Individual and network characteristic associated with hospital-acquired Middle East Respiratory Syndrome coronavirus

Background: During outbreaks of infectious diseases, transmission of the pathogen can form networks of infected individuals connected either directly or indirectly. Methods: Network centrality metrics were used to characterize hospital-acquired Middle East Respiratory Syndrome Coronavirus (HA-MERS) outbreaks in the Kingdom of Saudi Arabia between 2012 and 2016. Covariate-adjusted multivariable logistic regression models were applied to assess the effect of individual level risk factors and network level metrics associated with increase in length of hospital stay and risk of deaths from MERS. Results: About 27% of MERS cases were hospital acquired during the study period. The median age of healthcare workers and hospitalized patients were 35 years and 63 years, respectively, Although HA-MERS were more connected, we found no significant difference in degree centrality metrics between HA-MERS and non-HA-MERS cases. Pre-existing medical conditions (adjusted Odds ratio (aOR) = 2.43, 95% confidence interval: (CI) [1.11-5.33]) and hospitalized patients (aOR = 29.99, 95% CI [1.80-48.65]) were the strongest risk predictors of death from MERS. The risk of death associated with 1-day increased length of stay was significantly higher for patients with comorbidities. Conclusion: Our investigation also revealed that patients with an HA-MERS infection experienced a significantly longer hospital stay and were more likely to die from the disease. Healthcare worker should be reminded of their potential role as hubs for pathogens because of their proximity to and regular interaction with infected patients. On the other hand, this study has shown that while healthcare workers acted as epidemic attenuators, hospitalized patients played the role of an epidemic amplifier.Scopu

The increased risk of middle east respiratory syndrome coronavirus: effects of the interaction between temperature variability and dromedary exposure

Background: Environmental factors plays a very crucial role in the spread of infectious diseases especially those that are transmitted via pathogenic droplets such as MERS-CoV and Ebola. Recent data suggest a higher prevalence of MERS-CoV infection in dromedary camels in winter months compared to summer months within middle eastern countries. It is speculated that increase animal-to-human transmission in winter could exacerbate the putative human-to-human transmission via respiratory secretions. Therefore, this study focuses on investigating the effects of temperature variability and exposure to dromedary on the risk of MERS. Methods and materials: Often, exposure to certain environmental factors produces effects lasting well beyond the exposure period and with an increase in risk occurring from few hours to later in the future. In this study, we used time-varying distributed lag nonlinear models with doubly penalized spline to provide greater flexibility to the temperature-lag-MERS association. We also estimate the burden of the disease that can be attributed to temperature among patients exposed to dromedary camels. Results: Preliminary results revealed that the optimal temperature for MERS in the study area was 27.2 °C. The increased risk of MERS associated with high temperature indicates that environmental and dromedary interactions at plays a significant role in the transportation of the pathogens. Conclusion: Temperature variability in the winter months is associated with high risk of MERS as well as dromedary contact. MERS should not be regarded as seasonal infection because it occurs throughout the year, however the increased risk and timing of MERS peaks in lower temperatures clearly present a challenge

Differential Expression of Serum Proinflammatory Cytokine TNF-α and Genetic Determinants of TNF-α, CYP2C19*17, miR-423 Genes and Their Effect on Coronary Artery Disease Predisposition and Progression

Coronary artery disease (CAD) is the leading cause of death and hospitalization worldwide and represents a problem for public health systems everywhere. In Saudi Arabia, the prevalence of CAD is estimated to be 5.5%. Risk factors for CAD include older age, male gender, obesity, high blood pressure, smoking, diabetes, hyperlipidemia, and genetic factors. Reducing the risk factors in susceptible individuals will decrease the prevalence of CAD. Genome wide association studies have helped to reveal the association of many loci with diseases like CAD. In this study, we examined the link between single nucleotide variations (SNVs) of TNF-α-rs1800629 G>A, CYP2C19*17 (rs12248560) C>T, and miR-423 rs6505162 C>A and the expression of TNF-α with CAD. We used the mutation specific PCR, ARMS-PCR, and ELISA. The results showed that the A allele of the TNF-α rs1800629 G>A SNP is linked to CAD with odd ratio (OR) (95% CI) = 2.10, p-value = 0.0013. The T allele of the CYP2C19*17 (rs12248560) C>T is linked to CAD with OR (95% CI) = 2.02, p-value = 0.003. In addition, the A allele of the miR-423 rs6505162 C>A SNV is linked to CAD with OR (95% CI) = 1.49, p-value = 0.036. The ELISA results indicated that the TNF-α serum levels are significantly increased in CAD patients compared to healthy controls. We conclude the TNF-α rs1800629 G>A, CYP2C19*17, and miR-423 rs6505162 C>A are potential genetic loci for CAD in the Saudi population. These findings require further verification in future studies. After being verified, our results might be utilized in genetic testing to identify individuals that are susceptible to CAD and, therefore, for whom reducing modifiable risk factors (e.g., poor diet, diabetes, obesity, and smoking) would result in prevention or delay of CAD