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

Adegboye, Oyelola, Saffary, Timor, Adegboye, Majeed, and Elfaki, Faiz (2019) Individual and network characteristic associated with hospital-acquired Middle East Respiratory Syndrome coronavirus. Journal of Infection and Public Health, 12 (3). pp. 343-349.

PDF (Accepted Publisher Version) - Accepted Version
Available under License Creative Commons Attribution Non-commercial No Derivatives.

Download (1MB) | Preview
View at Publisher Website:


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.

Item ID: 56681
Item Type: Article (Research - C1)
ISSN: 1876-035X
Keywords: hospital-acquired infections, MERS, healthcare workers, network analysis
Copyright Information: ©2018 The Authors. Published by Elsevier Limited on behalf of King Saud Bin Abdulaziz University for Health Sciences. This is an open access article under the CC BY-NC-ND license (
Date Deposited: 24 Jan 2019 06:53
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320211 Infectious diseases @ 50%
49 MATHEMATICAL SCIENCES > 4905 Statistics > 490501 Applied statistics @ 50%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920109 Infectious Diseases @ 100%
Downloads: Total: 847
Last 12 Months: 111
More Statistics

Actions (Repository Staff Only)

Item Control Page Item Control Page