Critically ill healthcare workers with the middle east respiratory syndrome (MERS): A multicenter study

被引：21

作者：

Shalhoub, Sarah ^{[1
,2
]}

Al-Hameed, Fahad ^{[3
]}

Mandourah, Yasser ^{[4
]}

Balkhy, Hanan H. ^{[5
]}

Al-Omari, Awad ^{[6
]}

Al Mekhlafi, Ghaleb A. ^{[4
]}

Kharaba, Ayman ^{[7
]}

Alraddadr, Basem ^{[8
]}

Almotairi, Abdullah ^{[9
]}

Al Khatib, Kasim ^{[10
]}

Abdulmomen, Ahmed ^{[11
]}

Qushmaq, Ismael ^{[8
]}

Mady, Ahmed ^{[12
]}

Solaiman, Othman ^{[13
]}

Al-Aithan, Abdulsalam M. ^{[14
]}

Al-Raddadi, Rajaa ^{[15
]}

Ragab, Ahmed ^{[16
]}

Al Harthy, Abdulrahman ^{[12
]}

Al Qasim, Eman ^{[17
]}

Jose, Jesna ^{[17
]}

Al-Ghamdi, Ghassan ^{[17
]}

Merson, Laura ^{[18
]}

Fowler, Robert ^{[19
,20
]}

Hayden, Frederick G. ^{[21
]}

Arabi, Yaseen M. ^{[17
]}

机构：

[1] Univ Western Ontario, Div Infect Dis, Dept Med, London, ON, Canada

[2] King Fahad Armed Forces Hosp, Dept Med, Div Infect Dis, Jeddah, Saudi Arabia

[3] King Saud bin Abdulaziz Univ Hlth Sci, King Abdullah Int Med Res Ctr, King Abdulaziz Med City, Dept Intens Care, Jeddah, Saudi Arabia

[4] Prince Sultan Mil Med City, Dept Intens Care Serv, Riyadh, Saudi Arabia

[5] King Saud bin Abdulaziz Univ Hlth Sci, King Abdullah Int Med Res Ctr, King Abdulaziz Med City, Dept Infect Prevent & Control, Riyadh, Saudi Arabia

[6] Alfaisal Univ, Dept Intens Care, Dr Sulaiman Al Habib Grp Hosp, Riyadh, Saudi Arabia

[7] Ohoud Hosp, King Fahad Hosp, Dept Crit Care, Al Madinah Al Monawarah, Saudi Arabia

[8] Alfaisal Univ, Dept Med, King Faisal Specialist Hosp & Res Ctr, Jeddah, Saudi Arabia

[9] King Fahad Med City, Dept Crit Care Med, Riyadh, Saudi Arabia

[10] Al Noor Specialist Hosp, Intens Care Dept, Mecca, Saudi Arabia

[11] King Saud Univ, Dept Crit Care Med, Riyadh, Saudi Arabia

[12] King Saud Med City, Intens Care Dept, Riyadh, Saudi Arabia

[13] King Faisal Specialist Hosp & Res Ctr, Intens Care Dept, Riyadh, Saudi Arabia

[14] King Abdulaziz Hosp, Intens Care Dept, Al Hasa, Saudi Arabia

[15] King Abdulaziz Univ Hosp, Dept Family & Community Med, Minist Hlth, Jeddah, Saudi Arabia

[16] King Fahad Cent Hosp, Intens Care Dept, Jeddah, Saudi Arabia

[17] King Saud bin Abdulaziz Univ Hlth Sci, King Abdullah Int Med Res Ctr, Dept Intens Care, King Abdulaziz Med City, Riyadh, Saudi Arabia

[18] Univ Oxford, Infect Dis Data Observ, Headiington, England

[19] Univ Toronto, Inst Hlth Policy Management & Evaluat, Sunnybrook Hosp, Dept Crit Care Med, Toronto, ON, Canada

[20] Univ Toronto, Inst Hlth Policy Management & Evaluat, Sunnybrook Hosp, Dept Med, Toronto, ON, Canada

[21] Univ Virginia, Sch Med, Div Infect Dis & Int Hlth, Dept Med, Charlottesville, VA 22908 USA

来源：

PLOS ONE | 2018年 / 13卷 / 11期

关键词：

SYNDROME CORONAVIRUS INFECTION; SAUDI-ARABIA; NONPREGNANT WOMEN; HEMODIALYSIS-PATIENTS; PANDEMIC INFLUENZA; CLINICAL-COURSE; OUTCOMES; DISEASE; OUTBREAK; IMMUNITY;

D O I：

10.1371/journal.pone.0206831

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Background Middle East Respiratory Syndrome Coronavirus (MERS-CoV) leads to healthcare-associated transmission to patients and healthcare workers with potentially fatal outcomes. Aim We aimed to describe the clinical course and functional outcomes of critically ill healthcare workers (HCWs) with MERS. Methods Data on HCWs was extracted from a multi-center retrospective cohort study on 330 critically ill patients with MERS admitted between (9/2012-9/2015). Baseline demographics, interventions and outcomes were recorded and compared between survivors and non-survivors. Survivors were approached with questionnaires to elucidate their functional outcomes using Karnofsky Performance Status Scale. Findings Thirty-Two HCWs met the inclusion criteria. Comorbidities were recorded in 34% (11/32) HCW. Death resulted in 8/32 (25%) HCWs including all 5 HCWs with chronic renal impairment at baseline. Non-surviving HCW had lower PaO2/FiO2 ratios 63.5 (57, 116.2) vs 148 (84, 194.3), p = 0.043, and received more ECMO therapy compared to survivors, 9/32 (28%) vs 4/24(16.7%) respectively (p = 0.02). Thirteen of the surviving (13/24) HCWs responded to the questionnaire. Two HCWs confirmed functional limitations. Median number of days from hospital discharge until the questionnaires were filled was 580 (95% Cl 568, 723.5) days. Conclusion Approximately 10% of critically ill patients with MERS were HCWs. Hospital mortality rate was substantial (25%). Patients with chronic renal impairment represented a particularly high-risk group that should receive extra caution during suspected or confirmed MERS cases clinical care assignment and during outbreaks. Long-term repercussions of critical illness due to MERS on HCWs in particular, and patients in general, remain unknown and should be investigated in larger studies.

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