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Factors associated with recovery delay in a sample of patients diagnosed by MERS-CoV rRT-PCR: a Saudi Arabian multicenter retrospective study.

Factors associated with recovery delay in a sample of patients diagnosed by MERS-CoV rRT-PCR: a Saudi Arabian multicenter retrospective study.
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Ahmed AE, Al-Jahdali H, Alaqeel M, Siddiq SS, Alsaab HA, Sakr EA, Alyahya HA, Alandonisi MM, Subedar AT, Ali YZ, Al Otaibi H, Aloudah NM, Baharoon S, Al Johani S, Alghamdi MG,


Ahmed AE, Al-Jahdali H, Alaqeel M, Siddiq SS, Alsaab HA, Sakr EA, Alyahya HA, Alandonisi MM, Subedar AT, Ali YZ, Al Otaibi H, Aloudah NM, Baharoon S, Al Johani S, Alghamdi MG, (click to view)

Ahmed AE, Al-Jahdali H, Alaqeel M, Siddiq SS, Alsaab HA, Sakr EA, Alyahya HA, Alandonisi MM, Subedar AT, Ali YZ, Al Otaibi H, Aloudah NM, Baharoon S, Al Johani S, Alghamdi MG,

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Influenza and other respiratory viruses 2018 04 06() doi 10.1111/irv.12560
Abstract
AIM
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.

METHOD
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).

RESULTS
The median recovery delay in our sample was five 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 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 = 0.421; P = .001).

CONCLUSION
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. This article is protected by copyright. All rights reserved.

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