Title |
Clinical management of respiratory syndrome in patients hospitalized for suspected Middle East respiratory syndrome coronavirus infection in the Paris area from 2013 to 2016
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Published in |
BMC Infectious Diseases, July 2018
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DOI | 10.1186/s12879-018-3223-5 |
Pubmed ID | |
Authors |
A. Bleibtreu, S. Jaureguiberry, N. Houhou, D. Boutolleau, H. Guillot, D. Vallois, J. C. Lucet, J. Robert, B. Mourvillier, J. Delemazure, M. Jaspard, F. X. Lescure, C. Rioux, E. Caumes, Y. Yazdanapanah |
Abstract |
Patients with suspected Middle East respiratory syndrome coronavirus (MERS-CoV) infection should be hospitalized in isolation wards to avoid transmission. This suspicion can also lead to medical confusion and inappropriate management of acute respiratory syndrome due to causes other than MERS-CoV. We studied the characteristics and outcome of patients hospitalized for suspected MERS-CoV infection in the isolation wards of two referral infectious disease departments in the Paris area between January 2013 and December 2016. Of 93 adult patients (49 male (52.6%), median age 63.4 years) hospitalized, 82 out of 93 adult patients had returned from Saudi Arabia, and 74 of them were pilgrims (Hajj). Chest X-ray findings were abnormal in 72 (77%) patients. The 93 patients were negative for MERS-CoV RT-PCR, and 70 (75.2%) patients had documented infection, 47 (50.5%) viral, 22 (23.6%) bacterial and one Plasmodium falciparum malaria. Microbiological analysis identified Rhinovirus (27.9%), Influenza virus (26.8%), Legionella pneumophila (7.5%), Streptococcus pneumoniae (7.5%), and non-MERS-coronavirus (6.4%). Antibiotics were initiated in 81 (87%) cases, with two antibiotics in 63 patients (67.7%). The median duration of hospitalization and isolation was 3 days (1-33) and 24 h (8-92), respectively. Time of isolation decreased over time (P < 0.01). Two patients (2%) died. The management of patients with possible MERS-CoV infection requires medical facilities with trained personnel, and rapid access to virological results. Empirical treatment with neuraminidase inhibitors and an association of antibiotics effective against S. pneumoniae and L. pneumophila are the cornerstones of the management of patients hospitalized for suspected MERS-CoV infection. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
France | 1 | 7% |
United States | 1 | 7% |
Venezuela, Bolivarian Republic of | 1 | 7% |
Unknown | 12 | 80% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 12 | 80% |
Scientists | 2 | 13% |
Practitioners (doctors, other healthcare professionals) | 1 | 7% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 110 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 14 | 13% |
Student > Bachelor | 14 | 13% |
Student > Master | 10 | 9% |
Student > Doctoral Student | 8 | 7% |
Other | 8 | 7% |
Other | 14 | 13% |
Unknown | 42 | 38% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 21 | 19% |
Biochemistry, Genetics and Molecular Biology | 8 | 7% |
Nursing and Health Professions | 8 | 7% |
Pharmacology, Toxicology and Pharmaceutical Science | 6 | 5% |
Immunology and Microbiology | 4 | 4% |
Other | 14 | 13% |
Unknown | 49 | 45% |