Role of chest radiograph in MERS-Cov pneumonia: a single tertiary referral center experience in the United Arab Emirates

Karuna M. Das, Jamal Aldeen Alkoteesh, Mohamud Sheek-Hussein, Samira Ali Alzadjali, Mariam Tareq Alafeefi, Rajvir Singh, Yauhen Statsenko, Elpidoforos S. Soteriades, Vishwajeet Singh, Klaus Van Gorkom

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3 Citations (Scopus)


Background: The Middle East respiratory syndrome coronavirus (MERS-Cov) continues to be a source of concern due to intermittent outbreaks. Serial chest radiographic changes in MERS-Cov patients were analyzed for various variables that could be compared to the patients’ final outcomes in a cluster of MERS-Cov patients and to identify a predictor of mortality in the United Arab Emirates. Results: A total of 44 MERS-Cov cases were reviewed. The mean age of the patients was 43.7 ± 14.7 years. The chest radiograph was abnormal in 14/44 (31.8%). The commonest radiology features include ground-glass opacities (seven of 14, 50%), ground-glass and consolidation (seven of 14, 50%), pleural effusion (eight of 14, 57.1%), and air bronchogram (three of 14, 21.4%). The mortality rate was 13.6% (six of 44); the deceased group (6 of 44, 13.6%) was associated with significantly higher incidence of mechanical ventilation (p < 0.001), pleural effusion (p < 0.001), chest radiographic score (8.90 ± 6.31, p < 0.001), and type 4 radiographic progression of disease (p < 0.001). A chest radiographic score at presentation was seen to be an independent and strong predictor of mortality (OR [95% confidence interval] 3.20 [1.35, 7.61]). The Cohen κ coefficient for the interobserver agreement was k = 0.89 (p = 0.001). Conclusion: The chest radiographic score, associated with a higher degree of disease progression (type 4), particularly in patients with old age or with comorbidity, may indicate a poorer prognosis in MERS-Cov infection, necessitating intensive care unit management or predicting impending death.

Original languageEnglish
Article number133
JournalEgyptian Journal of Radiology and Nuclear Medicine
Issue number1
Publication statusPublished - Dec 2021


  • ARDS
  • Chest radiograph
  • MERS-Cov

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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