Diagnostic Delays in 537 Symptomatic Cases of MERS-CoV Infection in Saudi Arabia
July 19th, 2017International Journal of Infectious Diseases
Abstract
Background
Although the literature indicates the potential outcomes of a patient’s delay in seeking medical support is associated with poor clinical outcomes, delays in the diagnosis itself remain poorly understood in patients with Middle East Respiratory Syndrome − Coronavirus (MERS-CoV). This study aims to estimate the median time interval of confirmed diagnosis after symptom onset and identify its potential predictors in Saudi Arabian MERS patients.
Methods
A retrospective study involved patients confirmed with MERS who were publicly reported by the World Health Organization (WHO).
Results
537 symptomatic cases of MERS-CoV infection were included. The median time between symptom onset and confirming MERS diagnosis was 4 days (IQR: 2-7), ranging from 0 to 36 days. According to a negative binomial model, the unadjusted rate ratio (RR) of delays in the diagnosis was significantly higher in older patients (> 65 years) (RR = 1.42), non-healthcare workers (RR = 1.74), patients with severity of illness (RR = 1.22), those with unknown sources of infections (RR = 1.84), and those who were in close contact with camels (RR = 1.74). After accounting for confounders, the adjusted rate ratio (aRR) of delays in the diagnosis was independently associated with unknown sources of infections (aRR = 1.68) and those in close contact with camels (aRR = 1.58).
Conclusion
The time interval from onset until diagnosis was greater in older patients, non-healthcare workers, patients with severity of illness, patients with unknown sources of infections, and patients in close contact with camels. The findings warrant educational intervention to raise the general public awareness on the importance of early-symptom notification.