Presentation and outcome of Middle East respiratory syndrome in Saudi intensive care unit patients.
Presentation and outcome of Middle East respiratory syndrome in Saudi intensive care unit patients.
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DOI：
10.1186/s13054-016-1303-8
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发表时间：
2016-05-07
期刊：
影响因子：
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通讯作者：
Sakr Y
中科院分区：
文献类型：
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作者：
Almekhlafi GA;Albarrak MM;Mandourah Y;Hassan S;Alwan A;Abudayah A;Altayyar S;Mustafa M;Aldaghestani T;Alghamedi A;Talag A;Malik MK;Omrani AS;Sakr Y
中东呼吸综合征冠状病毒感染与高死亡率相关，但临床数据有限。我们描述了中东呼吸综合征冠状病毒（MERS-CoV）感染的重症监护室（ICU）患者的临床特征和结局。回顾性分析2012年10月1日至2014年5月31日期间入住我们20床混合ICU的中东呼吸综合征冠状病毒感染的所有成人（>18岁）患者的数据。所有患者的呼吸道样本均采用实时逆转录聚合酶链反应确诊。在观察期内，31例MERS-CoV感染患者入院（平均年龄59 ± 20岁，22例[71%]男性）。所有患者均报告咳嗽和呼吸急促; 22例（77.4%）患者有双侧肺浸润。在重症监护病房住院期间，27例（87.1%）患者应用有创机械通气，25例（80.6%）患者应用血管加压药治疗。23例（74.2%）患者在ICU死亡。死亡者年龄较大，入院时APACHE II和SOFA评分较高，更有可能接受有创机械通气和血管加压治疗。在调整了疾病的严重程度和器官功能障碍的程度后，血管加压药的需要是ICU死亡的独立危险因素（比值比= 18.33，95%置信区间：1.11-302.1，P = 0.04）。MERS-CoV感染需要进入ICU，与高发病率和死亡率相关。血管加压治疗的需要是这些患者死亡的主要危险因素。本文的在线版本（doi：10.1186/s13054-016-1303-8）包含补充材料，可供授权用户使用。
Middle East respiratory syndrome coronavirus infection is associated with high mortality rates but limited clinical data have been reported. We describe the clinical features and outcomes of patients admitted to an intensive care unit (ICU) with Middle East respiratory syndrome coronavirus (MERS-CoV) infection. Retrospective analysis of data from all adult (>18 years old) patients admitted to our 20-bed mixed ICU with Middle East respiratory syndrome coronavirus infection between October 1, 2012 and May 31, 2014. Diagnosis was confirmed in all patients using real-time reverse transcription polymerase chain reaction on respiratory samples. During the observation period, 31 patients were admitted with MERS-CoV infection (mean age 59 ± 20 years, 22 [71 %] males). Cough and tachypnea were reported in all patients; 22 (77.4 %) patients had bilateral pulmonary infiltrates. Invasive mechanical ventilation was applied in 27 (87.1 %) and vasopressor therapy in 25 (80.6 %) patients during the intensive care unit stay. Twenty-three (74.2 %) patients died in the ICU. Nonsurvivors were older, had greater APACHE II and SOFA scores on admission, and were more likely to have received invasive mechanical ventilation and vasopressor therapy. After adjustment for the severity of illness and the degree of organ dysfunction, the need for vasopressors was an independent risk factor for death in the ICU (odds ratio = 18.33, 95 % confidence interval: 1.11–302.1, P = 0.04). MERS-CoV infection requiring admission to the ICU is associated with high morbidity and mortality. The need for vasopressor therapy is the main risk factor for death in these patients. The online version of this article (doi:10.1186/s13054-016-1303-8) contains supplementary material, which is available to authorized users.