Javad Aghazadeh-Attari, Iraj Mohebbi, Behnam Mansorian, Jamal Ahmadzadeh, Mohammad Mirza-Aghazadeh-Attari, Kazhal Mobaraki, Sima Oshnouei

Middle East respiratory syndrome coronavirus (MERS-CoV) is an emerging threat to global health security with high intensity and lethality. This study was conducted to investigate epidemiological factors and patterns related to this disease. Full details of MERS-CoV cases available on the disease outbreak news section of the World Health Organization official website from January 2013 to November 2016 were retrieved; demographic and clinical information, global distribution status, potential contacts, and probable risk factors for the mortality of laboratory-confirmed MERS-CoV cases were extracted and analyzed by following standard statistical methods. Details of 1,094 laboratory-confirmed cases were recorded, including 421 related deaths. Significant differences were observed in the presentation of the disease from year to year, and all studied parameters differed during the years under study (all P-values <0.05). Evaluation of the effects of various potential risk factors of the final outcome (dead/survived) revealed that two factors, namely, the morbid case being native and travel history, are significant based on a unifactorial analysis (P <0.05). From 2013 to 2016, these factors remained important. However, factors that were significant in predicting mortality varied in different years. These findings point to interesting potential dimensions in the dynamic of this disease. Furthermore, effective national and international preparedness plans and actions are essential to prevent, control, and predict such viral outbreaks; improve patient management; and ensure global health security.