Clinical characteristics and outcome of ICU admitted MERS corona virus infected patients

Abstract

Middle East Respiratory Syndrome (MERS) is a novel respiratory illness firstly reported in Saudi Arabia in 2012. It is caused by a new corona virus, called MERS corona virus (MERS-CoV). Most people who have MERS-CoV infection developed severe acute respiratory illness.Aim of the work: This work is done to determine the clinical characteristics and the outcome of intensive care unit (ICU) admitted patients with confirmed MERS-CoV infection.Patients and methods: This study included 32 laboratory confirmed MERS corona virus infected patients who were admitted into ICU. It included 20 (62.50%) males and 12 (37.50%) females. The mean age was 43.99 ± 13.03 years. Diagnosis was done by real-time reverse transcription polymerase chain reaction (rRT-PCR) test for corona virus on throat swab, sputum, tracheal aspirate, or bronchoalveolar lavage specimens. Clinical characteristics, co-morbidities and outcome were reported for all subjects.Results: The main symptoms among the included patients were: fever (96.87%), cough (93.75%), dyspnea (90.62%), sore throat (75%), runny nose (75%), sputum (50%), headache (43.75%), myalgia (40.62%), chest pain (37.50%), hemoptysis (37.50%), nausea and vomiting (34.37%), abdominal pain (21.87%) and diarrhea (15.62%). The presence of abdominal symptoms is significantly (P < 0.05) associated with bad prognosis. Out of the included 32 patients, 18 patients (56.25%) survived and 14 patients (43.75%) expired. There was a statistically significant difference in the duration of symptoms before hospitalization, mechanical ventilation and ICU and total hospital stay between the expired group and survivors (P < 0.01). Current smoking and smoking severity were statistically significantly (P < 0.01) higher in the expired group compared to survivors. Also, there was a statistically (P < 0.05) significant positive correlation between mortality and smoking severity (r = 0.640). Most of the expired patients presented with bilateral pulmonary infiltrates or unilateral infiltrates, but most of the survivors presented with normal This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). radiology or increased bronchovascular markings, and this difference in the results was statistically highly significant (P < 0.01). There were statistically highly significant (P < 0.01) differences in the mean values of APACHE II score (21.11 ± 3.70 vs 24.21 ± 3.82), SOFA score (5.83 ± 2.64 vs 8.85 ± 2.17) and CPIS (7.55 ± 1.14 vs 8.64 ± 1.39) between the expired group and survivors respectively. Also, there was a statistically significant decrease in PH, PaO 2 , O 2 saturation and HCO 3 (P < 0.05) among the expired group in comparison with the survivors, but no statistical difference regarding PaCO 2 (P > 0.05). There was a statistically significant positive correlation between mortality and old age (r = 0.633), obesity (r = 0.712), diabetes mellitus (r = 0.685), renal failure (r = 0.705), chronic heart diseases (0.591), COPD (r = 0.523), malignancy (r = 0.692), kidney...

COVID-19, MERS and SARS with Concomitant Liver Injury—Systematic Review of the Existing Literature

“…Most of the studies (n = 35) [2,4,12,13,[16][17][18][19][20][21][22][23][24][25]27,[30][31][32][33][35][36][37][38][40][41][42][44][45][46][47][48][49][50][51][52] were observational and retrospective. We extracted data from eleven (n = 11) English abstracts provided for Chinese articles [17,26,30,32,34,35,37,38,42,44,48] and for one (n = 1) commentary [19].…”

“…There were 11 (n = 11) [2,4,12,[16][17][18][19][20][21][22][23] studies focusing on SARS CoV-2 and 23 (n = 23) [13, which reported data on patients infected with SARS CoV-1. MERS had the last amount of data (n = 9) [8,[46][47][48][49][50][51][52][53]. Overall, we analyzed clinical characteristics of 4591 subjects, most with SARS CoV-2 (n = 2541), followed by SARS CoV-1 (n = 1894) and MERS (n = 156).…”

Prevalence and risk factors of mortality among hospitalized patients with COVID-19: A systematic review and Meta-analysis

“…The challenge of COVID-19 is very high globally due to a lack of proven treatment and the complexity of its transmission 13,[21][22][23][24][25][26][27] . However, it will be more catastrophic for low and middleincome countries because of very poor health care system, high illiteracy and low awareness of the disease and its prevention, lack of skilled health personnel, scarce Intensive Care Unit, a limited number of mechanical ventilators and prevalence of co-morbidities/infection along with malnutrition.…”

“…The outcomes of patients with coronavirus infection are very variable. Studies revealed that in hospital mortality of patients with COVID-19 was very high which varied from 1% 52% of hospitalized patients 21,[23][24][25]32,[34][35][36][37] . Studies also showed that rate of ICU admission among coronavirus infected patients were higher which ranged from 3% to 100% of confirmed cases 11,21,[23][24][25]27,28,32,36,[38][39][40] .…”

“…Studies revealed that in hospital mortality of patients with COVID-19 was very high which varied from 1% 52% of hospitalized patients 21,[23][24][25]32,[34][35][36][37] . Studies also showed that rate of ICU admission among coronavirus infected patients were higher which ranged from 3% to 100% of confirmed cases 11,21,[23][24][25]27,28,32,36,[38][39][40] . Studies also showed that the prevalence of mortality among intensive care patients with coronavirus infection was very high which ranged from 6% to 86% of admitted patients 11,21,[23][24][25]27,28,32,36,[38][39][40] .…”