Middle East respiratory syndrome (MERS) - Complications | BMJ Best Practice US

Complications

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Complications table
Complication	Timeframe	Likelihood
acute respiratory failure	short term	medium
Reported in 25% to 95% of confirmed cases that required hospitalization.[8][26][33] Median time to invasive mechanical ventilation was 7 days in a cohort of 47 patients.[8] Extracorporeal membrane oxygenation has been used in some cases; however, efficacy has not been confirmed.[26][81] Risk factors include age ≥50 years, diabetes mellitus, end-stage renal disease, and obesity.[5][8][9][26] Acute respiratory failure
acute respiratory distress syndrome	short term	medium
New or worsening respiratory symptoms within one week of presentation. Chest x-ray shows bilateral opacities.[92] High-flow oxygen (up to 50 mL/minute) is recommended in some patients, although mechanical ventilation and intubation is usually required.[92] Acute respiratory distress syndrome
acute renal failure	short term	medium
Initially reported in a few case reports.[14][30][82] Has since been reported in 58% of critically ill patients in one study, and 26% of patients in one cohort.[81][162] Possibly due to the presence of dipeptidyl peptidase-4 (DPP4) receptors in renal epithelial cells.[163] Detection of the virus in urine samples has been previously documented.[161] Acute kidney injury
multiorgan failure	short term	low
Occurs in a minority of patients late in the course of illness. Underlying mechanism of action is unknown. Usually presents with thrombocytopenia, prolonged coagulation profile, and circulatory collapse.[26][33][81] Patients may require vasopressor and inotrope support.

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