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Volume 25, Number 4—April 2019
Research

Middle East Respiratory Syndrome Coronavirus Infection Dynamics and Antibody Responses among Clinically Diverse Patients, Saudi Arabia

Hail M. Al-Abdely1, Claire M. Midgley1Comments to Author , Abdulrahim M. Alkhamis, Glen R. Abedi, Xiaoyan Lu, Alison M. Binder, Khalid H. Alanazi, Azaibi Tamin, Weam M. Banjar, Sandra Lester, Osman Abdalla, Rebecca M. Dahl, Mutaz Mohammed, Suvang Trivedi, Homoud S. Algarni, Senthilkumar K. Sakthivel, Abdullah Algwizani, Fahad Bafaqeeh, Abdullah Alzahrani, Ali Abraheem Alsharef, Raafat F. Alhakeem, Hani A. Aziz Jokhdar, Sameeh S. Ghazal, Natalie J. Thornburg, Dean D. Erdman, Abdullah M. Assiri, John T. WatsonComments to Author , and Susan I. Gerber
Author affiliations: Ministry of Health, Riyadh, Saudi Arabia (H.M. Al-Abdely, A.M. Alkhamis, K.H. Alanazi, W.M. Banjar, O. Abdalla, M. Mohammed, H.S. Algarni, A. Alzahrani, A.A. Alsharef, R.F. Alhakeem, H.A.A. Jokhdar, A.M. Assiri); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (C.M. Midgley, G.R. Abedi, X. Lu, A.M. Binder, A. Tamin, S. Lester, R.M. Dahl, S.K. Sakthivel, N.J. Thornburg, D.D. Erdman, J.T. Watson, S.I. Gerber); Princess Nourah Bint Abdulrahman University, Riyadh (W.M. Banjar); Prince Mohammed Bin Abdulaziz Hospital, Riyadh (A. Algwizani, F. Bafaqeeh, S.S. Ghazal)

Main Article

Table 2

Demographic and exposure characteristics of survivors with prolonged MERS-CoV detection, Saudi Arabia, August 1, 2015–August 31, 2016*

Characteristic Total, N = 19 Days to negativity
p value†
<11 d, n = 11 >11 d, n = 8
Demographics
Sex
M 13/19 (68) 6/11 (55) 7/8 (88) 0.177
F 6/19 (32) 5/11 (45) 1/8 (12)
Nationality
Saudi 10/19 (53) 5/11 (45) 5/8 (63) 0.650
Non-Saudi 9/19 (47) 6/11 (55) 3/8 (37)
Age group, y
25–44 14/19 (74) 9/11 (82) 5/8 (63) 0.262
45–64 4/19 (21) 1/11 (9) 3/8 (38)
>65 1/19 (5) 1/11 (9) 0/8
Median age, y (range)
36 (26–73)
30 (26–73)
40 (27–62)
0.083
Underlying conditions
None reported 10/19 (53) 8/11 (73) 2/8 (25) 0.070
Any reported underlying condition 9/19 (47) 3/11 (27) 6/8 (75)
DM‡ 7/18 (39) 2/11 (20) 5/7 (71) 0.049
DM and possible DM§ 8/19 (42) 2/11 (20) 6/8 (75) 0.024
Hypertension 3/19 (16) 1/11 (9) 2/8 (25) 0.546
Cardiac disease¶ 1/19 (5) 1/11 (9) 0/8 1.000
Pulmonary disease# 1/19 (5) 1/11 (9) 0/8 1.000
On oxygen at home**
1/19 (5)
1/11 (9)
0/8
1.000
Possible preillness exposure
Secondary,†† healthcare personnel 5/19 (26) 4/11 (36) 1/8 (13) NA
Secondary, household contact 5/19 (26) 3/11 (27) 2/8 (25) NA
Secondary, hospital visitor 3/19 (16) 0/11 3/8 (38) NA
Secondary, hospital inpatient 0/19 0/11 0/8 NA
Any secondary exposure 13/19 (68) 7/11 (64) 6/8 (75) 0.796
Direct camel contact 0/19 0/11 0/8
Multiple possible exposures 2/19 (11) 1/11 (9) 1/8 (13)
No recognized risks‡‡ 4/19 (21) 3/11 (27) 1/8 (13)
Primary vs. secondary exposure§§
Primary¶¶ 4/17 (24) 3/10 (30) 1/7 (14) 0.603
Secondary 13/17 (78) 7/10 (70) 6/7 (86)

*Values are no. (%) patients except as indicated. CoV, coronavirus; DM, diabetes mellitus; MERS, Middle East respiratory syndrome; NA, not applicable.
†p values are for Fisher exact or Kruskall–Wallis tests comparing long-term and short-term.
‡Based on documented medical history of DM; comparison excludes 1 patient with possible DM status; total, N = 18; prolonged shedding >11 days, n = 7.
§Includes 7 patients with a documented history of DM and 1 patient (of possible DM status) who had no documented history of DM but exhibited multiple periods of hyperglycemia (>200 mg/dL) during hospitalization, with a maximum random glucose reading of 404 mg/dL.
¶Cardiac disease includes congestive heart failure, coronary artery disease, a history of coronary artery bypass, or a history of myocardial infarction. Reports of isolated hypertension were not included.
#Pulmonary disease includes chronic obstructive pulmonary disease, asthma or reactive airway disease, or use of supplemental oxygen at home.
**Patient who was on supplemental oxygen (bilevel positive airway pressure) at home required mechanical ventilation when hospitalized.
††Secondary exposure defined as reported contact with a known MERS case-patient.
‡‡No recognized risks defined as no reported contact with a known MERS case-patient or camel (direct or indirect contact).
§§Comparison excludes 2 patients with multiple exposures; total, N = 17; shed <11 days, n = 10; shed >11 days, n = 7.
¶¶Primary exposure defined as no reported contact with a known MERS case-patient; includes direct camel contact and patients with no recognized risks.

Main Article

1These first authors contributed equally to this article.

Page created: March 18, 2019
Page updated: March 18, 2019
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