Factors associated with recovery delay in a sample of patients diagnosed by MERS-CoV rRT-PCR: A Saudi Arabian multicenter retrospective study.
Influenza and Other Respiratory Viruses
Ahmed AE1, Al-Jahdali H1, Alaqeel M1, Siddiq SS2, Alsaab HA3, Sakr EA2, Alyahya HA2, Alandonisi MM2, Subedar AT2, Ali YZ1, Al Otaibi H1, Aloudah NM4, Baharoon S1, Al Johani S1, Alghamdi MG2.
1 King Abdullah International Medical Research Center (KAIMRC)/King Saud bin Abdulaziz University for Health Sciences (KSAU-HS)/King Abdulaziz Medical City (KAMC), Ministry of National Guard – Health Affairs, Riyadh, Saudi Arabia.
2 King Fahad General Hospital – Jeddah, Jeddah, Saudi Arabia.
3 Medical Records Department, Ministry of Health, Jeddah, Saudi Arabia.
4 King Saud University, Riyadh, Saudi Arabia.
Year of Publication:
Research evidence exists that poor prognosis is common in Middle East respiratory syndrome coronavirus (MERS-CoV) patients.
This study estimates recovery delay intervals and identifies associated factors in a sample of Saudi Arabian patients admitted for suspected MERS-CoV and diagnosed by rRT-PCR assay.
A multicenter retrospective study was conducted on 829 patients admitted between September 2012 and June 2016 and diagnosed by rRT-PCR procedures to have MERS-CoV and non-MERS-CoV infection in which 396 achieved recovery. Detailed medical charts were reviewed for each patient who achieved recovery. Time intervals in days were calculated from presentation to the initial rRT-PCR diagnosis (diagnosis delay) and from the initial rRT-PCR diagnosis to recovery (recovery delay).
The median recovery delay in our sample was 5 days. According to the multivariate negative binomial model, elderly (age ≥ 65), MERS-CoV infection, ICU admission, and abnormal radiology findings were associated with longer recovery delay (adjusted relative risk (aRR): 1.741, 2.138, 2.048, and 1.473, respectively). Camel contact and the presence of respiratory symptoms at presentation were associated with a shorter recovery delay (expedited recovery) (aRR: 0.267 and 0.537, respectively). Diagnosis delay is a positive predictor for recovery delay (r = .421; P = .001).
The study evidence supports that longer recovery delay was seen in patients of older age, MERS-CoV infection, ICU admission, and abnormal radiology findings. Shorter recovery delay was found in patients who had camel contact and respiratory symptoms at presentation. These findings may help us understand clinical decision making on directing hospital resources toward prompt screening, monitoring, and implementing clinical recovery and treatment strategies.