Where we missed? Middle East Respiratory Syndrome (MERS-CoV) epidemiology in Saudi Arabia; 2012–2019

Abstract

MERS-CoV first case was reported on 23rd November 2012 in Saudi Arabia, Since, then MERS has remained on World Health Organization (WHO) Blueprint list and declared pandemic. This study was conducted on MERS lab confirmed cases reported to Ministry of Health, Saudi Arabia and WHO for year 2012–2019. The epidemiology was investigated based on infection rate, death rate, case fatality rate, Gender, Age group, and Medical conditions (Comorbid and Symptomatic). The overall median age of infected male was 58 years and of female was 45 years. While average mortality age in male was 60 years and of female was 65 years which is greater than the global average of 50 years. The results also report that specially after age of 40 years in both men and women, chances of infection are more while comorbidities increase the infection rate. The men are more susceptible to infection than women. In case of asymptomatic distribution trend was vice versa with 69.4% women and 30.6% in men. Second, most infected age group was reduced by 20 years in case of men with 47.37% infection for age group of 20–39 years. This was also observed in age-group of 20–39 years for no comorbid cases (men (50%) & women (79%)). This explains MERS-CoV prevalence in Saudi Arabia, as young and healthy population were infected, and acted as carrier and on coming in contact with vulnerable population (Elderly, chronic and comorbid) transferred the infection. Hence, MERS-CoV outbreak kept on happening from time to time over past years. This finding might very well explain the exponential spread of Novel CoV-19 globally, as initial control measures required older people to stay indoors while younger generation brought infection from outside. Further studies are required for epidemiology analysis based on clusters, travel history and specific disease related mortality.

The direct and indirect effects of bioactive compounds against coronavirus

“…Although the MERS‐CoV was diagnosed as the human respiratory pathogen in June 2012 in Saudi Arabia, as of April 15, 2020, globally a total of 2468 MERS‐CoV confirmed cases were reported (Khan et al., 2020 ). The MERS‐CoV, which is a betacoronavirus belonging to lineage C, is an enveloped virus with a single‐stranded RNA genome with a size of about 30 kb.…”

MERS-CoV Confirmation among 6,873 suspected persons and relevant Epidemiologic and Clinical Features, Saudi Arabia — 2014 to 2019

“…MERS-CoV patients were hospitalized for an average of 18 days, two-thirds (64%) developed organ complications, more than a quarter (29%) developed severity requiring ventilation, and 21% died at hospital. Our findings on key characteristics of MERS-CoV (percent with comorbidity, days of hospitalization, percent who require ventilation, case fatality rate) are in the lowest range of values reported to date [ 7 , 15 , 34 , 35 ]. Our report updates information on the most common concurrent infections that are likely to be observed in settings that have implemented most advanced infection control measures.…”

“…This would mean that men aged 40-60 years in Saudi Arabia have greater exposure to the source of infection than women. Further, the high prevalence of metabolic diseases -related pathophysiology in men [ 14 , 34 , 35 , 40 , 41 ] predisposes them to the expression of MERS-CoV disease. KSA has the 4 th largest camel to population ratio (1 to 40 persons) after Somalia, Mauritania (1 to 1.4) and Sudan (1 to 8.6) [ 39 , 48 ].…”

Prevalence of Common Respiratory Viruses in Children at a Tertiary Care Hospital in Saudi Arabia

“…4 It is worth mentioning that Middle East Respiratory Syndrome-related Coronavirus (MERS-CoV) is not included in the respiratory panel test in our hospital. Indeed, Khan et al 7 found that the MERS-CoV infection ratio have significantly declined during 2016-2019 with the least infected ages on average being below 20 years old (ref).…”