Abstract
The Middle East respiratory syndrome coronavirus (MERS-CoV) is a life-threatening respiratory disease with a high case fatality rate; however, its risk factors remain unclear. We aimed to explore the influence of demographic factors, clinical manifestations and underlying comorbidities on mortality in MERS-CoV patients. Retrospective chart reviews were performed to identify all laboratory-confirmed cases of MERS-COV infection in Saudi Arabia that were reported to the Ministry of Health of Saudi Arabia between 23 April 2014 and 7 June 2016. Statistical analyses were conducted to assess the effect of sex, age, clinical presentation and comorbidities on mortality from MERS-CoV. A total of 281 confirmed MERS-CoV cases were identified: 167 (59.4%) patients were male and 55 (20%) died. Mortality predominantly occurred among Saudi nationals and older patients and was significantly associated with respiratory failure and shortness of breath. Of the 281 confirmed cases, 160 (56.9%) involved comorbidities, wherein diabetes mellitus, hypertension, ischemic heart disease, congestive heart failure, end-stage renal disease and chronic kidney disease were significantly associated with mortality from MERS-CoV and two or three comorbidities significantly affected the fatality rates from MERS-CoV. The findings of this study show that old age and the existence of underlying comorbidities significantly increase mortality from MERS-CoV.
Highlights
The first case of Middle East respiratory syndrome coronavirus (MERS-CoV) was reported in Saudi Arabia in 2012 and the novel causative virus, MERS-CoV, was identified [1, 2]
0.001*
The demographic features of the laboratory-confirmed cases of MERS-COV infection in the current study showed that only nine patients were aged 61 years
Summary
The first case of Middle East respiratory syndrome coronavirus (MERS-CoV) was reported in Saudi Arabia in 2012 and the novel causative virus, MERS-CoV, was identified [1, 2]. 2040 laboratory-confirmed cases of MERS-CoV infection have been reported to the World Health Organization [3] from 27 countries [3]. Owing to the high mortality rate and the lack of antiviral treatment or a preventative vaccine, MERS-CoV remains a major public health concern. Coronaviruses are enveloped, positive-sense, single-stranded RNA viruses that belong to the subfamily Coronavirinae within the Nidovirales order, which are further subdivided into four genera: alpha, beta, gamma and delta. Human coronaviruses belong to the alpha and beta genera [4]
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