Association of Higher MERS-CoV Virus Load with Severe Disease and Death, Saudi Arabia, 2014

Feikin, Daniel R.; Alraddadi, Basem; Mohammed, Qutub; Shabouni, Omaima I.; Curns, Aaron T.; Oboho, Ikwo; Tomczyk, Sara; Wolff, Bernard J.; Watson, John T.; Madani, Tariq A.

doi:10.3201/eid2111.150764

Cited by 85 publications

(91 citation statements)

References 23 publications

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“…Previous studies have shown that the severities of the illnesses caused by avian influenza are linked to host factors, including chronic diseases, immuno-suppressive disorders, delayed confirmation of infection and late antiviral treatment [5,24,25,26,27], as well as virus factors such as pathogenicity, replications and mutations [25,28]. In the present study, we aimed to identify the high risks associated with host factors with regard to fatal outcomes.…”

Section: Discussionmentioning

confidence: 99%

Comparative Epidemiology of Human Fatal Infections with Novel, High (H5N6 and H5N1) and Low (H7N9 and H9N2) Pathogenicity Avian Influenza A Viruses

Zhang²,

Zhao

et al. 2017

IJERPH

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This study aimed to assess the mortality risks for human infection with high (HPAI) and low (LPAI) pathogenicity avian influenza viruses. The HPAI case fatality rate (CFR) was far higher than the LPAI CFR [66.0% (293/444) vs. 68.75% (11/16) vs. 40.4% (265/656) vs. 0.0% (0/18) in the cases with H5N1, H5N6, H7N9, and H9N2 viruses, respectively; p < 0.001]. Similarly, the CFR of the index cases was greater than the secondary cases with H5N1 [100% (43/43) vs. 43.3% (42/97), p < 0.001]. Old age [22.5 vs. 17 years for H5N1, p = 0.018; 61 vs. 49 years for H7H9, p < 0.001], concurrent diseases [18.8% (15/80) vs. 8.33% (9/108) for H5N1, p = 0.046; 58.6% (156/266) vs. 34.8% (135/388) for H7H9, p < 0.001], delayed confirmation [13 vs. 6 days for H5N1, p < 0.001; 10 vs. 8 days for H7N9, p = 0.011] in the fatalities and survivors, were risk factors for deaths. With regard to the H5N1 clusters, exposure to poultry [67.4% (29/43) vs. 45.2% (19/42), p = 0.039] was the higher risk for the primary than the secondary deaths. In conclusion, old age, comorbidities, delayed confirmation, along with poultry exposure are the major risks contributing to fatal outcomes in human HPAI and LPAI infections.

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Section: Discussionmentioning

confidence: 99%

Comparative Epidemiology of Human Fatal Infections with Novel, High (H5N6 and H5N1) and Low (H7N9 and H9N2) Pathogenicity Avian Influenza A Viruses

Zhang²,

Zhao

et al. 2017

IJERPH

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“…22 In Korea, 36 (19.9%) of 181 confirmed MERS-CoV cases were HCWs. 27 Systematic thorough screening for MERS-CoV among contacts is needed for effective infection control of outbreaks. Comparing MERS-CoV with severe acute respiratory syndrome (SARS), most HCWs with SARS had symptomatic infection with an associated high case fatality rate.…”

Section: Discussionmentioning

confidence: 99%

Middle East respiratory syndrome coronavirus transmission among health care workers: Implication for infection control

Alfaraj

Al‐Tawfiq

Altuwaijri

et al. 2018

American Journal of Infection Control

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The role of HCWs in MERS-CoV transmission is complex. Although most MERS-CoV-infected HCWs are asymptomatic or have mild disease, fatal infections can occur and HCWs can play a major role in propagating health care facility outbreaks. This investigation highlights the need to continuously review infection control guidance relating to the role of HCWs in MERS-CoV transmission in health care outbreaks, especially as it relates to the complex questions on definition of risky exposures, who to test, and the frequency of MERS-CoV testing; criteria for who to quarantine and for how long; and clearance and return to active duty criteria.

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“…These factors were related with severe disease and poor prognosis of MERS in previous reports. 1,12,13,15,16,34,35 Our study has several strengths and limitations. Due to its retrospective nature, there may be a bias regarding collecting medical information in retrospective manner.…”

Section: Discussionmentioning

confidence: 99%

Predictive factors for pneumonia development and progression to respiratory failure in MERS-CoV infected patients

Park

Lee

et al. 2016

Journal of Infection

132

123

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Association of Higher MERS-CoV Virus Load with Severe Disease and Death, Saudi Arabia, 2014

Abstract: More data are needed to determine whether modulation of virus load by therapeutic agents affects clinical outcomes.

Cited by 85 publications

References 23 publications

Comparative Epidemiology of Human Fatal Infections with Novel, High (H5N6 and H5N1) and Low (H7N9 and H9N2) Pathogenicity Avian Influenza A Viruses

Comparative Epidemiology of Human Fatal Infections with Novel, High (H5N6 and H5N1) and Low (H7N9 and H9N2) Pathogenicity Avian Influenza A Viruses

Middle East respiratory syndrome coronavirus transmission among health care workers: Implication for infection control

Predictive factors for pneumonia development and progression to respiratory failure in MERS-CoV infected patients

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