Comparative Epidemiology of Human Infections with Middle East Respiratory Syndrome and Severe Acute Respiratory Syndrome Coronaviruses among Healthcare Personnel.
Comparative Epidemiology of Human Infections with Middle East Respiratory Syndrome and Severe Acute Respiratory Syndrome Coronaviruses among Healthcare Personnel.
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中东呼吸道综合征和严重急性呼吸道综合征冠状病毒在医疗保健人员中的人类感染的比较流行病学。
DOI：
10.1371/journal.pone.0149988
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
King CC
中科院分区：
文献类型：
--
作者：
Liu S;Chan TC;Chu YT;Wu JT;Geng X;Zhao N;Cheng W;Chen E;King CC
中东呼吸综合征（MERS）最大的医院爆发发生在2015年的韩国。医护人员（HCP）感染MERS-冠状病毒（MERS-CoV）的风险很高，与2003年首次发现的严重急性呼吸综合征（SARS）-冠状病毒（SARS-CoV）感染相似。本研究描述了183例全球MERS确诊病例和98例台湾SARS病例的流行病学和临床特征的相似性和差异。流行病学调查结果显示，MERS-HCP和总MERS病例的平均年龄分别为40（24~74）岁和49（2~90）岁，明显高于SARS患者[SARS-HCP：35（21~68）岁，p = 0.006;总SARS：42（0~94）岁，p = 0.0002]。MERS-HCP组[7.03%（9/128）]或SARS-HCP组[12.24%（12/98）]的病死率（CFR）远低于MERS-非HCP组[36.96%（34/92），p<0.001]或SARS-非HCP组[24.50%（61/249），p<0.001]，然而，MERS-HCP和SARS-HCP之间无差异[p = 0.181]。从发病至死亡的天数[13（4~17）vs 14.5（0~52），p = 0.045]、至出院的天数[11（5~24）vs 24（0~74），p = 0.010]和住院天数[9.5（3~22）vs 22（0~69），p = 0.040]在MERS-HCP中比SARS-HCP短得多。同样，MERS-HCP患者从发病至确诊的天数短于MERS-非HCP患者[6（1~14）vs 10（1~21），p = 0.044]。总之，由于HCP组的年龄较小和早期确认，MERS-HCP和SARS-HCP的严重程度低于MERS-非HCP和SARS-非HCP。MERS-HCP与SARS-HCP之间差异无统计学意义。因此，预防涉及两种新型冠状病毒的医院感染对于保护HCP至关重要。
The largest nosocomial outbreak of Middle East respiratory syndrome (MERS) occurred in South Korea in 2015. Health Care Personnel (HCP) are at high risk of acquiring MERS-Coronavirus (MERS-CoV) infections, similar to the severe acute respiratory syndrome (SARS)-Coronavirus (SARS-CoV) infections first identified in 2003. This study described the similarities and differences in epidemiological and clinical characteristics of 183 confirmed global MERS cases and 98 SARS cases in Taiwan associated with HCP. The epidemiological findings showed that the mean age of MERS-HCP and total MERS cases were 40 (24~74) and 49 (2~90) years, respectively, much older than those in SARS [SARS-HCP: 35 (21~68) years, p = 0.006; total SARS: 42 (0~94) years, p = 0.0002]. The case fatality rates (CFR) was much lower in MERS-HCP [7.03% (9/128)] or SARS-HCP [12.24% (12/98)] than the MERS-non-HCP [36.96% (34/92), p<0.001] or SARS-non-HCP [24.50% (61/249), p<0.001], however, no difference was found between MERS-HCP and SARS-HCP [p = 0.181]. In terms of clinical period, the days from onset to death [13 (4~17) vs 14.5 (0~52), p = 0.045] and to discharge [11 (5~24) vs 24 (0~74), p = 0.010] and be hospitalized days [9.5 (3~22) vs 22 (0~69), p = 0.040] were much shorter in MERS-HCP than SARS-HCP. Similarly, days from onset to confirmation were shorter in MERS-HCP than MERS-non-HCP [6 (1~14) vs 10 (1~21), p = 0.044]. In conclusion, the severity of MERS-HCP and SARS-HCP was lower than that of MERS-non-HCP and SARS-non-HCP due to younger age and early confirmation in HCP groups. However, no statistical difference was found in MERS-HCP and SARS-HCP. Thus, prevention of nosocomial infections involving both novel Coronavirus is crucially important to protect HCP.