Predictors of Mortality Among Confirmed, Symptomatic MERS Cases in KSA 2012-2015 Open Access
Kashkary, Abdulhameed Mohammed (2016)
Abstract
BACKGROUND: Since the 1960s when human coronaviruses (HCoVs) were first described, they were only associated with the common cold. Since 2003 scientists and health communities were giving more attention to coronaviruses after discovering the Severe Acute Respiratory Syndrome (SARS) Coronaviruse (CoV) and the Middle East Respiratory Syndrome (MERS-CoV) in 2012. SARS and MERS both have a relationship with the Acute Respiratory Distress Syndrome (ARDS), and both have high case fatality rates.
OBJECTIVE: The objective of this study is to describe the survival experience of confirmed symptomatic MERS patients in the Kingdom of Saudi Arabia from July 2012 to December 2015 and looking for factors that are significantly related to their survival experience.
METHODS:The dataset for this study was received from Saudi's Ministry of Health (SMoH), department of public health for the period of 2012 to the end of December 2015. Descriptive analysis and Cox Proportional Hazards Model were applied to address the relationship between the survival of the patients and the variables of interest.
RESULTS: There were 1128 confirmed symptomatic MERS cases reported to SMoH from September 2012 to the end of December 2015 (48.67% mortality rate). Several factors were associated with mortality of confirmed symptomatic MERS. Being a health care personal (HCP) and infected inside the health care facility as a secondary case (HCP) means that their hazard of death is 18.5% of the hazard of death among cases who acquired their disease from the community as primary cases (HRadj 0.185, CI 0.105-0.327, p-value <.0001). In contrast, the hazard of death of symptomatic MERS cases who acquired their infection in a health care facility are 41% more than the hazard of death of cases who are acquiring their disease from the community (HRadj 1.409, CI 1.105-1.798, p-value 0.0057). Also, the hazard of death of symptomatic MERS cases who were 71 years and older was 152% more than the hazard of death of symptomatic MERS cases who were 40 year and less (HRadj 2.520, CI 1.890-3.361, p-value <.0001). The history of camel contact has been investigated as the reservoir / or source of infection, but the data are not statistically significant associated with the MERS mortality.
Table of Contents
Acknowledgements - - - - - - - - - - - - - - - - - - - 7
Table of Contents - - - - - - - - - - - - - - - - - - - - 8
Chapter 1 - Introduction - - - - - - - - - - - - - - - -9
Chapter 2 - Literature Review - - - - - - - - - - - - 12
Chapter 3 - Self-Contained Manuscript - - - - - - 20
Abstract - - - - - - - - - - - - - - - - - - - - - - - - - - 20
Introduction- - - - - - - - - - - - - - - - - - - - - - - -20
Methods - - - - - - - - - - - - - - - - - - - - - - - - - - 23
Results - - - - - - - - - - - - - - - - - - - - - - - - - - - 26
Discussion - - - - - - - - - - - - - - - - - - - - - - - - - 31
Chapter 4 - Conclusion and Recommendations - - - - 34
Reference - - - - - - - - - - - - - - - - - - - - - - - - - -35
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