Table 2.
Epidemical and clinical comparison of the fatal and nonfatal cases in human nosocomial outbreaks with MERS-CoV in the Middle East and South Korea as of 31 March 2016
| Characteristic | Nosocomial outbreaks in the Middle East (N = 51 clusters, 216 cases) |
p 1 value | Nosocomial outbreaks in South Korea (N = 1 cluster,174 cases) |
p 2 value | Outgroup comparison | |||
|---|---|---|---|---|---|---|---|---|
| Fatal (n = 56) |
Nonfatal (n = 160) | Fatal (n = 24) |
Nonfatal (n = 150) | p 3 value | p4 value | |||
| Epidemical features | ||||||||
| Nosocomial outbreaks | ||||||||
| Cluster size | 4 (2–28) | - | 174 (174) | - | - | - | ||
| Cluster year | 2012–2016 | - | 2015 | - | - | - | ||
| Peak season | February–May | April–May | ||||||
| Country |
KSA (41 clusters) UAE (5 clusters) Jordan (3 clusters) France (1 cluster) Iran (1 cluster) |
- | South Korea | - | - | - | ||
| Case fatality rate [% (no.)] | ||||||||
| Overall CFR | 25.9 (56/216) | - | 13.8 (24/174) | - | 0.003 | - | ||
| HCP-specific CFR | 4.2 (3/71) | - | 3.2 (1/31) | - | 0.137 | - | ||
| Patient composition [% (no.)] | ||||||||
| Percentage HCP | 32.9 (71/216) | - | 18.7 (31/166) | - | 0.002 | - | ||
| Percentage visiting a patient at a healthcare facility | 18.5 (40/216) | - | 30.1 (50/166) | - | 0.008 | - | ||
| Percentage of hospitalized patients | 48.6 (105/216) | - | 51.2 (85/166) | - | 0.615 | - | ||
| Co-morbidities [% (no.)] | 64.3 (36/56) | 28.1 (45/160) | 0.000 | 45.8 (11/24) | 12.0 (18/150) | 0.000 | 0.124 | 0.000 |
| Mean age (years) | 64 (25–98) | 46 (2–85) | 0.000 | 68 (49–82) | 53.5 (16–87) | 0.000 | 0.215 | 0.000 |
| Percentage of male cases [% (no.)] | 71.4 (40/56) | 56.8 (90/160) | 0.057 | 66.7 (16/24) | 58.7 (88/150) | 0.509 | 0.791 | 0.730 |
| Age groups [% (no.)] | ||||||||
| 0-14 | 0.0 (0/56) | 1. 1 (1/89) | <0.001 | 0.0 (0/24) | 0.0 (0/150) | <0.001 | 0.0584 | 0.0034 |
| 15-29 | 5.4 (3/56) | 14.6 (13/89) | 0.0 (0/24) | 5.3 (8/150) | ||||
| 30-44 | 12.5 (7/56) | 32.6 (29/89) | 0.0 (0/24) | 28.7 (43/150) | ||||
| 45-59 | 32.1 (18/56) | 37.1 (33/89) | 20.8 (5/24) | 32.0 (48/150) | ||||
| 60+ | 50.0 (28/56) | 14.6 (13/89) | 79.2 (19/24) | 34.0 (51/150) | ||||
| Gender ratio (male:female) | 2.5:1.0 | 1.28:1.0 | 0.057 | 2:1.0 | 1.4:1.0 | 0.509 | 0.791 | 0.730 |
| Exposure history [% (no.)] | ||||||||
| Exposure to an animal | 10.7 (6/56) | 11.25 (18/160) | 1.000 | 0.0 (0/24) | 0.0 (0/150) | - | 0.171 | 0.000 |
| Exposure to a camel | 8.9 (5/56) | 8.8 (14/160) | 0.968 | 0.0 (0/24) | 0.0 (0/150) | - | 0.315 | 0.000 |
| Human-human transmission | 57.1 (32/56) | 86.3 (138/160) | 0.000 | 100.0 (24/24) | 99.3 (149/150) | 1.000 | 0.000 | 0.000 |
| Clinical features | ||||||||
| Disease progress (days) | ||||||||
| Incubation | 5 (3–7) | 4.5 (2–9) | 0.0900 | 6 (0–12) | 6 (1–15) | 0.863 | 0.353 | 0.084 |
| From onset to admission | 4 (0–9) | 3 (0–11) | 0.072 | 4 (0–25) | 4 (0–38) | 0.937 | 0.683 | 0.304 |
| From onset to confirmation | 8 (1–47) | 4 (0–14) | 0.009 | 4 (1–13) | 5 (0–15) | 0.299 | 0.132 | 0.449 |
| From onset to death | 11.5 (1–36) | - | - | 11 (1–23) | - | - | 0.648 | - |
| From onset to discharge | - | 14 (5–38) | - | - | 17 (7–28) | - | - | 0.152 |
| Hospitalized days | 10 (2–35) | 6.5 (2–35) | 0.004 | 10 (0–22) | 15 (6–39) | 0.109 | 0.908 | 0.035 |
p 1: comparison of fatal and nonfatal cases of MERS nosocomial outbreaks in the Middle East
p 2: comparison of fatal and nonfatal cases of MERS nosocomial outbreak in South Korea
p 3: comparison of fatal cases in MERS nosocomial outbreaks in the Middle East and South Korea
p 4: comparison of nonfatal cases in MERS nosocomial outbreaks in the Middle East and South Korea
CFR, case fatality rate; HCP, healthcare personnel; KSA, Kingdom of Saudi Arabia; UAE, United Arab Emirates; “-”, no data available