Table 2.

Themes and key clinical questions asked during outbreaks of SARS and MERS

Theme	Key question(s)	Objective
Clinical characterisation	What is the clinical presentation and spectrum of disease?	Determine symptomology, progression of disease, laboratory findings, and radiological features in different patient groups (adults vs children, immunosuppressed patients) and identify early presenting symptoms
Prognosis	What are the risk factors for death or severe illness?	Identify factors such as comorbidities, demographic factors, test parameters, etc. that predict death, ICU admission, etc.
Clinical management	What treatments are effective for MERS/SARS patients?	Determine the role of antiviral treatments, steroid treatments, or combination in comparison to supportive therapy
	What is the role of antivirals in treatment?
	What is the role of steroids in treatment?
Diagnosis	What is the optimal diagnostic test for detecting the virus?	Evaluate sensitivity/specificity/positive predictive value/negative predictive value of different diagnostic assays such as real-time RT-PCR and ELISA
Viral pathogenesis	What is the duration of viral shedding?	Determine the viral shedding profiles over time and in different body fluids
Epidemiological characterisation	What characteristics define a “case”?	Develop criteria for suspected, probable, and confirmed cases
Infection prevention and control / Transmission	What are the risk factors that pre-dispose health care workers to infection or transmission?	Determine the activities or prevention measures that are correlated with protection or infection in health care workers
Susceptibility	What are the risk factors for infection? (patient population)	Determine the risk factors for patient infection, in the community and health care setting
Psychosocial	What are the psychosocial consequences of infection with the virus?	Determine effect of illness, treatment, and isolation procedures on the psychological and social well-being of those infected