IU Indianapolis ScholarWorks :: Browsing by Subject "Middle East Respiratory Syndrome Coronavirus"

Browsing by Subject "Middle East Respiratory Syndrome Coronavirus"

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Clinical predictors of mortality of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection: A cohort study
(Elsevier, 2019) Alfaraj, Sarah; Al-Tawfiq, Jaffar A.; Alzahrani, Nojoom A.; Alanazi, Amal A.; Memish, Ziad A.; Medicine, School of Medicine
Background Since the emergence of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in 2012, the virus had caused a high case fatality rate. The clinical presentation of MERS varied from asymptomatic to severe bilateral pneumonia, depending on the case definition and surveillance strategies. There are few studies examining the mortality predictors in this disease. In this study, we examined clinical predictors of mortality of Middle East Respiratory Syndrome (MERS) infection. Methods This is a retrospective analysis of symptomatic admitted patients to a large tertiary MERS-CoV center in Saudi Arabia over the period from April 2014 to March 2018. Clinical and laboratory data were collected and analysis was done using a binary regression model. Results A total of 314 symptomatic MERS-CoV patients were included in the analysis, with a mean age of 48 (±17.3) years. Of these cases, 78 (24.8%) died. The following parameters were associated with increased mortality, age, WBC, neutrophil count, serum albumin level, use of a continuous renal replacement therapy (CRRT) and corticosteroid use. The odd ratio for mortality was highest for CRRT and corticosteroid use (4.95 and 3.85, respectively). The use of interferon-ribavirin was not associated with mortality in this cohort. Conclusion Several factors contributed to increased mortality in this cohort of MERS-CoV patients. Of these factors, the use of corticosteroid and CRRT were the most significant. Further studies are needed to evaluate whether these factors were a mark of severe disease or actual contributors to higher mortality.
Dynamics of scientific publications on the MERS-CoV outbreaks in Saudi Arabia
(Elsevier, 2017-11) Rabaan, Ali A.; Al-Ahmed, Shamsah H.; Bazzi, Ali M.; Al-Tawfiq, Jaffar A.; Medicine, School of Medicine
Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is an emerging disease with a relatively high case fatality rate. Most cases have been reported from Saudi Arabia, and the disease epidemic potential is considered to be limited. However, human–human transmission has occurred, usually in the context of healthcare facility-associated outbreaks. The scientific and medical community depends on timely publication of epidemiological information on emerging diseases during outbreaks to appropriately target public health responses. In this review, we considered the academic response to four MERS CoV outbreaks that occurred in Al-Hasa in 2013, Jeddah in 2014 and Riyadh in 2014 and 2015. We analysed 68 relevant epidemiology articles. For articles for which submission dates were available, six articles were submitted during the course of an outbreak. One article was published within a month of the Al-Hasa outbreak, and one each was accepted during the Jeddah and Riyadh outbreaks. MERS-CoV epidemiology articles were cited more frequently than articles on other subjects in the same journal issues. Thus, most epidemiology articles on MERS-CoV were published with no preferential advantage over other articles. Collaboration of the research community and the scientific publishing industry is needed to facilitate timely publication of emerging infectious diseases.
Emerging respiratory viral infections: MERS-CoV and influenza
(Elsevier, 2014-01) Al-Tawfiq, Jaffar A.; Memish, Ziad A.; Medicine, School of Medicine
Emerging viral respiratory tract infections—environmental risk factors and transmission
(Elsevier, 2014-11) Gautret, Philippe; Gray, Gregory C.; Charrel, Remi N.; Odezulu, Nnanyelugo G.; Al-Tawfiq, Jaffar A.; Zumla, Alimuddin; Memish, Ziad A.; Medicine, School of Medicine
The past decade has seen the emergence of several novel viruses that cause respiratory tract infections in human beings, including Middle East respiratory syndrome coronavirus (MERS-CoV) in Saudi Arabia, an H7N9 influenza A virus in eastern China, a swine-like influenza H3N2 variant virus in the USA, and a human adenovirus 14p1 also in the USA. MERS-CoV and H7N9 viruses are still a major worldwide public health concern. The pathogenesis and mode of transmission of MERS-CoV and H7N9 influenza A virus are poorly understood, making it more difficult to implement intervention and preventive measures. A united and coordinated global response is needed to tackle emerging viruses that can cause fatal respiratory tract infections and to fill major gaps in the understanding of the epidemiology and transmission dynamics of these viruses.
Evaluation of visual triage for screening of Middle East respiratory syndrome coronavirus patients
(Elsevier, 2018-11) Alfaraj, S. H.; Al-Tawfiq, J. A.; Gautret, P.; Alenazi, M. G.; Asiri, A. Y.; Memish, Z. A.; Medicine, School of Medicine
The emergence of Middle East respiratory syndrome coronavirus (MERS-CoV) in September 2012 in Saudi Arabia had attracted the attention of the global health community. In 2017 the Saudi Ministry of Health released a visual triage system with scoring to alert healthcare workers in emergency departments (EDs) and haemodialysis units for the possibility of occurrence of MERS-CoV infection. We performed a retrospective analysis of this visual score to determine its sensitivity and specificity. The study included all cases from 2014 to 2017 in a MERS-CoV referral centre in Riyadh, Saudi Arabia. During the study period there were a total of 2435 suspected MERS cases. Of these, 1823 (75%) tested negative and the remaining 25% tested positive for MERS-CoV by PCR assay. The application of the visual triage score found a similar percentage of MERS-CoV and non–MERS-CoV patients, with each score from 0 to 11. The percentage of patients with a cutoff score of ≥4 was 75% in patients with MERS-CoV infection and 85% in patients without MERS-CoV infection (p 0.0001). The sensitivity and specificity of this cutoff score for MERS-CoV infection were 74.1% and 18.6%, respectively. The sensitivity and specificity of the scoring system were low, and further refinement of the score is needed for better prediction of MERS-CoV infection.
First Confirmed Case of Middle East Respiratory Syndrome Coronavirus Infection in the Kingdom of Bahrain: In a Saudi Gentleman after Cardiac Bypass Surgery
(Hindawi, 2017-08) Seddiq, Nahed; Al-Qahtani, Manaf; Al-Tawfiq, Jaffar A.; Bukamal, Mazar; Medicine, School of Medicine
Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is well known to cause severe respiratory infection and was first reported in the Kingdom of Saudi Arabia in 2012. We report here the first confirmed MERS-CoV infection in the Kingdom of Bahrain in a Saudi gentleman who was admitted electively for coronary bypass surgery, postoperatively developed an acute respiratory illness, and tested positive for MERS-CoV. 40 close contacts, all healthcare workers, were traced and followed with no documented secondary cases.
The Hajj 2019 Vaccine Requirements and Possible New Challenges
(Atlantis, 2019-09) Al-Tawfiq, Jaffar A.; Memish, Ziad A.; Medicine, School of Medicine
Each year millions of pilgrims perform the annual Hajj from more than 180 countries around the world. This is one of the largest mass gathering events and may result in the occurrence and spread of infectious diseases. As such, there are mandatory vaccinations for the pilgrims such as meningococcal vaccines. The 2019 annual Hajj will take place during August 8–13, 2019. Thus, we review the recommended and mandated vaccinations for the 2019 Hajj and Umrah. The mandatory vaccines required to secure the visa include the quadrivalent meningococcal vaccine for all pilgrims, while yellow fever, and poliomyelitis vaccines are required for pilgrims coming from countries endemic or with disease activity. The recommended vaccines are influenza, pneumococcal, in addition to full compliance with basic vaccines for all pilgrims against diphtheria, tetanus, pertussis, polio, measles, and mumps. It is imperative to continue surveillance for the spread of antimicrobial resistance and occurrence of all infectious diseases causing outbreaks across the globe in the last year, like Zika virus, MDR-Typhoid, Nipah, Ebola, cholera, chikungunya and Middle East Respiratory Syndrome Coronavirus.
Healthcare-associated Infections: The Hallmark of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) With Review of the Literature
(Elsevier, 2018) Al-Tawfiq, Jaffar A.; Auwaerter, Paul G.; Medicine, School of Medicine
The Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is a coronavirus capable of causing acute respiratory illness. Laboratory confirmed MERS-CoV cases may be asymptomatic, have mild disease or life-threatening infection with a high case fatality rate. There are three patterns of transmission: sporadic community cases from presumed non-human exposure, family clusters arising from contact with the infected family index case, and healthcare-acquired infections among patients and from patients to healthcare workers. Healthcare-acquired MERS infection has become a well-known characteristic of the disease and a leading means of spread. Contributing factors foremost to such healthcare-associated outbreaks include delayed recognition, inadequate infection control measures, inadequate triaging and isolation of suspected MERS or other respiratory illness patients, crowding, and patients remaining in the emergency department for many days. A review of the literature suggests effective control of these hospital outbreaks was accomplished in most instances by the application of proper infection control procedures. Prompt recognition, isolation, and management of suspected cases are key factors for the prevention of the spread of MERS. Repeated assessments of infection control and monitoring of corrective measures contribute to changing the course of an outbreak. Limiting the number of contacts and hospital visits are also important factors to decrease the spread of infection.
Hematologic, hepatic, and renal function changes in hospitalized patients with Middle East respiratory syndrome coronavirus
(Wiley, 2017-06) Al-Tawfiq, J. A.; Hinedi, K.; Abbasi, S.; Babiker, M.; Sunji, A.; Eltigani, M.; Medicine, School of Medicine
Background There are no longitudinal data on the changes in hematologic, hepatic, and renal function findings in patients with Middle East respiratory syndrome coronavirus (MERS‐CoV) infection. Methods This is a retrospective cohort study of 16 MERS‐CoV patients, to describe the hematological, hepatic, and renal findings of patients with MERS‐CoV. Results During the 21 days of observation, there was no significant change in the hepatic panel or creatinine tests. There was a significant increase in the mean ± SD of the white blood cell count from 8.3 ± 4.6 to 14.53 ± 7 (P value = 0.001) and an increase in mean ± SD of the absolute neutrophil count from 6.33 ± 4.2 to 12 ± 5.5 (P value = 0.015). Leukocytosis was observed in 31% (5/16) of the patients on day 1 and in 80% (4/5) on day 21. Transient leukopenia developed in 6% (1/16) of the patients on day 1 and in 13% (1/8) on day 8. None of the patients had neutropenia. Lymphopenia was a prominent feature with a rate of 44% (7/16) of the patients on day 1 and 60% (3/5) on day 21. Lymphocytosis was not a feature of MERS‐CoV infection. Thrombocytopenia developed in 31% (5/16) of the patients on day 1 and 40% (2/5) on day 21. Thrombocytosis was not a prominent feature and was observed in 6% (1/16) of the patients on day 1 and 17% (1/6) on day 9. Conclusions Patients with MERS‐CoV infection showed variable hematologic parameters over time. Lymphocytosis and neutropenia were not features of MERS‐CoV infection.
The impact of co-infection of influenza A virus on the severity of Middle East Respiratory Syndrome Coronavirus
(Elsevier, 2017-05) Alfaraj, Sarah H.; Al-Tawfiq, Jaffar A.; Alzahrani, Nojoom A.; Altwaijri, Talal A.; Memish, Ziad A.; Medicine, School of Medicine
Ho and colleagues recently drew attention to the consequences of co-infection with Influenza and HIV.1 We present four cases of combined infection with influenza and Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection. Nasopharyngeal swabs or tracheal aspirates were tested for MERS-CoV using real-time reverse-transcription polymerase chain reaction (RT-PCR).2, 3 Samples were tested for Influenza A, B and H1N1 by rapid molecular test (GenEXper for detection of flu A, B and 2009 H1N1, Cepheid).

Browsing by Subject "Middle East Respiratory Syndrome Coronavirus"

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