Infect Chemother.  2016 Jun;48(2):118-126. 10.3947/ic.2016.48.2.118.

Clinical Presentation and Outcomes of Middle East Respiratory Syndrome in the Republic of Korea

• Choi WS
• Kang CI
• Kim Y
• Choi JP
• Joh JS
• Shin HS
• Kim G
• Peck KR
• Chung DR
• Kim HO
• Song SH
• Kim YR
• Sohn KM
• Jung Y
• Bang JH
• Kim NJ
• Lee KS
• Jeong HW
• Rhee JY
• Kim ES
• Woo H
• Oh WS
• Huh K
• Lee YH
• Song JY
• Lee J
• Lee CS
• Kim BN
• Choi YH
• Jeong SJ
• Lee JS
• Yoon JH
• Wi YM
• Joung MK
• Park SY
• Lee SH
• Jung SI
• Kim SW
• Lee JH
• Lee H
• Ki HK
• Kim YS
• The Korean Society of Infectious Diseases

• KMID: 2327979
• DOI: http://doi.org/10.3947/ic.2016.48.2.118

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.

Keyword

Middle East respiratory syndrome; Republic of Korea

MeSH Terms

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
Antiviral Agents
Aspartate Aminotransferases

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