Clinical Presentation and Outcomes of Middle East Respiratory Syndrome in the Republic of Korea.
- Author:
Won Suk CHOI
1
;
Cheol In KANG
;
Yonjae KIM
;
Jae Phil CHOI
;
Joon Sung JOH
;
Hyoung Shik SHIN
;
Gayeon KIM
;
Kyong Ran PECK
;
Doo Ryeon CHUNG
;
Hye Ok KIM
;
Sook Hee SONG
;
Yang Ree KIM
;
Kyung Mok SOHN
;
Younghee JUNG
;
Ji Hwan BANG
;
Nam Joong KIM
;
Kkot Sil LEE
;
Hye Won JEONG
;
Ji Young RHEE
;
Eu Suk KIM
;
Heungjeong WOO
;
Won Sup OH
;
Kyungmin HUH
;
Young Hyun LEE
;
Joon Young SONG
;
Jacob LEE
;
Chang Seop LEE
;
Baek Nam KIM
;
Young Hwa CHOI
;
Su Jin JEONG
;
Jin Soo LEE
;
Ji Hyun YOON
;
Yu Mi WI
;
Mi Kyong JOUNG
;
Seong Yeon PARK
;
Sun Hee LEE
;
Sook In JUNG
;
Shin Woo KIM
;
Jae Hoon LEE
;
Hyuck LEE
;
Hyun Kyun KI
;
Yeon Sook KIM
Author Information
- Publication Type:Original Article
- Keywords: Middle East respiratory syndrome; Republic of Korea
- MeSH: Antiviral Agents; Aspartate Aminotransferases; Coronavirus Infections*; Disease Outbreaks; Dyspnea; Extracorporeal Membrane Oxygenation; Fever; Humans; Hypotension; Leukocytosis; Leukopenia; Lung Diseases; Middle East Respiratory Syndrome Coronavirus; Middle East*; Mortality; Pneumonia; Polymerase Chain Reaction; Republic of Korea*; Respiration, Artificial; Thrombocytopenia
- From:Infection and Chemotherapy 2016;48(2):118-126
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND: 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. MATERIALS AND METHODS: 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. RESULTS: 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. CONCLUSION: 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.
