J Korean Med Sci.  2017 Jan;32(1):151-154. 10.3346/jkms.2017.32.1.151.

Differential Cell Count and CRP Level in Blood as Predictors for Middle East Respiratory Syndrome Coronavirus Infection in Acute Febrile Patients during Nosocomial Outbreak

• Park GE
• Kang CI
• Ko JH
• Cho SY
• Ha YE
• Kim YJ
• Peck KR
• Song JH
• Chung DR

• KMID: 2417598
• DOI: http://doi.org/10.3346/jkms.2017.32.1.151

Abstract

A case-control study was performed to identify clinical predictors for Middle East respiratory syndrome coronavirus (MERS-CoV) infection among patients with acute febrile illness during the nosocomial outbreak. Patients with MERS-CoV were more likely to have monocytosis with normal white blood cell (WBC) count and lower C-reactive protein (CRP) level. Simple laboratory data such as complete blood counts (CBC) with differential count could be a useful marker for the prediction of MERS and triage at the initial presentation of acute febrile patients in outbreak setting.

Keyword

Middle East Respiratory Syndrome; Coronavirus; Predictors; Monocytosis

MeSH Terms

Blood Cell Count
C-Reactive Protein
Case-Control Studies
Cell Count*
Coronavirus
Coronavirus Infections*
Humans
Leukocytes
Middle East Respiratory Syndrome Coronavirus*
Middle East*
Triage
C-Reactive Protein

Figure

• 

  Fig. 1 Study inclusion and exclusion criteria applied for patient identification. MERS = Middle East respiratory syndrome.

Reference

1. Korea Centers for Disease Control and Prevention. Middle East respiratory syndrome coronavirus outbreak in the Republic of Korea, 2015. Osong Public Health Res Perspect. 2015; 6:269–278.

2. Korean Society of Infectious Diseases; Korean Society for Healthcare-associated Infection Control and Prevention. An unexpected outbreak of Middle East respiratory syndrome coronavirus infection in the Republic of Korea, 2015. Infect Chemother. 2015; 47:120–122.

3. Al-Abdallat MM, Payne DC, Alqasrawi S, Rha B, Tohme RA, Abedi GR, Al Nsour M, Iblan I, Jarour N, Farag NH, et al. Hospital-associated outbreak of Middle East respiratory syndrome coronavirus: a serologic, epidemiologic, and clinical description. Clin Infect Dis. 2014; 59:1225–1233.

4. Assiri A, Al-Tawfiq JA, Al-Rabeeah AA, Al-Rabiah FA, Al-Hajjar S, Al-Barrak A, Flemban H, Al-Nassir WN, Balkhy HH, Al-Hakeem RF, et al. Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study. Lancet Infect Dis. 2013; 13:752–761.

5. Assiri A, McGeer A, Perl TM, Price CS, Al Rabeeah AA, Cummings DA, Alabdullatif ZN, Assad M, Almulhim A, Makhdoom H, et al. Hospital outbreak of Middle East respiratory syndrome coronavirus. N Engl J Med. 2013; 369:407–416.

6. Oh MD, Choe PG, Oh HS, Park WB, Lee SM, Park J, Lee SK, Song JS, Kim NJ. Middle East respiratory syndrome coronavirus superspreading event involving 81 persons, Korea 2015. J Korean Med Sci. 2015; 30:1701–1705.

7. Al-Tawfiq JA, Hinedi K, Ghandour J, Khairalla H, Musleh S, Ujayli A, Memish ZA. Middle East respiratory syndrome coronavirus: a case-control study of hospitalized patients. Clin Infect Dis. 2014; 59:160–165.

8. Zumla A, Hui DS, Perlman S. Middle East respiratory syndrome. Lancet. 2015; 386:995–1007.

9. Lee N, Hui D, Wu A, Chan P, Cameron P, Joynt GM, Ahuja A, Yung MY, Leung CB, To KF, et al. A major outbreak of severe acute respiratory syndrome in Hong Kong. N Engl J Med. 2003; 348:1986–1994.

10. Liu CY, Huang LJ, Lai CH, Chen HP, Chen TL, Fung CP, Liu CY. Clinical characteristics, management and prognostic factors in patients with probable severe acute respiratory syndrome (SARS) in a SARS center in Taiwan. J Chin Med Assoc. 2005; 68:110–117.

11. Tsang KW, Ho PL, Ooi GC, Yee WK, Wang T, Chan-Yeung M, Lam WK, Seto WH, Yam LY, Cheung TM, et al. A cluster of cases of severe acute respiratory syndrome in Hong Kong. N Engl J Med. 2003; 348:1977–1985.

12. McClain MT, Park LP, Nicholson B, Veldman T, Zaas AK, Turner R, Lambkin-Williams R, Gilbert AS, Ginsburg GS, Woods CW. Longitudinal analysis of leukocyte differentials in peripheral blood of patients with acute respiratory viral infections. J Clin Virol. 2013; 58:689–695.

13. Chng WJ, Lai HC, Earnest A, Kuperan P. Haematological parameters in severe acute respiratory syndrome. Clin Lab Haematol. 2005; 27:15–20.

14. Wong RS, Wu A, To KF, Lee N, Lam CW, Wong CK, Chan PK, Ng MH, Yu LM, Hui DS, et al. Haematological manifestations in patients with severe acute respiratory syndrome: retrospective analysis. BMJ. 2003; 326:1358–1362.