A deadly zoonotic Middle East respiratory syndrome coronavirus (MERS-CoV) had emerged over the last 7 years in the Arabian Peninsula. As of Feb 28, 2018, 2182 cases of MERS-CoV infection (with 779 deaths) in 27 countries were reported to WHO worldwide. The objectives of this study were to identify the clinical and epidemiological characteristics of MERS-CoV infection as well as determine its clinical outcome.
Methods: This was a retrospective-observational study of all laboratory confirmed cases of MERS-CoV infection conducted at the main seven hospitals in the State of Qatar from January, 2012 to April 2018. We used the Fast Track diagnostics real-time reverse-transcription polymerase chain reaction (rRT-PCR), targeting the upE and ORF1a genes respectively. Demographics, clinical information, potential contacts and probable risk factors were collected and analyzed by standard statistical methods.
The mean annual incidence was 1.7 per 100, 0000 person years. Among the 24 confirmed cases of of MERS-CoV, males constituted the vast majority of cases (23 males) with a median age of 52 years (range 22-74). 50% of the cases were Qatari and 42% reside in the same region. 67 % of the cases had contact with camels, and 21% had contact with MERS-CoV infected patient. 38 % had travel history within 2 weeks of symptoms onset to the Kingdom of Saudi Arabia. 50% were smokers and 42% had comorbidities.
The median symptoms duration was 4.5 days. Most of the patient presented with flu-like symptoms, were fever was the most common presentation, followed by cough, SOB, diarrhea, abdominal pain and headache, 96%, 83%, 33%, 8%, 8% and 4 % respectively. All patients were admitted to a tertiary hospital with a median hospital stay 41 days (8-97). 45% patients developed severe sepsis with multi-organ failure and needed ICU admission. 50% patients developed acute kidney injury, 29% patients were on hemodialysis and 16% needed extra-corporeal membrane oxygenation. 33% patients died. The rest of patients had recovered from the infection and discharged home. Among those who died all had one or more comorbidities.
MERS-CoV infection is a rare infection in the State of Qatar, seen in both Qataris and expatriates with and without travel history. The infection in patients with comorbidities carries high mortality.
E. Farag, None
H. Alsoub, None
H. G. Ghazouani, None
M. Mohed Saleh, None
K. M. Dousa, None
A. Al-Khal, None
S. Mahmoud A. Hashim, None
M. Al- Maslamani, None