Clinical Presentation and Outcomes of Middle East Respiratory Syndrome in the Republic of Korea.
Clinical Presentation and Outcomes of Middle East Respiratory Syndrome in the Republic of Korea.
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DOI：
10.3947/ic.2016.48.2.118
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发表时间：
2016-06
影响因子：
4.2
通讯作者：
Korean Society of Infectious Diseases
中科院分区：
文献类型：
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作者：
Choi WS;Kang CI;Kim Y;Choi JP;Joh JS;Shin HS;Kim G;Peck KR;Chung DR;Kim HO;Song SH;Kim YR;Sohn KM;Jung Y;Bang JH;Kim NJ;Lee KS;Jeong HW;Rhee JY;Kim ES;Woo H;Oh WS;Huh K;Lee YH;Song JY;Lee J;Lee CS;Kim BN;Choi YH;Jeong SJ;Lee JS;Yoon JH;Wi YM;Joung MK;Park SY;Lee SH;Jung SI;Kim SW;Lee JH;Lee H;Ki HK;Kim YS;Korean Society of Infectious Diseases
2015年5月至7月，大韩民国经历了阿拉伯半岛以外最大规模的中东呼吸综合征疫情。截至2015年9月30日，共有186名患者被诊断为MERS冠状病毒（MERS-CoV）感染，其中36人死亡。我们获得了被证实患有MERS CoV感染的患者的信息。MERS冠状病毒感染诊断使用实时逆转录聚合酶链反应检测。患者的中位年龄为55岁（范围为16至86岁）。共有55.4%的患者有一种或多种并存的医疗条件。最常见的症状是发热（95.2%）。入院时，观察到白细胞减少（42.6%）、血小板减少（46.6%）和天冬氨酸转氨酶升高（42.7%）。68.3%的患者入院时发现肺炎，80.8%的患者在病程中出现肺炎。74.7%的患者使用抗病毒药物。分别有24.5%、7.1%和3.8%的患者采用机械通气、体外膜肺氧合和恢复期血清。年龄较大、合并糖尿病或慢性肺病、入院时存在呼吸困难、低血压和白细胞增多以及使用机械通气是死亡的独立预测因素。大韩民国MERS-CoV感染的临床特征与中东以前爆发的临床特征相似。但总死亡率（20.4%）低于以往报告。在疫情爆发期间加强监测和积极管理患者可能会改善结果。
From May to July 2015, the Republic of Korea experienced the largest outbreak of Middle East respiratory syndrome (MERS) outside the Arabian Peninsula. A total of 186 patients, including 36 deaths, had been diagnosed with MERS-coronavirus (MERS-CoV) infection as of September 30th, 2015. We obtained information of patients who were confirmed to have MERS-CoV infection. MERS-CoV infection was diagnosed using real-time reverse-transcriptase polymerase chain reaction assay. The median age of the patients was 55 years (range, 16 to 86). A total of 55.4% of the patients had one or more coexisting medical conditions. The most common symptom was fever (95.2%). At admission, leukopenia (42.6%), thrombocytopenia (46.6%), and elevation of aspartate aminotransferase (42.7%) were observed. Pneumonia was detected in 68.3% of patients at admission and developed in 80.8% during the disease course. Antiviral agents were used for 74.7% of patients. Mechanical ventilation, extracorporeal membrane oxygenation, and convalescent serum were employed for 24.5%, 7.1%, and 3.8% of patients, respectively. Older age, presence of coexisting medical conditions including diabetes or chronic lung disease, presence of dyspnea, hypotension, and leukocytosis at admission, and the use of mechanical ventilation were revealed to be independent predictors of death. The clinical features of MERS-CoV infection in the Republic of Korea were similar to those of previous outbreaks in the Middle East. However, the overall mortality rate (20.4%) was lower than that in previous reports. Enhanced surveillance and active management of patients during the outbreak may have resulted in improved outcomes.