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Clin Infect Dis. Middle East Respiratory Syndrome-Coronavirus (MERS-CoV): a case-controlstudy of hospitalized patients

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  • Clin Infect Dis. Middle East Respiratory Syndrome-Coronavirus (MERS-CoV): a case-controlstudy of hospitalized patients

    [Source: Clinical Infectious Diseases, full page: (LINK). Abstract, edited.]

    Middle East Respiratory Syndrome-Coronavirus (MERS-CoV): a case-controlstudy of hospitalized patients

    Jaffar A. Al-Tawfiq 1,2,*, Kareem Hinedi 1, Jihad Ghandour 1, Hanan Khairalla 1, Samir Musleh 1, Alaa Ujayli 1, and Ziad A Memish 3

    Author Affiliations: <SUP>1</SUP>Specialty Internal Medicine, Saudi Aramco Medical Services Organization, Dhahran, Saudi Arabia <SUP>2</SUP>Indiana University School of Medicine, Indiana, USA <SUP>3</SUP>Deputy Minister for Public Health, and Director WHO Collaborating Center for Mass Gathering Medicine Ministry of Health, and Professor, Al-Faisal University, Riyadh, Saudi Arabia

    *Corresponding author: Dr. Jaffar A. Al-Tawfiq, P.O. Box 76; Room A-428-2, Building 61, Dhahran Health Center, Saudi Aramco, Dhahran 31311, Saudi Arabia. E-mail address:;, Tel: +966-13-877-3524; Fax: +966-13-877-3790
    Alternate corresponding author: Dr Kareem Hinedi (

    <CITE><ABBR>Clin Infect Dis.</ABBR> (2014) doi: 10.1093/cid/ciu226 </CITE>First published online: April 9, 2014



    There is a paucity of data regarding the differentiating characteristics of laboratory confirmed cases and negative Middle East Respiratory Syndrome coronavirus (MERS-CoV) patients.


    This is a hospital-based case-control study comparing MERS-CoV positive patients (cases) with MERS-CoVnegative controls.


    A total of 17 cases and 82 controls with a mean age of 60.7 years and 57 years, respectively (P=0.5532) were included. No statistical differences were observed in relation to gender, the presence of a fever or cough, and the presence of a single or multi-lobar infiltrate on chest x-ray. The cases were more likely to be overweight than the control group (mean BMI 32 vs. 27.8; P=0.0353), to have diabetes mellitus (87% vs. 47%; OR=7.24; P=0.015),and end-stage renal disease (33% vs. 7%; OR=7; P=0.012). At the time of admission, tachypnea (27% vs. 60%; OR=0.24; P=0.031) and respiratory distress (15% vs. 51%; OR=0.15; P=0.012) were less frequentamong cases. MERS-CoV patients were more likely to have a normal WBC than the control group (82% vs. 52%; OR=4.33; P=0.029). Admission chest x-rays with interstitial infiltrates were more frequent in cases than in controls (67% vs. 20%; OR=8.13; P=0.001). Cases were more likely to be admitted to the ICU (53% vs. 20%; OR=4.65; P=0.025) and to have a high mortality rate among (76% vs. 15%; OR=18.96; P<0.001).


    MERS-CoV patients were more likely to be overweight, have a normal WBC on admission, and interstitial infiltrates on initial chest x-ray, and had a higher mortality rate.

    Received January 13, 2014. Accepted March 25, 2014.

    ? The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: