Epidemiology and predictors of survival of MERS-CoV infections in Riyadh region, 2014–2015

Al-Jasser, Fahad; Nouh, Randa M.; Youssef, Randa M.

doi:10.1016/j.jiph.2018.09.008

Cited by 23 publications

(13 citation statements)

References 30 publications

(30 reference statements)

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“…We identified 11 studies on MERS-CoV. Three studies (324 participants) reporting MERS-CoV shedding in the upper respiratory tract 99 , 100 , 101 and four studies (93 participants) reporting MERS-CoV shedding in the lower respiratory tract 91 , 92 , 96 , 101 were included in the quantitative analysis. The mean shedding duration was 15·3 days (95% CI 11·6–19·0) in the upper respiratory tract and 16·3 days (13·8–18·9) in the lower respiratory tract ( Figure 3 , Figure 4 ).…”

Section: Resultsmentioning

confidence: 99%

SARS-CoV-2, SARS-CoV, and MERS-CoV viral load dynamics, duration of viral shedding, and infectiousness: a systematic review and meta-analysis

et al. 2021

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Background Viral load kinetics and duration of viral shedding are important determinants for disease transmission. We aimed to characterise viral load dynamics, duration of viral RNA shedding, and viable virus shedding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in various body fluids, and to compare SARS-CoV-2, SARS-CoV, and Middle East respiratory syndrome coronavirus (MERS-CoV) viral dynamics. Methods In this systematic review and meta-analysis, we searched databases, including MEDLINE, Embase, Europe PubMed Central, medRxiv, and bioRxiv, and the grey literature, for research articles published between Jan 1, 2003, and June 6, 2020. We included case series (with five or more participants), cohort studies, and randomised controlled trials that reported SARS-CoV-2, SARS-CoV, or MERS-CoV infection, and reported viral load kinetics, duration of viral shedding, or viable virus. Two authors independently extracted data from published studies, or contacted authors to request data, and assessed study quality and risk of bias using the Joanna Briggs Institute Critical Appraisal Checklist tools. We calculated the mean duration of viral shedding and 95% CIs for every study included and applied the random-effects model to estimate a pooled effect size. We used a weighted meta-regression with an unrestricted maximum likelihood model to assess the effect of potential moderators on the pooled effect size. This study is registered with PROSPERO, CRD42020181914. Findings 79 studies (5340 individuals) on SARS-CoV-2, eight studies (1858 individuals) on SARS-CoV, and 11 studies (799 individuals) on MERS-CoV were included. Mean duration of SARS-CoV-2 RNA shedding was 17•0 days (95% CI 15•5-18•6; 43 studies, 3229 individuals) in upper respiratory tract, 14•6 days (9•3-20•0; seven studies, 260 individuals) in lower respiratory tract, 17•2 days (14•4-20•1; 13 studies, 586 individuals) in stool, and 16•6 days (3•6-29•7; two studies, 108 individuals) in serum samples. Maximum shedding duration was 83 days in the upper respiratory tract, 59 days in the lower respiratory tract, 126 days in stools, and 60 days in serum. Pooled mean SARS-CoV-2 shedding duration was positively associated with age (slope 0•304 [95% CI 0•115-0•493]; p=0•0016). No study detected live virus beyond day 9 of illness, despite persistently high viral loads, which were inferred from cycle threshold values. SARS-CoV-2 viral load in the upper respiratory tract appeared to peak in the first week of illness, whereas that of SARS-CoV peaked at days 10-14 and that of MERS-CoV peaked at days 7-10. Interpretation Although SARS-CoV-2 RNA shedding in respiratory and stool samples can be prolonged, duration of viable virus is relatively short-lived. SARS-CoV-2 titres in the upper respiratory tract peak in the first week of illness. Early case finding and isolation, and public education on the spectrum of illness and period of infectiousness are key to the effective containment of SARS-CoV-2. Funding None.

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Section: Resultsmentioning

confidence: 99%

SARS-CoV-2, SARS-CoV, and MERS-CoV viral load dynamics, duration of viral shedding, and infectiousness: a systematic review and meta-analysis

et al. 2021

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“…Seven studies [ 3 , 63 , 65 , 67 , 72 , 77 , 80 ] reported the highest rate of urgent-start KRT use (35.0%, 95% CI: 16.8%–55.4%) in hospitalized patients with MERS. The mortality rate of urgent-start KRT patients with MERS was 85.5% (95% CI: 78.9%–91.2%) in four studies [ 65 , 67 , 72 , 80 ]. The use of urgent-start KRT was also associated with a higher risk of mortality in MERS patients (Four studies [ 65 , 67 , 72 , 80 ], OR 4.56, 95% CI 1.49 to 13.90, p = 0.008; I 2 = 93%, p < 0.00001, Figure 3 ).…”

Section: Resultsmentioning

confidence: 99%

Coronavirus-associated kidney outcomes in COVID-19, SARS, and MERS: a meta-analysis and systematic review

Zhou

Xue

et al. 2020

Renal Failure

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Objectives: A meta-analysis and systematic review was conducted on kidney-related outcomes of three recent pandemics: SARS, MERS, and COVID-19, which were associated with potentially fatal acute respiratory distress syndrome (ARDS). Methods: A search of all published studies until 16 June 2020 was performed. The incidence/ prevalence and mortality risk of acute and chronic renal events were evaluated, virus prevalence, and mortality in preexisting hemodialysis patients was investigated. Results: A total of 58 eligible studies involving 13452 hospitalized patients with three types of coronavirus infection were included. The reported incidence of new-onset acute kidney injury (AKI) was 12.5% (95% CI: 7.6%-18.3%). AKI significantly increased the mortality risk (OR ¼ 5.75, 95% CI 3.75-8.77, p < 0.00001) in patients with coronavirus infection. The overall rate of urgentstart kidney replacement therapy (urgent-start KRT) use was 8.9% (95% CI: 5.0%-13.8%) and those who received urgent-start KRT had a higher risk of mortality (OR ¼ 3.43, 95% CI 2.02-5.85, p < 0.00001). Patients with known chronic kidney disease (CKD) had a higher mortality than those without CKD (OR ¼ 1.97, 95% CI 1.56-2.49, p < 0.00001). The incidence of coronavirus infection was 7.7% (95% CI: 4.9%-11.1%) in prevalent hemodialysis patients with an overall mortality rate of 26.2% (95% CI: 20.6%-32.6%). Conclusions: Primary kidney involvement is common with coronavirus infection and is associated with significantly increased mortality. The recognition of AKI, CKD, and urgent-start KRT as major risk factors for mortality in coronavirus-infected patients are important steps in reducing future mortality and long-term morbidity in hospitalized patients with coronavirus infection.

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“…55 Complete resolution in the chest CT could be observed only at 4 weeks or longer after the onset of symptoms. 22,56 The radiological manifestation should be tracked until the complete resolution of pulmonary lesions in chest radiographs or CT scanning. [57][58][59][60] In the rehabilitation period, fibrotic changes in the lungs did not resolve in some patients.…”

Section: Radiology and Pulmonary Function In Surveillancementioning

confidence: 99%

“…A significantly greater number of intensive care unit admission days, older age, higher chest radiographic scores, chest radiographic deterioration patterns, and peak lactate dehydrogenase levels were observed in patients with lung fibrosis 55 . Complete resolution in the chest CT could be observed only at 4 weeks or longer after the onset of symptoms 22,56 . The radiological manifestation should be tracked until the complete resolution of pulmonary lesions in chest radiographs or CT scanning 57‐60 …”

Section: The Follow‐up Strategiesmentioning

confidence: 99%

Patient follow‐up after discharge after COVID‐19 pneumonia: Considerations for infectious control

Zhong

Yao

et al. 2020

Journal of Medical Virology

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Coronavirus disease 2019 (COVID-19) represents a significant global medical issue, with a growing number of cumulative confirmed cases. However, a large number of COVID-19 patients have overcome the disease, meeting hospital discharge criteria, and are gradually returning to work and social life. Nonetheless, COVID-19 may cause further downstream issues in these patients, such as due to possible reactivation of the virus, long-term pulmonary defects, and post-traumatic stress disorder. In this study, we therefore queried relevant literature concerning SARS, MERS, and COVID-19 for reference to come to a consensus on follow-up strategies. We found that strategies such as implementation of PCR testing, imaging surveillance, and psychological assessments, starting at the time of discharge, were necessary for long-term follow-up. If close care is given to every aspect of coronavirus management, we expect that the pandemic outbreak will soon be overcome. Role of the Funder/SponsorThe funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Ethical StatementAll analyses were based on previously published studies. Thus, no ethical approval and patient consent are required.

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Epidemiology and predictors of survival of MERS-CoV infections in Riyadh region, 2014–2015

Cited by 23 publications

References 30 publications

SARS-CoV-2, SARS-CoV, and MERS-CoV viral load dynamics, duration of viral shedding, and infectiousness: a systematic review and meta-analysis

SARS-CoV-2, SARS-CoV, and MERS-CoV viral load dynamics, duration of viral shedding, and infectiousness: a systematic review and meta-analysis

Coronavirus-associated kidney outcomes in COVID-19, SARS, and MERS: a meta-analysis and systematic review

Patient follow‐up after discharge after COVID‐19 pneumonia: Considerations for infectious control

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