MERS-CoV transmitted from animal-to-human vs MERS-CoV transmitted from human-to-human: Comparison of virulence and therapeutic outcomes in a Saudi hospital
MERS-CoV transmitted from animal-to-human vs MERS-CoV transmitted from human-to-human: Comparison of virulence and therapeutic outcomes in a Saudi hospital
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DOI：
10.4314/tjpr.v17i6.23
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发表时间：
2018-06-01
影响因子：
0.6
通讯作者：
Alali, Jalal
中科院分区：
文献类型：
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作者：
Alhumaid, Saad;Tobaiqy, Mansour;Alali, Jalal
目的：检查中东呼吸综合征冠状病毒动物间传播确诊病例与人际传播病例之间的毒力（70种疾病和/或症状）和对治疗（药物、支持性措施）的反应。方法：对 2012 年 4 月 1 日至 2016 年 11 月 30 日在法赫德胡富夫国王医院（沙特阿拉伯阿哈萨）诊断的实验室确诊中东呼吸综合征冠状病毒感染的记录进行了审查结果：共有 107 例中东呼吸综合征冠状病毒实验室确诊病例。病毒从动物到人类的传播不太常见（21.4% vs 78.6%）。人际传播组的死亡率较高（53.57% vs 39.13%）。该组患者的 APACHEE II 评分（11.2 vs 23，p = 0.043）、SOFA 评分（10.9 vs 12.55，p = 0.076）也较高，败血症发生率较高（17.39 vs 26.19%，p = 0.582）和感染性休克（13.04 vs 20.23%，p = 0.582）。 0.555）。人际传播组的感染更为严重；患者入住重症监护病房 (ICU) 的比例增加（43.47% vs 51.19%），从症状出现到入住 ICU 的时间缩短，机械通气的需求增加（分别为 8 天 vs 4 天，p = 0.041 和 6 天 vs 4 天），抗病毒治疗和解决感染的时间更长（分别为 5 天 vs 11 天和 7 天 vs 13 天），并且从症状开始的时间更短直至死亡（11 天 vs 5 天，p = 0.048）。结论：人与人之间传播的 MERS-CoV 毒性更强，导致更高的病例死亡率，需要更多的 ICU 治疗。
Purpose: To examine virulence (seventy of disease and/or symptoms) and response to therapy (medications, supportive measures) between confirmed cases of MERS-CoV animal-to-human transmission compared with cases resulting from human-to-human transmission.Methods: The records for laboratory-confirmed MERS-CoV infections that were diagnosed at King Fahad Hofuf Hospital (Al-Ahsa, Saudi Arabia) from April 1, 2012 to November 30, 2016 were reviewed retrospectively.Results: There were 107 laboratory-confirmed MERS-CoV cases. Transmission of the virus from animal-to-human was less common (21.4 vs 78.6 %). The human-to-human transmission group had a higher mortality rate (53.57 vs 39.13 %). Patients in this group also had higher APACHEE II (11.2 vs 23, p = 0.043), SOFA scores (10.9 vs 12.55, p = 0.076), and higher rates of sepsis (17.39 vs 26.19%, p = 0.582) and septic shock (13.04 vs 20.23 %, p = 0.555). The infections were more severe in the human-to-human transmission group; patients had increased rates of intensive care unit (ICU) admission (43.47 vs 51.19 %), decreased time from symptom onset until ICU admission, and greater need for mechanical ventilation (8 days vs 4 days, p = 0.041, and 6 days vs 4 days, respectively), longer time to respond to antiviral treatment and resolve the infection (5 days vs 11 days and 7 days vs 13 days, respectively) and a shorter time from the beginning of symptoms until death (11 days vs 5 days, p = 0.048).Conclusion: MERS-CoV transmitted from human-to-human was more virulent, resulted in higher case-mortality rates and required more ICU treatment.