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Predictors of mortality in Middle East respiratory syndrome (MERS)

Ki-Ho Hong1, Jae-Phil Choi2, Seon-Hui Hong3

  • 1Department of Laboratory Medicine, Seoul Medical Center, Seoul, Republic of Korea.

Thorax
|July 21, 2017
PubMed

Insights

This study on Middle East respiratory syndrome (MERS) found that older age, low albumin, and severe inflammation markers like inducible protein-10 predict mortality. Poor viral control and inadequate antibody response also correlate with fatal outcomes in MERS patients.

Area of Science:

  • Virology
  • Immunology
  • Clinical Medicine

Background:

  • This study investigated clinical characteristics, cytokine/chemokine profiles, viral shedding, and antibody kinetics in 30 patients with Middle East respiratory syndrome (MERS).
  • The research included 6 non-survivors from 3 designated MERS hospitals to identify factors associated with mortality.

Discussion:

  • Risk factors for MERS mortality identified at admission include advanced age, hypoalbuminemia, altered mental status, and a high pneumonia severity index score.
  • Severe inflammatory responses during the initial phase of hospitalization (days 1-4), characterized by elevated levels of inducible protein-10, monocyte chemoattractant protein-1, and interleukin-6, were significantly associated with mortality.
  • Inadequate control of viral load (high viral shedding from days 5-10) and insufficient antibody production (low antibody titers from days 11-16) were also linked to increased mortality in MERS patients.

Key Insights:

  • Early clinical indicators such as age, albumin levels, mental status, and pneumonia severity predict MERS mortality.
  • Specific inflammatory markers (IP-10, MCP-1, IL-6) during the acute phase are critical predictors of MERS patient outcomes.
  • Effective viral clearance and robust antibody development are crucial for MERS survival, with poor control correlating to higher mortality.

Outlook:

  • Further research could explore targeted immunotherapies or antiviral strategies to improve MERS patient outcomes.
  • Understanding the interplay between inflammation, viral load, and immune response can guide the development of novel therapeutic interventions for MERS.
  • Longitudinal studies tracking immune responses could refine prognostic markers for Middle East respiratory syndrome.
Keywords:
infection controlrespiratory infectionviral infection

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