCLUSION</title><p>Treatment with ribavirin and IFN-α2b may be effective in patients infected with MERS CoV. There appears to be a low infectivity rate among close contacts of MERS CoV patients.</p></sec></abstract></article-meta></front><floats-group><fig id="f1-asm-5-396" position="float"><label>Figure 1</label><caption><p>Chest x-ray of a patient showing bilateral lung infiltrates.</p></caption><graphic xlink:href="asm-5-396f1"></graphic></fig><fig id="f2-asm-5-396" position="float"><label>Figure 2</label><caption><p>Chest x-ray showing upper respiratory tract infection and lung infiltrates.</p></caption><graphic xlink:href="asm-5-396f2"></graphic></fig><fig id="f3-asm-5-396" position="float"><label>Figure 3</label><caption><p>Chest x-ray showing almost complete resolution of the lung infiltrate.</p></caption><graphic xlink:href="asm-5-396f3"></graphic></fig><table-wrap id="t1-asm-5-396" position="float"><label>Table 1</label><caption><p>Suggested treatment protocol for Ribavirin and Interferon-α2b therapy.</p></caption><table frame="hsides" rules="cols"><thead><tr><th valign="middle" align="left" rowspan="1" colspan="1">Agent</th><th colspan="3" valign="middle" align="center" rowspan="1">Dosing regimen based on CrCl</th></tr><tr><th colspan="4" valign="bottom" align="left" rowspan="1"><hr></hr></th></tr></thead><tbody><tr><td valign="middle" align="left" rowspan="1" colspan="1"></td><td valign="middle" align="center" rowspan="1" colspan="1">CrCl >50 mL/min</td><td valign="middle" align="center" rowspan="1" colspan="1">CrCl 20–50 mL/min</td><td valign="middle" align="center" rowspan="1" colspan="1">CrCl <20 mL/min or on dialysis</td></tr><tr><td valign="middle" align="left" rowspan="1" colspan="1">Ribavirin (oral)</td><td valign="middle" align="center" rowspan="1" colspan="1">2000 mg loading dose followed by 1200 mg every 8 h for 4 d, then 600 mg every 8 h for 4–6 d</td><td valign="middle" align="center" rowspan="1" colspan="1">2000 mg loading dose followed by 1200 mg every 8 h for 4 d, then 600 mg every 6 h for 4–6 d</td><td valign="middle" align="center" rowspan="1" colspan="1">2000 mg loading dose followed by 200 mg every 6 h for 4 d, then 200 mg every 12 h for 4–6 d</td></tr><tr><td valign="middle" align="left" rowspan="1" colspan="1">Interferon-α2b</td><td colspan="3" valign="middle" align="center" rowspan="1">180 μg subcutaneously once per wk for 2 wk</td></tr></tbody></table><table-wrap-foot><fn id="tfn2-asm-5-396"><p>Note: All dosing recommendations were adopted from Hisham Momattin et al.<xref rid="b15-asm-5-396" ref-type="bibr">15</xref> Abbreviation: CrCl: creatinine clearance.</p></fn></table-wrap-foot></table-wrap><table-wrap id="t2-asm-5-396" position="float"><label>Table 2</label><caption><p>Six cases with MERS CoV infection and treatment response to Ribavirin and Interferon-α2b.</p></caption><table frame="hsides" rules="cols"><thead><tr><th valign="middle" align="left" rowspan="1" colspan="1">Patient (case number)</th><th valign="middle" align="center" rowspan="1" colspan="1">Age (y)</th><th valign="middle" align="center" rowspan="1" colspan="1">Sex</th><th valign="middle" align="center" rowspan="1" colspan="1">Comorbid conditions</th><th valign="middle" align="center" rowspan="1" colspan="1">Time to diagnosis (d)</th><th valign="middle" align="center" rowspan="1" colspan="1">Time to treatment (d)</th><th valign="middle" align="center" rowspan="1" colspan="1">Renal failure</th><th valign="middle" align="center" rowspan="1" colspan="1">Hemodynamic instability</th><th valign="middle" align="center" rowspan="1" colspan="1">Outcome</th></tr><tr><th colspan="9" valign="bottom" align="left" rowspan="1"><hr></hr></th></tr></thead><tbody><tr><td valign="middle" align="left" rowspan="1" colspan="1">1</td><td valign="middle" align="center" rowspan="1" colspan="1">74</td><td valign="middle" align="center" rowspan="1" colspan="1">M</td><td valign="middle" align="center" rowspan="1" colspan="1">Ischemic heart disease heart failure</td><td valign="middle" align="center" rowspan="1" colspan="1">18</td><td valign="middle" align="center" rowspan="1" colspan="1">19</td><td valign="middle" align="center" rowspan="1" colspan="1">+</td><td valign="middle" align="center" rowspan="1" colspan="1">+</td><td valign="middle" align="center" rowspan="1" colspan="1">Expired</td></tr><tr><td valign="middle" align="left" rowspan="1" colspan="1">2</td><td valign="middle" align="center" rowspan="1" colspan="1">84</td><td valign="middle" align="center" rowspan="1" colspan="1">M</td><td valign="middle" align="center" rowspan="1" colspan="1">Right bundle branch block</td><td valign="middle" align="center" rowspan="1" colspan="1">12</td><td valign="middle" align="center" rowspan="1" colspan="1">12</td><td valign="middle" align="center" rowspan="1" colspan="1">+</td><td valign="middle" align="center" rowspan="1" colspan="1">+</td><td valign="middle" align="center" rowspan="1" colspan="1">Expired</td></tr><tr><td valign="middle" align="left" rowspan="1" colspan="1">3</td><td valign="middle" align="center" rowspan="1" colspan="1">76</td><td valign="middle" align="center" rowspan="1" colspan="1">M</td><td valign="middle" align="center" rowspan="1" colspan="1">Cardiomyopathy heart failure</td><td valign="middle" align="center" rowspan="1" colspan="1">14</td><td valign="middle" align="center" rowspan="1" colspan="1">15</td><td valign="middle" align="center" rowspan="1" colspan="1">+</td><td valign="middle" align="center" rowspan="1" colspan="1">+</td><td valign="middle" align="center" rowspan="1" colspan="1">Expired</td></tr><tr><td valign="middle" align="left" rowspan="1" colspan="1">4</td><td valign="middle" align="center" rowspan="1" colspan="1">54</td><td valign="middle" align="center" rowspan="1" colspan="1">M</td><td valign="middle" align="center" rowspan="1" colspan="1">None</td><td valign="middle" align="center" rowspan="1" colspan="1">2</td><td valign="middle" align="center" rowspan="1" colspan="1">2</td><td valign="middle" align="center" rowspan="1" colspan="1">−</td><td valign="middle" align="center" rowspan="1" colspan="1">−</td><td valign="middle" align="center" rowspan="1" colspan="1">Survived</td></tr><tr><td valign="middle" align="left" rowspan="1" colspan="1">5</td><td valign="middle" align="center" rowspan="1" colspan="1">48</td><td valign="middle" align="center" rowspan="1" colspan="1">F</td><td valign="middle" align="center" rowspan="1" colspan="1">None</td><td valign="middle" align="center" rowspan="1" colspan="1">1</td><td valign="middle" align="center" rowspan="1" colspan="1">1</td><td valign="middle" align="center" rowspan="1" colspan="1">−</td><td valign="middle" align="center" rowspan="1" colspan="1">−</td><td valign="middle" align="center" rowspan="1" colspan="1">Survived</td></tr><tr><td valign="middle" align="left" rowspan="1" colspan="1">6</td><td valign="middle" align="center" rowspan="1" colspan="1">17</td><td valign="middle" align="center" rowspan="1" colspan="1">M</td><td valign="middle" align="center" rowspan="1" colspan="1">None</td><td valign="middle" align="center" rowspan="1" colspan="1">1</td><td valign="middle" align="center" rowspan="1" colspan="1">2</td><td valign="middle" align="center" rowspan="1" colspan="1">−</td><td valign="middle" align="center" rowspan="1" colspan="1">−</td><td valign="middle" align="center" rowspan="1" colspan="1">Survived</td></tr></tbody></table><table-wrap-foot><fn id="tfn1-asm-5-396"><p>Abbreviations: MERS CoV: Middle Eastern respiratory syndrome coronavirus; M: male; F: female.</p></fn></table-wrap-foot></table-wrap></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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