Predictors of MERS-CoV infection: A large case control study of patients presenting with ILI at a MERS-CoV referral hospital in Saudi Arabia
Identifieur interne : 001153 ( Pmc/Curation ); précédent : 001152; suivant : 001154Predictors of MERS-CoV infection: A large case control study of patients presenting with ILI at a MERS-CoV referral hospital in Saudi Arabia
Auteurs : Hamzah A. Mohd [Arabie saoudite] ; Ziad A. Memish [Arabie saoudite] ; Sarah H. Alfaraj [Arabie saoudite] ; Donna Mcclish [États-Unis] ; Talal Altuwaijri [Arabie saoudite] ; Marzouqah S. Alanazi [Arabie saoudite] ; Saleh A. Aloqiel [Arabie saoudite] ; Ahmed M. Alenzi [Arabie saoudite] ; Fahad Bafaqeeh [Arabie saoudite] ; Amal M. Mohamed [Arabie saoudite] ; Kamel Aldosari [Arabie saoudite] ; Sameeh Ghazal [Arabie saoudite]Source :
- Travel Medicine and Infectious Disease [ 1477-8939 ] ; 2016.
Abstract
A case control study to better characterize the clinical features, laboratory, and radiological abnormalities associated with MERS-CoV infection in order to help with early identification of this syndrome from other respiratory infections.
Eighty patients admitted to a hospital in Riyadh, diagnosed with MERS-CoV infection based on RT-PCR were matched on age, sex, and the presence of a co-morbid condition on a basis of 1:2 to other patients admitted with respiratory symptoms and tested negative for MERS-CoV on RT-PCR.
None of the reported MERS-CoV presenting symptoms was significantly associated with being infected with MERS-CoV. On the other hand, WBC count was significantly lower in patients with confirmed MERS-CoV infection (median 5.7 vs 9.3, P: 0.0004). Neutrophil count was as well significantly lower in MERS-CoV patients (median 3.7 vs 6.7, P: 0.0001). Both AST, and ALT values were significantly higher in MERS-CoV infected group (AST median 42 vs 36, P: 0.03, and ALT median 33 vs 28, P: 0.003). Overall our MERS-CoV mortality rate was (10%) below the national figure of (40%).
None of the presenting symptoms are specific for MERS-CoV infection. And out of all the investigations WBC, neutrophil counts, AST and ALT values have some predictive utility.
Url:
DOI: 10.1016/j.tmaid.2016.09.008
PubMed: 27671972
PubMed Central: 7110705
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Alenzi</name><affiliation wicri:level="1"><nlm:aff id="aff8">Department of Medicine, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Department of Medicine, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Bafaqeeh, Fahad" sort="Bafaqeeh, Fahad" uniqKey="Bafaqeeh F" first="Fahad" last="Bafaqeeh">Fahad Bafaqeeh</name><affiliation wicri:level="1"><nlm:aff id="aff9">Critical Care Department, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Critical Care Department, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Mohamed, Amal M" sort="Mohamed, Amal M" uniqKey="Mohamed A" first="Amal M." last="Mohamed">Amal M. Mohamed</name><affiliation wicri:level="1"><nlm:aff id="aff10">Nursing Department, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Nursing Department, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Aldosari, Kamel" sort="Aldosari, Kamel" uniqKey="Aldosari K" first="Kamel" last="Aldosari">Kamel Aldosari</name><affiliation wicri:level="1"><nlm:aff id="aff11">Pathology and Laboratory Department, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Pathology and Laboratory Department, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Ghazal, Sameeh" sort="Ghazal, Sameeh" uniqKey="Ghazal S" first="Sameeh" last="Ghazal">Sameeh Ghazal</name><affiliation wicri:level="1"><nlm:aff id="aff12">Medical Affairs, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Medical Affairs, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27671972</idno><idno type="pmc">7110705</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7110705</idno><idno type="RBID">PMC:7110705</idno><idno type="doi">10.1016/j.tmaid.2016.09.008</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">001153</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001153</idno><idno type="wicri:Area/Pmc/Curation">001153</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">001153</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Predictors of MERS-CoV infection: A large case control study of patients presenting with ILI at a MERS-CoV referral hospital in Saudi Arabia</title><author><name sortKey="Mohd, Hamzah A" sort="Mohd, Hamzah A" uniqKey="Mohd H" first="Hamzah A." last="Mohd">Hamzah A. Mohd</name><affiliation wicri:level="1"><nlm:aff id="aff1">Infectious Diseases Division, Department of Medicine, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Infectious Diseases Division, Department of Medicine, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Memish, Ziad A" sort="Memish, Ziad A" uniqKey="Memish Z" first="Ziad A." last="Memish">Ziad A. Memish</name><affiliation wicri:level="1"><nlm:aff id="aff1">Infectious Diseases Division, Department of Medicine, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Infectious Diseases Division, Department of Medicine, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2">College of Medicine, Alfaisal University, Riyadh, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>College of Medicine, Alfaisal University, Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Alfaraj, Sarah H" sort="Alfaraj, Sarah H" uniqKey="Alfaraj S" first="Sarah H." last="Alfaraj">Sarah H. Alfaraj</name><affiliation wicri:level="1"><nlm:aff id="aff3">Infection Control Department, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Infection Control Department, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Mcclish, Donna" sort="Mcclish, Donna" uniqKey="Mcclish D" first="Donna" last="Mcclish">Donna Mcclish</name><affiliation wicri:level="1"><nlm:aff id="aff4">Department of Biostatistics at Virginia Commonwealth University, Richmond, VA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Biostatistics at Virginia Commonwealth University, Richmond, VA</wicri:regionArea></affiliation></author><author><name sortKey="Altuwaijri, Talal" sort="Altuwaijri, Talal" uniqKey="Altuwaijri T" first="Talal" last="Altuwaijri">Talal Altuwaijri</name><affiliation wicri:level="1"><nlm:aff id="aff5">Department of Surgery, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Department of Surgery, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Alanazi, Marzouqah S" sort="Alanazi, Marzouqah S" uniqKey="Alanazi M" first="Marzouqah S." last="Alanazi">Marzouqah S. Alanazi</name><affiliation wicri:level="1"><nlm:aff id="aff6">Emergency Department, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Emergency Department, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Aloqiel, Saleh A" sort="Aloqiel, Saleh A" uniqKey="Aloqiel S" first="Saleh A." last="Aloqiel">Saleh A. Aloqiel</name><affiliation wicri:level="1"><nlm:aff id="aff7">Pediatric Department, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Pediatric Department, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Alenzi, Ahmed M" sort="Alenzi, Ahmed M" uniqKey="Alenzi A" first="Ahmed M." last="Alenzi">Ahmed M. Alenzi</name><affiliation wicri:level="1"><nlm:aff id="aff8">Department of Medicine, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Department of Medicine, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Bafaqeeh, Fahad" sort="Bafaqeeh, Fahad" uniqKey="Bafaqeeh F" first="Fahad" last="Bafaqeeh">Fahad Bafaqeeh</name><affiliation wicri:level="1"><nlm:aff id="aff9">Critical Care Department, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Critical Care Department, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Mohamed, Amal M" sort="Mohamed, Amal M" uniqKey="Mohamed A" first="Amal M." last="Mohamed">Amal M. Mohamed</name><affiliation wicri:level="1"><nlm:aff id="aff10">Nursing Department, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Nursing Department, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Aldosari, Kamel" sort="Aldosari, Kamel" uniqKey="Aldosari K" first="Kamel" last="Aldosari">Kamel Aldosari</name><affiliation wicri:level="1"><nlm:aff id="aff11">Pathology and Laboratory Department, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Pathology and Laboratory Department, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Ghazal, Sameeh" sort="Ghazal, Sameeh" uniqKey="Ghazal S" first="Sameeh" last="Ghazal">Sameeh Ghazal</name><affiliation wicri:level="1"><nlm:aff id="aff12">Medical Affairs, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Medical Affairs, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh</wicri:regionArea></affiliation></author></analytic><series><title level="j">Travel Medicine and Infectious Disease</title><idno type="ISSN">1477-8939</idno><idno type="eISSN">1873-0442</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Summary</title><sec><title>Background</title><p>A case control study to better characterize the clinical features, laboratory, and radiological abnormalities associated with MERS-CoV infection in order to help with early identification of this syndrome from other respiratory infections.</p></sec><sec><title>Methods</title><p>Eighty patients admitted to a hospital in Riyadh, diagnosed with MERS-CoV infection based on RT-PCR were matched on age, sex, and the presence of a co-morbid condition on a basis of 1:2 to other patients admitted with respiratory symptoms and tested negative for MERS-CoV on RT-PCR.</p></sec><sec><title>Results</title><p>None of the reported MERS-CoV presenting symptoms was significantly associated with being infected with MERS-CoV. On the other hand, WBC count was significantly lower in patients with confirmed MERS-CoV infection (median 5.7 vs 9.3, P: 0.0004). Neutrophil count was as well significantly lower in MERS-CoV patients (median 3.7 vs 6.7, P: 0.0001). Both AST, and ALT values were significantly higher in MERS-CoV infected group (AST median 42 vs 36, P: 0.03, and ALT median 33 vs 28, P: 0.003). Overall our MERS-CoV mortality rate was (10%) below the national figure of (40%).</p></sec><sec><title>Conclusions</title><p>None of the presenting symptoms are specific for MERS-CoV infection. And out of all the investigations WBC, neutrophil counts, AST and ALT values have some predictive utility.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Zaki, A M" uniqKey="Zaki A">A.M. Zaki</name></author><author><name sortKey="Boheemena, S" uniqKey="Boheemena S">S. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Travel Med Infect Dis</journal-id><journal-id journal-id-type="iso-abbrev">Travel Med Infect Dis</journal-id><journal-title-group><journal-title>Travel Medicine and Infectious Disease</journal-title></journal-title-group><issn pub-type="ppub">1477-8939</issn><issn pub-type="epub">1873-0442</issn><publisher><publisher-name>Elsevier Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">27671972</article-id><article-id pub-id-type="pmc">7110705</article-id><article-id pub-id-type="publisher-id">S1477-8939(16)30126-0</article-id><article-id pub-id-type="doi">10.1016/j.tmaid.2016.09.008</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Predictors of MERS-CoV infection: A large case control study of patients presenting with ILI at a MERS-CoV referral hospital in Saudi Arabia</article-title></title-group><contrib-group><contrib contrib-type="author" id="au1"><name><surname>Mohd</surname><given-names>Hamzah A.</given-names></name><email>dr.hmohd@gmail.com</email><xref rid="aff1" ref-type="aff">a</xref></contrib><contrib contrib-type="author" id="au2"><name><surname>Memish</surname><given-names>Ziad A.</given-names></name><email>zmemish@yahoo.com</email><xref rid="aff1" ref-type="aff">a</xref><xref rid="aff2" ref-type="aff">b</xref><xref rid="cor1" ref-type="corresp">∗</xref></contrib><contrib contrib-type="author" id="au3"><name><surname>Alfaraj</surname><given-names>Sarah H.</given-names></name><email>alfarajsa@pmah.med.sa</email><xref rid="aff3" ref-type="aff">c</xref></contrib><contrib contrib-type="author" id="au4"><name><surname>McClish</surname><given-names>Donna</given-names></name><email>donna.mcclish@vcuhealth.org</email><xref rid="aff4" ref-type="aff">d</xref></contrib><contrib contrib-type="author" id="au5"><name><surname>Altuwaijri</surname><given-names>Talal</given-names></name><email>altuwaijrit@pmah.med.sa</email><xref rid="aff5" ref-type="aff">e</xref></contrib><contrib contrib-type="author" id="au6"><name><surname>Alanazi</surname><given-names>Marzouqah S.</given-names></name><email>Alanazima@pmah.med.sa</email><xref rid="aff6" ref-type="aff">f</xref></contrib><contrib contrib-type="author" id="au7"><name><surname>Aloqiel</surname><given-names>Saleh A.</given-names></name><email>aloqiels@pmah.med.sa</email><xref rid="aff7" ref-type="aff">g</xref></contrib><contrib contrib-type="author" id="au8"><name><surname>Alenzi</surname><given-names>Ahmed M.</given-names></name><email>alenezia@pmah.med.sa</email><xref rid="aff8" ref-type="aff">h</xref></contrib><contrib contrib-type="author" id="au9"><name><surname>Bafaqeeh</surname><given-names>Fahad</given-names></name><email>bafaqeehf@pmah.med.sa</email><xref rid="aff9" ref-type="aff">i</xref></contrib><contrib contrib-type="author" id="au10"><name><surname>Mohamed</surname><given-names>Amal M.</given-names></name><email>mohameda@pmah.med.sa</email><xref rid="aff10" ref-type="aff">j</xref></contrib><contrib contrib-type="author" id="au11"><name><surname>Aldosari</surname><given-names>Kamel</given-names></name><email>aldosaryk@pmah.med.sa</email><xref rid="aff11" ref-type="aff">k</xref></contrib><contrib contrib-type="author" id="au12"><name><surname>Ghazal</surname><given-names>Sameeh</given-names></name><email>ghazals@pmah.med.sa</email><xref rid="aff12" ref-type="aff">l</xref></contrib></contrib-group><aff id="aff1"><label>a</label>Infectious Diseases Division, Department of Medicine, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia</aff><aff id="aff2"><label>b</label>College of Medicine, Alfaisal University, Riyadh, Saudi Arabia</aff><aff id="aff3"><label>c</label>Infection Control Department, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia</aff><aff id="aff4"><label>d</label>Department of Biostatistics at Virginia Commonwealth University, Richmond, VA, USA</aff><aff id="aff5"><label>e</label>Department of Surgery, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia</aff><aff id="aff6"><label>f</label>Emergency Department, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia</aff><aff id="aff7"><label>g</label>Pediatric Department, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia</aff><aff id="aff8"><label>h</label>Department of Medicine, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia</aff><aff id="aff9"><label>i</label>Critical Care Department, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia</aff><aff id="aff10"><label>j</label>Nursing Department, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia</aff><aff id="aff11"><label>k</label>Pathology and Laboratory Department, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia</aff><aff id="aff12"><label>l</label>Medical Affairs, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia</aff><author-notes><corresp id="cor1"><label>∗</label>Corresponding author. Infectious Diseases Division, Department of Medicine, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia. <email>zmemish@yahoo.com</email></corresp></author-notes><pub-date pub-type="pmc-release"><day>24</day><month>9</month><year>2016</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="ppub" iso-8601-date="2016-10-01"><season>September-October</season><year>2016</year></pub-date><pub-date pub-type="epub"><day>24</day><month>9</month><year>2016</year></pub-date><volume>14</volume><issue>5</issue><fpage>464</fpage><lpage>470</lpage><history><date date-type="received"><day>30</day><month>8</month><year>2016</year></date><date date-type="rev-recd"><day>14</day><month>9</month><year>2016</year></date><date date-type="accepted"><day>16</day><month>9</month><year>2016</year></date></history><permissions><copyright-statement>© 2016 Elsevier Ltd. All rights reserved.</copyright-statement><copyright-year>2016</copyright-year><copyright-holder>Elsevier Ltd</copyright-holder><license><license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p></license></permissions><abstract id="abs0010"><title>Summary</title><sec><title>Background</title><p>A case control study to better characterize the clinical features, laboratory, and radiological abnormalities associated with MERS-CoV infection in order to help with early identification of this syndrome from other respiratory infections.</p></sec><sec><title>Methods</title><p>Eighty patients admitted to a hospital in Riyadh, diagnosed with MERS-CoV infection based on RT-PCR were matched on age, sex, and the presence of a co-morbid condition on a basis of 1:2 to other patients admitted with respiratory symptoms and tested negative for MERS-CoV on RT-PCR.</p></sec><sec><title>Results</title><p>None of the reported MERS-CoV presenting symptoms was significantly associated with being infected with MERS-CoV. On the other hand, WBC count was significantly lower in patients with confirmed MERS-CoV infection (median 5.7 vs 9.3, P: 0.0004). Neutrophil count was as well significantly lower in MERS-CoV patients (median 3.7 vs 6.7, P: 0.0001). Both AST, and ALT values were significantly higher in MERS-CoV infected group (AST median 42 vs 36, P: 0.03, and ALT median 33 vs 28, P: 0.003). Overall our MERS-CoV mortality rate was (10%) below the national figure of (40%).</p></sec><sec><title>Conclusions</title><p>None of the presenting symptoms are specific for MERS-CoV infection. And out of all the investigations WBC, neutrophil counts, AST and ALT values have some predictive utility.</p></sec></abstract><kwd-group id="kwrds0010"><title>Keywords</title><kwd>Middle East Respirator Syndrome</kwd><kwd>MERS-CoV</kwd><kwd>Coronavirus</kwd><kwd>Predictors</kwd><kwd>Mortality</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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