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KMID : 1144320160480020118
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감염과 화학요법
2016 Volume.48 No. 2 p.118 ~ p.126
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Clinical Presentation and Outcomes of Middle East Respiratory Syndrome in the Republic of Korea
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Choi Won-Suk
Kang Cheol-In
Kim Yon-Jae
Choi Jae-Phil
Joh Joon-Sung
Shin Hyoung-Shik
Kim Ga-Yeon
Peck Kyong-Ran
Chung Doo-Ryeon
Kim Hye-Ok
Song Sook-Hee
Kim Yang-Ree
Sohn Kyung-Mok
Jung Young-Hee
Bang Ji-Hwan
Kim Nam-Joong
Oh Kkot
Huh Kyung-Min
Lee Young-Hyun
Song Joon-Young
Lee Ja-Cob
Lee Chang-Seop
Kim Baek-Nam
Choi Young-Hwa
Jeong Su-Jin
Lee Jin-Soo
Yoon Ji-Hyun
Wi Yu-Mi
Joung Mi-Kyong
Park Seong-Yeon
Lee Sun-Hee
Jung Sook-In
Kim Shin-Woo
Lee Jae-Hoon
Lee Hyuck
Ki Hyun-Kyun
Kim Yeon-Sook
Korean Society of Infectious Diseases
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Abstract
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Background: From May to July 2015, the Republic of Korea experienced the largest outbreak of Middle East respiratory syndrome (MERS) outside the Arabian Peninsula. A total of 186 patients, including 36 deaths, had been diagnosed with MERS-coronavirus (MERS-CoV) infection as of September 30th, 2015.
Materials and Methods: We obtained information of patients who were confirmed to have MERS-CoV infection. MERS-CoV infection was diagnosed using real-time reverse-transcriptase polymerase chain reaction assay.
Results: The median age of the patients was 55 years (range, 16 to 86). A total of 55.4% of the patients had one or more coexisting medical conditions. The most common symptom was fever (95.2%). At admission, leukopenia (42.6%), thrombocytopenia (46.6%), and elevation of aspartate aminotransferase (42.7%) were observed. Pneumonia was detected in 68.3% of patients at admission and developed in 80.8% during the disease course. Antiviral agents were used for 74.7% of patients. Mechanical ventilation, extracorporeal membrane oxygenation, and convalescent serum were employed for 24.5%, 7.1%, and 3.8% of patients, respectively. Older age, presence of coexisting medical conditions including diabetes or chronic lung disease, presence of dyspnea, hypotension, and leukocytosis at admission, and the use of mechanical ventilation were revealed to be independent predictors of death.
Conclusion: The clinical features of MERS-CoV infection in the Republic of Korea were similar to those of previous outbreaks in the Middle East. However, the overall mortality rate (20.4%) was lower than that in previous reports. Enhanced surveillance and active management of patients during the outbreak may have resulted in improved outcomes.
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KEYWORD
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Middle East respiratory syndrome, Republic of Korea
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