Impact of Comorbidity on Fatality Rate of Patients with Middle East Respiratory Syndrome.

Impact of Comorbidity on Fatality Rate of Patients with Middle East Respiratory Syndrome.
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DOI:
10.1038/s41598-017-10402-1
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发表时间:
2017-09-12
期刊:
影响因子:
4.6
通讯作者:
Wang TH
Wang TH
中科院分区:
综合性期刊3区
文献类型:
--
作者:
Yang YM;Hsu CY;Lai CC;Yen MF;Wikramaratna PS;Chen HH;Wang TH

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迄今为止,全球已报告了1841例中东呼吸综合征冠状病毒感染病例,其中652人死亡。我们使用公开的病例线列表来探讨相关因素,特别是潜在合并症,对截至2016年10月底中东呼吸综合征(MERS)病例致命结局的影响。采用贝叶斯威布尔比例风险回归模型评估合并症、年龄、流行期和性别对MERS病例病死率的影响及其在各国间的差异。MERS病例粗病死率为32.1%(95%可信区间(CI): 29.9%, 34.3%)。值得注意的是,日死亡率的增量变化在发病后的第一周最为显著,平均增加13%,但在其余两周稳定下来,平均仅增加3%。在考虑到患者的年龄和合并症状况后,没有发现性别和感染国家对死亡率有显著影响。校正年龄、流行期后,合并合并症的MERS患者发生致死性感染的风险约为未合并合并症患者的4倍(校正风险比为3.74 (95% CI: 2.57, 5.67))。
To date, 1841 cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection have been reported worldwide, with 652 deaths. We used a publically available case line list to explore the effect of relevant factors, notably underlying comorbidities, on fatal outcome of Middle East respiratory syndrome (MERS) cases up to the end of October 2016. A Bayesian Weibull proportional hazards regression model was used to assess the effect of comorbidity, age, epidemic period and sex on the fatality rate of MERS cases and its variation across countries. The crude fatality rate of MERS cases was 32.1% (95% credibility interval (CI): 29.9%, 34.3%). Notably, the incremental change of daily death rate was most prominent during the first week since disease onset with an average increase of 13%, but then stabilized in the remaining two weeks when it only increased 3% on average. Neither sex, nor country of infection were found to have a significant impact on fatality rates after taking into account the age and comorbidity status of patients. After adjusting for age, epidemic period, MERS patients with comorbidity had around 4 times the risk for fatal infection than those without (adjusted hazard ratio of 3.74 (95% CI: 2.57, 5.67)).
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