Predictors of mortality in Middle East respiratory syndrome (MERS)

Thorax. 2018 Mar;73(3):286-289. doi: 10.1136/thoraxjnl-2016-209313. Epub 2017 Jul 19.

Abstract

We evaluated the clinical characteristics, cytokine/chemokine concentrations, viral shedding and antibody kinetics in 30 patients with Middle East respiratory syndrome (MERS), including 6 non-survivors admitted to 3 MERS-designated hospitals. Old age, low albumin, altered mentality and high pneumonia severity index score at admission were risk factors for mortality. In addition, severe signs of inflammation at initial presentation (at hospital days 1-4), such as high inducible protein-10 (p=0.0013), monocyte chemoattractant protein-1 (p=0.0007) and interleukin 6 (p=0.0007) concentrations, and poor viral control (high viral load at hospital days 5-10, p<0.001) without adequate antibody titres (low antibody titre at hospital days 11-16, p=0.07) during the course of disease, were associated with mortality.

Keywords: infection control; respiratory infection; viral infection.

Publication types

  • Letter
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Viral / blood*
  • Coronavirus / genetics
  • Coronavirus Infections / mortality*
  • Cytokines / blood*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Real-Time Polymerase Chain Reaction
  • Risk Factors
  • Survival Rate
  • Viral Load / genetics*

Substances

  • Antibodies, Viral
  • Cytokines