Table 4.
Association of Ribavirin/Recombinant Interferon With 90-Day Mortality and Middle East Respiratory Syndrome (MERS) Coronavirus RNA Clearance in Critically Ill Patients With MERS
| Day 90 Mortality | MERS-CoV RNA Clearance | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Logistic Regression | Cox Proportional Hazards Regression Model | Marginal Structural Model | Cox Proportional Hazards Regression Model | Marginal Structural Cox Proportional Hazards Model | |||||||||||
| Variable | No. | aOR (95% CI) | P Value | No. | aHR (95% CI) | P Value | No. | aOR (95% CI) | P Value | No. | aHR (95% CI) | P Value | No. | aHR (95% CI) | P Value |
| RBV/rIFN vs no RBV/ rIFN (ref) | 342 | 2.27 (1.20–4.32) | .01 | 342 | 1.52 (1.13–2.06) | .006 | 342 | 1.03 (.73–1.44) | .87 | 154 | 1.09 (.58–2.04) | .80 | 154 | 0.65 (.30–1.44) | .29 |
| RBV vs no RBV (ref) | 342 | 2.02 (1.09–3.73) | .02 | 342 | 1.41 (1.04–1.90) | .03 | 342 | 1.19 (.84–1.68) | .33 | 154 | 1.03 (.55–1.95) | .92 | 154 | 0.53 (.23–1.23) | .14 |
| rIFN vs no rIFN (ref) | 342 | 2.53 (1.32–4.85) | .005 | 342 | 1.57 (1.18–2.09) | .002 | 342 | 1.05 (.74–1.48) | .80 | 154 | 1.03 (.55–1.92) | .92 | 154 | 0.86 (.38–1.93) | .71 |
Logistic regression and Cox proportional hazards regression models were adjusted for the following variables: diabetes with chronic complications, liver disease, renal disease, any malignancy including leukemia or lymphoma, Sequential Organ Failure Assessment (SOFA) score on day 1, source of infection (community-acquired/healthcare worker, hospital-acquired/non–healthcare worker, hospital-acquired), and year (before 1 July 2014 and after). For logistic regression, Hosmer-Lemeshow goodness-of-fit test was used to assess the model fitness, and P values were not significant for all analyses. For marginal structural model, adjustment was made for the same afore mentioned baseline characteristics and for the following time-varying covariates: SOFA on the index day of RBV/rIFN initiation and the previous day, ventilation status on the index day and on the previous day (0: not ventilated, 1: noninvasive ventilation, 2: invasive mechanical ventilation, 3: oxygen rescue therapy), hemoglobin, white cell count, aspartate aminotransferase and creatinine on the index day, and corticosteroid therapy on the index day. For Cox proportional hazards regression model and marginal structural Cox proportional hazards model, we censored patients if they never cleared MERS-CoV RNA or at the time of last real-time reverse-transcription polymerase chain reaction test.
Abbreviations: aHR, adjusted hazard ratio; aOR, adjusted odds ratio; CI, confidence interval; MERS-CoV, Middle East respiratory syndrome coronavirus; RBV, ribavirin; rIFN, recombinant interferon.