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Clinical presentation and outcomes of middle east respiratory syndrome in the Republic of Koreaopen access

Authors
Choi W.S.Kang C.-I.Kim Y.Choi J.-P.Joh J.S.Shin H.-S.Kim G.Peck K.R.Chung D.R.Kim H.O.Song S.H.Kim Y.R.Sohn K.M.Jung Y.Bang J.H.Kim N.J.Lee K.S.Jeong H.W.Rhee J.-Y.Kim E.S.Woo H.Oh W.S.Huh K.Lee Y.H.Song J.Y.Lee J.Lee C.-S.Kim B.-N.Choi Y.H.Jeong S.J.Lee J.-S.Yoon J.H.Wi Y.M.Joung M.K.Park S.Y.Lee S.H.Jung S.-I.Kim S.-W.Lee J.H.Lee H.Ki H.K.Kim Y.-S.The Korean Society of Infectious Diseases
Issue Date
2016
Publisher
Korean Society for Antimicrobial Therapy
Keywords
Middle East respiratory syndrome; Republic of Korea
Citation
Infection and Chemotherapy, v.48, no.2, pp 118 - 126
Pages
9
Indexed
SCOPUS
ESCI
KCI
Journal Title
Infection and Chemotherapy
Volume
48
Number
2
Start Page
118
End Page
126
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/7113
DOI
10.3947/ic.2016.48.2.118
ISSN
2093-2340
2092-6448
Abstract
Background: From May to July 2015, the Republic of Korea experienced the largest outbreak of Middle East respiratory syndrome (MERS) outside the Arabian Peninsula. A total of 186 patients, including 36 deaths, had been diagnosed with MERS-coronavirus (MERS-CoV) infection as of September 30th, 2015. Materials and Methods: We obtained information of patients who were confirmed to have MERS-CoV infection. MERS-CoV infection was diagnosed using real-time reverse-transcriptase polymerase chain reaction assay. Results: The median age of the patients was 55 years (range, 16 to 86). A total of 55.4% of the patients had one or more coexisting medical conditions. The most common symptom was fever (95.2%). At admission, leukopenia (42.6%), thrombocytopenia (46.6%), and elevation of aspartate aminotransferase (42.7%) were observed. Pneumonia was detected in 68.3% of patients at admission and developed in 80.8% during the disease course. Antiviral agents were used for 74.7% of patients. Mechanical ventilation, extracorporeal membrane oxygenation, and convalescent serum were employed for 24.5%, 7.1%, and 3.8% of patients, respectively. Older age, presence of coexisting medical conditions including diabetes or chronic lung disease, presence of dyspnea, hypotension, and leukocytosis at admission, and the use of mechanical ventilation were revealed to be independent predictors of death. Conclusion: The clinical features of MERS-CoV infection in the Republic of Korea were similar to those of previous outbreaks in the Middle East. However, the overall mortality rate (20.4%) was lower than that in previous reports. Enhanced surveillance and active management of patients during the outbreak may have resulted in improved outcomes. © 2016 by The Korean Society of Infectious Diseases | Korean Society for Chemotherapy.
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