Middle East Respiratory Syndrome Coronavirus: A Case-Control Study of Hospitalized Patients
Middle East Respiratory Syndrome Coronavirus: A Case-Control Study of Hospitalized Patients
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DOI：
10.1093/cid/ciu226
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发表时间：
2014-07-15
影响因子：
11.8
通讯作者：
Memish, Ziad A.
中科院分区：
文献类型：
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作者：
Al-Tawfiq, Jaffar A.;Hinedi, Kareem;Memish, Ziad A.
背景关于实验室确诊的中东呼吸综合征冠状病毒（MERS-CoV）患者和阴性患者的鉴别特征的数据很少。这是一项以医院为基础的病例对照研究，比较MERS-CoV阳性患者（病例）与MERS-CoV阴性对照。共纳入17例患者和82例对照，平均年龄分别为60.7岁和57岁（P = 0.553）。在性别、是否存在发热或咳嗽以及胸部X线片是否存在单叶或多叶浸润方面，未观察到统计学差异。与对照组相比，病例组患者更可能超重（平均体重指数，32 vs 27.8; P = 0.035），患有糖尿病（87% vs 47%;比值比[OR]，7.24; P = 0.015），患有终末期肾病（33% vs 7%; OR，7; P = 0.012）。入院时，呼吸急促（27% vs 60%; OR，0.24; P = 0.031）和呼吸窘迫（15% vs 51%; OR，0.15; P = 0.012）在病例患者中发生率较低。MERS-CoV患者比对照组更有可能具有正常的白色血细胞计数（82% vs 52%; OR，4.33; P = .029）。病例组入院时胸部X线片显示间质性浸润的发生率高于对照组（67% vs 20%; OR，8.13; P = .001）。病例组患者更容易进入重症监护室（53%比20%; OR，4.65; P = .025），死亡率更高（76%比15%; OR，18.96; P < .001）。很少有临床预测因子能够提高预测哪些肺炎患者会感染MERS CoV的能力。然而，进一步的前瞻性分析和匹配的病例对照研究可能会揭示感染的其他预测因素。
Background. There is a paucity of data regarding the differentiating characteristics of patients with laboratory-confirmed and those negative for Middle East respiratory syndrome coronavirus (MERS-CoV).Methods. This is a hospital-based case-control study comparing MERS-CoV-positive patients (cases) with MERS-CoV-negative controls.Results. A total of 17 case patients and 82 controls with a mean age of 60.7 years and 57 years, respectively (P =.553), were included. No statistical differences were observed in relation to sex, the presence of a fever or cough, and the presence of a single or multilobar infiltrate on chest radiography. The case patients were more likely to be overweight than the control group (mean body mass index, 32 vs 27.8; P = .035), to have diabetesmellitus (87% vs 47%; odds ratio [OR], 7.24; P = .015), and to have end-stage renal disease (33% vs 7%; OR, 7; P = .012). At the time of admission, tachypnea (27% vs 60%; OR, 0.24; P = .031) and respiratory distress (15% vs 51%; OR, 0.15; P = .012) were less frequent among case patients. MERS-CoV patients were more likely to have a normal white blood cell count than the control group (82% vs 52%; OR, 4.33; P = .029). Admission chest radiography with interstitial infiltrates was more frequent in case patients than in controls (67% vs 20%; OR, 8.13; P = .001). Case patients were more likely to be admitted to the intensive care unit (53% vs 20%; OR, 4.65; P = .025) and to have a highmortality rate (76% vs 15%; OR, 18.96; P < .001).Conclusions. Few clinical predictors could enhance the ability to predict which patients with pneumonia would have MERS-CoV. However, further prospective analysis and matched case-control studies may shed light on other predictors of infection.