Abstract
Severe acute respiratory syndrome (SARS) has caused a major epidemic worldwide. A novel coronavirus is deemed to be the causative agent. Early diagnosis can be made with reverse transcriptase-polymerase chain reaction (RT-PCR) of nasopharyngeal aspirate samples. We compared symptoms of 156 SARS-positive and 62 SARS-negative patients in Hong Kong; SARS was confirmed by RT-PCR. The RT-PCR–positive patients had significantly more shortness of breath, a lower lymphocyte count, and a lower lactate dehydrogenase level; they were also more likely to have bilateral and multifocal chest radiograph involvement, to be admitted to intensive care, to need mechanical ventilation, and to have higher mortality rates. By multivariate analysis, positive RT-PCR on nasopharyngeal aspirate samples was an independent predictor of death within 30 days.
Highlights
Severe acute respiratory syndrome (SARS) has caused a major epidemic worldwide
We looked for possible microbiologic evidence of coronavirus infection in reverse transcriptase-polymerase chain reaction (RT-PCR)–negative patients
We included in our study 218 patients who had nasopharyngeal RT-PCR performed at illness onset
Summary
Severe acute respiratory syndrome (SARS) has caused a major epidemic worldwide. A novel coronavirus is deemed to be the causative agent. A probable SARS case requires radiologic evidence of pneumonia or respiratory distress syndrome or autopsy findings consistent with pneumonia or respiratory distress syndrome without an identifiable cause [1]. Because of this nonspecific definition, many non-SARS patients may be mislabeled as having SARS. The discovery of coronavirus as the causative agent and the establishment of laboratory tests for coronavirus have aided the research direction These tests only act as supplementary aids to the diagnosis of suspected and probable cases of SARS. The diagnostic tools for coronavirus infection include reverse transcriptase-polymerase chain reaction (RT-PCR), serologic testing, electron microscopy, and viral culture. We looked for possible microbiologic evidence of coronavirus infection in RT-PCR–negative patients
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