Patient selection: infection with MERS coronavirus with the Middle East Respiratory Syndrome (MERS)
Risk factors for mortality:
(1) older age (nonsurvivors 59 +/- 8 vs survivors 46 +/-13)
(2) low serum albumin (< 3.5 g/dL)
(3) altered mental status
(4) high pneumonia severity index (median for nonsurvivors 119 vs 46 for survivors)
Predictors of mortality:
(1) severe inflammation at initial presentation, as reflected by high serum concentrations of proinflammatory cytokines (IP-10, MCP-1, IL-6)
(2) poor viral control with high viral loads during late stage disease (days 5-10)
(3) poor antibody response during the course of the infection (low titers during days 11-16)
where:
• The high level of cytokine release is associated with multi-organ failure.
• The poor antibody response may be associated with old age.
