Background Patients with suspected Middle East respiratory syndrome coronavirus (MERS-CoV) infection should be hospitalized in isolation wards to avoid transmission. This suspicion can also lead to medical confusion and inappropriate management of acute respiratory syndrome due to causes other than MERS-CoV. Methods We studied the characteristics and outcome of patients hospitalized for suspected MERS-CoV infection in the isolation wards of two referral infectious disease departments in the Paris area between January 2013 and December 2016. Results Of 93 adult patients (49 male (52.6%), median age 63.4 years) hospitalized, 82 out of 93 adult patients had returned from Saudi Arabia, and 74 of them were pilgrims (Hajj). Chest X-ray findings were abnormal in 72 (77%) patients. The 93 patients were negative for MERS-CoV RT-PCR, and 70 (75.2%) patients had documented infection, 47 (50.5%) viral, 22 (23.6%) bacterial and one Plasmodium falciparum malaria. Microbiological analysis identified Rhinovirus (27.9%), Influenza virus (26.8%), Legionella pneumophila (7.5%), Streptococcus pneumoniae (7.5%), and non-MERS-coronavirus (6.4%). Antibiotics were initiated in 81 (87%) cases, with two antibiotics in 63 patients (67.7%). The median duration of hospitalization and isolation was 3 days (1–33) and 24 h (8–92), respectively. Time of isolation decreased over time ( P < 0.01). Two patients (2%) died. Conclusion The management of patients with possible MERS-CoV infection requires medical facilities with trained personnel, and rapid access to virological results. Empirical treatment with neuraminidase inhibitors and an association of antibiotics effective against S. pneumoniae and L. pneumophila are the cornerstones of the management of patients hospitalized for suspected MERS-CoV infection. Electronic supplementary material The online version of this article (10.1186/s12879-018-3223-5) contains supplementary material, which is available to authorized users.
【저자키워드】 respiratory tract infection, Saudi Arabia, Middle East respiratory syndrome coronavirus (MERS-CoV), Pilgrims, Isolation ward, Legionella, 【초록키워드】 Treatment, Hospitalized, Infection, Antibiotics, Transmission, Infectious disease, outcome, RT-PCR, virus, MERS-CoV, X-ray, Characteristics, management, male, Patient, Isolation, Legionella pneumophila, patients, Bacterial, association, Analysis, Streptococcus pneumoniae, Middle East, Plasmodium falciparum malaria, Confusion, acute respiratory syndrome, Virological, supplementary material, median age, Paris, respiratory syndrome coronavirus, MERS-CoV infection, duration of hospitalization, time, effective, Result, died, median, Two patient, initiated, cause, returned, neuraminidase inhibitor, patients hospitalized, 【제목키워드】 Infection, clinical, management, Middle East, Paris, syndrome, respiratory syndrome coronavirus, patients hospitalized,