Systematic Narrative Review of MERS-CoV Risk of Severe Disease and Death, Kingdom of Saudi Arabia, 2017 Open Access

Jumbi, Roaa Kamil (2017)

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Introduction: The factors leading to severe life-threatening manifestations and death associated with Middle East respiratory syndrome coronavirus (MERS-CoV or MERS) are not well defined. As with any newly emerging pathogen, this study aims to systematically review the risk of death among MERS-infected patients, as well as assess the risk of required mechanical ventilation and intensive care unit (ICU) admission.

Method: Using Pubmed and Web-of-Science databases, a search was performed for studies of MERS. Articles reporting clinical outcomes of severe (confirmed) case-patients with MERS in the Kingdom of Saudi Arabia (KSA) were included. Specifically, studies that reviewed the risk of mechanical ventilation, ICU admission, and death were the focus of this study.

Results: Of 21 eligible articles, most focused on patients in ICUs; these had higher death rates. Five articles reported 100% of MERS case-patients admitted to ICU received mechanical ventilation. Twice as many males as females were reported.

Conclusion: Given the extensive complications and fatality rates associated with MERS, further research should provide a better understanding of transmission, its clinical course and association with severe manifestations and death. The initiation of well-designed research in the KSA Ministry of Health is important to improve preparedness and strategy planning. This could aid in building effective public health surveillance, evidence-based strategies and recommendations for MERS management and prevention.

Table of Contents

1. Introduction a. Rationale b. Objectives 2. Method

a. Eligibility criteria

b. Information sources

c. Search strategy

d. Study selection

e. Data collection

f.Data synthesis and analysis

3. Results a. Study selection b. Study characteristics d. Results of individual studies 4. Discussion a. Summary of evidence b. Limitations c. Conclusion 5. Funding References Appendices

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