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==Prognosis==
==Prognosis==
To date, it has been noted a broad range of presentations of [[MERS-CoV]] [[infection]]. Some patients were [[asymptomatic]] while others presented with multiple [[complications]]. According to the data, about 30% of the patients [[infected]] with [[MERS-CoV]] have died. Most of these patients suffered from multiple previous conditions, such as [[diabetes]] or [[lung disease|lung]] or [[kidney disease]], which made them more susceptible not only to the development of the [[disease]], but also more prone to evolve to more severe states of the condition. The risk of [[mortality]] from [[MERS]] is greatly influenced by the [[complications]] developed throughout the course of the disease. Therefore<ref name=CDC1>{{cite web | title = Symptoms & Complications | url = http://www.cdc.gov/coronavirus/MERS/about/symptoms.html }}</ref>
To date, it has been noted a broad range of presentations of [[MERS-CoV]] [[infection]]. Some patients were [[asymptomatic]] while others presented with multiple [[complications]]. According to the data, about 30% of the patients [[infected]] with [[MERS-CoV]] have died. Most of these patients suffered from multiple previous conditions, such as [[diabetes]] or [[lung disease|lung]] or [[kidney disease]], which made them more susceptible not only to the development of the [[disease]], but also more prone to evolve to more severe states of the condition. The risk of [[mortality]] from [[MERS]] is greatly influenced by the [[complications]] developed throughout the course of the disease.<ref name=CDC1>{{cite web | title = Symptoms & Complications | url = http://www.cdc.gov/coronavirus/MERS/about/symptoms.html }}</ref>


==References==
==References==

Revision as of 19:04, 23 June 2014

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]

Overview

Middle East Respiratory Syndrome (MERS) is a viral respiratory illness. It is caused by an emerging coronavirus, specifically a betacoronavirus called MERS-CoV (Middle East Respiratory Syndrome Coronavirus), first discovered in 2012. Being a relatively novel virus, there is no virus-specific prevention or treatment options for MERS patients. Attending to the fact that a vaccine hasn't been developed yet, enhancing infection prevention and control measures is critical to prevent the possible spread of MERS-CoV in hospitals and communities. To date, the mortality rate of MERS-CoV is approximately 30%. Cases have been reported where critically ill patients have developed complications such as: acute renal failure, pericarditis and disseminated intravascular coagulation .[1][2][3][4]

Natural History

The median incubation period for secondary cases associated with limited human-to-human transmission is approximately 5 days (range 2-13 days). In MERS-CoV patients, the median time from illness onset to hospitalization is approximately 4 days. In critically ill patients, the median time from onset to intensive care unit (ICU) admission is approximately 5 days, and median time from onset to death is approximately 12 days.[5]

Complications

There have been reported different stages of MERS-CoV infection in the discovered cases. These may range from asymptomatic patients to critically ill patients.[4][6] According to the underlying comorbidities of each patient, along with the evolution of the disease, some complications may develop, involving other organ systems, including:[6][7][8][9][10][11][12][13][14]

Prognosis

To date, it has been noted a broad range of presentations of MERS-CoV infection. Some patients were asymptomatic while others presented with multiple complications. According to the data, about 30% of the patients infected with MERS-CoV have died. Most of these patients suffered from multiple previous conditions, such as diabetes or lung or kidney disease, which made them more susceptible not only to the development of the disease, but also more prone to evolve to more severe states of the condition. The risk of mortality from MERS is greatly influenced by the complications developed throughout the course of the disease.[15]

References

  1. ↑ Drosten C, Seilmaier M, Corman VM, Hartmann W, Scheible G, Sack S; et al. (2013). "Clinical features and virological analysis of a case of Middle East respiratory syndrome coronavirus infection". Lancet Infect Dis. 13 (9): 745–51. doi:10.1016/S1473-3099(13)70154-3. PMID 23782859.
  2. ↑ Dyall J, Coleman CM, Hart BJ, Venkataraman T, Holbrook MR, Kindrachuk J; et al. (2014). "Repurposing of clinically developed drugs for treatment of Middle East Respiratory Coronavirus Infection". Antimicrob Agents Chemother. doi:10.1128/AAC.03036-14. PMID 24841273.
  3. ↑ "Clinical management of severe acute respiratory infections when novel coronavirus is suspected: What to do and what not to do" (PDF).
  4. ↑ 4.0 4.1 "MERS Prevention and Treatment".
  5. ↑ "Clinical Course".
  6. ↑ 6.0 6.1 Memish, Ziad A.; Zumla, Alimuddin I.; Assiri, Abdullah (2013). "Middle East Respiratory Syndrome Coronavirus Infections in Health Care Workers". New England Journal of Medicine. 369 (9): 884–886. doi:10.1056/NEJMc1308698. ISSN 0028-4793.
  7. ↑ Zaki, Ali M.; van Boheemen, Sander; Bestebroer, Theo M.; Osterhaus, Albert D.M.E.; Fouchier, Ron A.M. (2012). "Isolation of a Novel Coronavirus from a Man with Pneumonia in Saudi Arabia". New England Journal of Medicine. 367 (19): 1814–1820. doi:10.1056/NEJMoa1211721. ISSN 0028-4793.
  8. ↑ "Novel coronavirus summary and literature update as of 17 May 2013".
  9. ↑ Drosten, Christian; Seilmaier, Michael; Corman, Victor M; Hartmann, Wulf; Scheible, Gregor; Sack, Stefan; Guggemos, Wolfgang; Kallies, Rene; Muth, Doreen; Junglen, Sandra; Müller, Marcel A; Haas, Walter; Guberina, Hana; Röhnisch, Tim; Schmid-Wendtner, Monika; Aldabbagh, Souhaib; Dittmer, Ulf; Gold, Hermann; Graf, Petra; Bonin, Frank; Rambaut, Andrew; Wendtner, Clemens-Martin (2013). "Clinical features and virological analysis of a case of Middle East respiratory syndrome coronavirus infection". The Lancet Infectious Diseases. 13 (9): 745–751. doi:10.1016/S1473-3099(13)70154-3. ISSN 1473-3099.
  10. ↑ Assiri, Abdullah; McGeer, Allison; Perl, Trish M.; Price, Connie S.; Al Rabeeah, Abdullah A.; Cummings, Derek A.T.; Alabdullatif, Zaki N.; Assad, Maher; Almulhim, Abdulmohsen; Makhdoom, Hatem; Madani, Hossam; Alhakeem, Rafat; Al-Tawfiq, Jaffar A.; Cotten, Matthew; Watson, Simon J.; Kellam, Paul; Zumla, Alimuddin I.; Memish, Ziad A. (2013). "Hospital Outbreak of Middle East Respiratory Syndrome Coronavirus". New England Journal of Medicine. 369 (5): 407–416. doi:10.1056/NEJMoa1306742. ISSN 0028-4793.
  11. ↑ Guery, Benoit; Poissy, Julien; el Mansouf, Loubna; Séjourné, Caroline; Ettahar, Nicolas; Lemaire, Xavier; Vuotto, Fanny; Goffard, Anne; Behillil, Sylvie; Enouf, Vincent; Caro, Valérie; Mailles, Alexandra; Che, Didier; Manuguerra, Jean-Claude; Mathieu, Daniel; Fontanet, Arnaud; van der Werf, Sylvie (2013). "Clinical features and viral diagnosis of two cases of infection with Middle East Respiratory Syndrome coronavirus: a report of nosocomial transmission". The Lancet. 381 (9885): 2265–2272. doi:10.1016/S0140-6736(13)60982-4. ISSN 0140-6736.
  12. ↑ Assiri, Abdullah; Al-Tawfiq, Jaffar A; Al-Rabeeah, Abdullah A; Al-Rabiah, Fahad A; Al-Hajjar, Sami; Al-Barrak, Ali; Flemban, Hesham; Al-Nassir, Wafa N; Balkhy, Hanan H; Al-Hakeem, Rafat F; Makhdoom, Hatem Q; Zumla, Alimuddin I; Memish, Ziad A (2013). "Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study". The Lancet Infectious Diseases. 13 (9): 752–761. doi:10.1016/S1473-3099(13)70204-4. ISSN 1473-3099.
  13. ↑ Arabi, Yaseen M.; Arifi, Ahmed A.; Balkhy, Hanan H.; Najm, Hani; Aldawood, Abdulaziz S.; Ghabashi, Alaa; Hawa, Hassan; Alothman, Adel; Khaldi, Abdulaziz; Al Raiy, Basel (2014). "Clinical Course and Outcomes of Critically Ill Patients With Middle East Respiratory Syndrome Coronavirus Infection". Annals of Internal Medicine. 160 (6): 389–397. doi:10.7326/M13-2486. ISSN 0003-4819.
  14. ↑ "Background and summary of novel coronavirus infection - as of 21 December 2012".
  15. ↑ "Symptoms & Complications".

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