This article is more than 5 years old. Information may no longer be current.
Mortality, severe illness more common in MERS vs. SARI
Click Here to Manage Email Alerts
Middle East respiratory syndrome, or MERS, was associated with higher mortality and more severe illness compared with non-MERS severe acute respiratory infection, according to data presented at the American Thoracic Society International Conference.
As of March 20, WHO has identified 1,690 cases of MERS, with 80% of cases reported in Saudi Arabia, according to a press release. Although the disease is associated with a mortality rate of 35%, few studies have evaluated how the clinical presentations, comorbidities and outcomes differ from other respiratory infections, according to Yaseen M. Arabi, MD, FCCP, FCCM, chairman of the intensive care department, medical director of respiratory services, and professor at the college of medicine, King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center in Saudi Arabia, and colleagues.
In response, the researchers conducted the largest study of its kind comparing the clinical course of MERS with non-MERS severe acute respiratory infection (SARI). They examined data on 299 patients with laboratory-confirmed MERS SARI and 218 patients with SARI alone treated at 14 hospitals in four Saudi Arabian cities.
Arabi and colleagues found that patients with MERS had a higher mortality rate (70% vs. 36%; P = .001) and were more likely to be hypoxemic and require invasive mechanical ventilation (85% vs. 73%; P = .001), vasopressor therapy (77% vs. 55%; P = .001) and renal replacement therapy (47% vs. 23%; P = .001) compared with non-MERS patients.
“MERS is a much more severe disease than non-MERS SARI with significantly higher mortality,” Arabi told Infectious Disease News. “This is a call to expedite the development and research for effective therapeutics and vaccine, which at present are lacking.”
Results also showed that patients with MERS were more likely to be febrile vs. those with non-MERS (71% vs. 41%; P = .001); however, other symptoms such as cough, shortness of breath and sputum production, and chronic comorbidities including diabetes and liver disease, were similar between groups. According to Arabi, the overlapping signs and symptoms and underlying comorbidities make it difficult to distinguish MERS from other forms of pneumonia.
“As a result, physicians need to perform molecular testing for MERS in any patient who has an epidemiologic link — a resident or traveler from an endemic country with MERS, such as the Arabian Peninsula, for instance — and not to rely on clinical features to distinguish who may or may not have MERS,” he said. – by Gerard Gallagher and Stephanie Viguers
Reference: Arabi YM, et al. Abstract A6891. Presented at: American Thoracic Society International Conference. May 13-18, 2016; San Francisco.
Disclosure: The researchers report no relevant financial disclosures.