Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study

By A. Assiri, J. Al-Tawfiq, A. Al-Rabeeah, F. Al-rabiah, S. Al-Hajjar, A. Al-Barrak, H. Flemban, Wafa Alnassir, H. Balkhy, Rafat F Al-Hakeem and 3 more. Lancet. Infectious Diseases (Print), 2013

1,386 citations recorded by the source corpus.

Summary Background Middle East respiratory syndrome (MERS) is a new human disease caused by a novel coronavirus (CoV). Clinical data on MERS-CoV infections are scarce. We report epidemiological, demographic, clinical, and laboratory characteristics of 47 cases of MERS-CoV infections, identify knowledge gaps, and define research priorities. Methods We abstracted and analysed epidemiological, demographic, clinical, and laboratory data from confirmed cases of sporadic, household, community, and health-care-associated MERS-CoV infections reported from Saudi Arabia between Sept 1, 2012, and June 15, 2013. Cases were confirmed as having MERS-CoV by real-time RT-PCR. Findings 47 individuals (46 adults, one child) with laboratory-confirmed MERS-CoV disease were identified; 36 (77%) were male (male:female ratio 3·3:1). 28 patients died, a 60% case-fatality rate. The case-fatality rate rose with increasing age. Only two of the 47 cases were previously healthy; most patients (45 [96%]) had underlying comorbid medical disorders, including diabetes (32 [68%]), hypertension (16 [34%]), chronic cardiac disease (13 [28%]), and chronic renal disease (23 [49%]). Common symptoms at presentation were fever (46 [98%]), fever with chills or rigors (41 [87%]), cough (39 [83%]), shortness of breath (34 [72%]), and myalgia (15 [32%]). Gastrointestinal symptoms were also frequent, including diarrhoea (12 [26%]), vomiting (ten [21%]), and abdominal pain (eight [17%]). All patients had abnormal findings on chest radiography, ranging from subtle to extensive unilateral and bilateral abnormalities. Laboratory analyses showed raised concentrations of lactate dehydrogenase (23 [49%]) and aspartate aminotransferase (seven [15%]) and thrombocytopenia (17 [36%]) and lymphopenia (16 [34%]). Interpretation Disease caused by MERS-CoV presents with a wide range of clinical manifestations and is associated with substantial mortality in admitted patients who have medical comorbidities. Major gaps in our knowledge of the epidemiology, community prevalence, and clinical spectrum of infection and disease need urgent definition. Funding None.

Subfields: Infectious Diseases

View Paper: https://www.semanticscholar.org/paper/5cefa6972b13eb81665ac1bc60a46756d48408c7

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In Infectious Diseases

Citations in the corpus

Recognition of aerosol transmission of infectious agents: a commentary (2019, result): “Although several studies compared and contrasted SARS and MERS from clinical and epidemiological angles [43] [44] [45] , the predominant transmission mode was not discussed in detail, if at all.”
Plasma IP-10 and MCP-3 levels are highly associated with disease severity and predict the progression of COVID-19 (2020, neutral): “5 (22-78) 63 (38-74) 65 (46-73) Age subgroups (y) 0-15 0 of 50 (0%) 0 of 14 (0%) 0 of 25 (0%) 0 of 11 (0%) 16-59 18 of 50 (36%) 9 of 14 (64.”
The SARS, MERS and novel coronavirus (COVID-19) epidemics, the newest and biggest global health threats: what lessons have we learned? (2020, methodology): “Severe cases were subjected to laboratory testing.(13) Similar to COVID-19, RT-PCR was used for diagnosis.”
Longitudinal characteristics of lymphocyte responses and cytokine profiles in the peripheral blood of SARS-CoV-2 infected patients (2020, background): “A detailed clinical study showed that 14 % of MERS patients had leukopenia, while 34 % of the patients had lymphopenia[14].”
Clinical Features of COVID-19-Related Liver Functional Abnormality (2020, neutral): “The levels of LDH in the patients with severe acute respiratory syndrome and Middle East respiratory syndrome are also increased.(20,21) and can be seen as an independent risk factor for severe acute respiratory syndrome.”
From SARS to MERS, Thrusting Coronaviruses into the Spotlight (2019, background): “Nosocomial transmission for MERS has similarly been seen in the Middle East [16] and in the Republic of Korea [22] .”
Chest CT Severity Score: An Imaging Tool for Assessing Severe COVID-19 (2020, background): “coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) [6,7].”
Clinical characteristics of fatal and recovered cases of coronavirus disease 2019 in Wuhan, China: a retrospective study (2020, background): “Previous studies also showed that the transaminases were elevated in the MERS and SARS patients.([20-23]) A recent study showed that elderly patients infected with 2019-nCoV have higher CRP levels.”
Gastrointestinal Manifestations of SARS-CoV-2 Infection and Virus Load in Fecal Samples From a Hong Kong Cohort: Systematic Review and Meta-analysis (2020, neutral): “Similarly, up to a quarter of patients with MERS also reported gastrointestinal symptoms such as diarrhea or abdominal pain.(10) In our COVID-19 cohort in Hong Kong, 22% of patients reported diarrhea, which was slightly higher than our previous SARS cohort.”
Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID‐19) implicate special control measures (2020, background): “Similar to SARS, common laboratory findings include leukopenia,(79,80,84,89) elevated LDH, AST, thrombocytopenia, and lymphopenia.(79) 2.”