Abstract
Severe acute respiratory syndrome (SARS) poses a major threat to the health of people worldwide. We performed a retrospective case series analysis to assess clinical outcome and identify pretreatment prognostic correlates of SARS, managed under a standardized treatment protocol. We studied 127 male and 196 female patients with a mean age of 41±14 (range 18–83). All patients, except two, received ribavirin and steroid combination therapy. In 115 (36%) patients, the course of disease was limited. Pneumonitis progressed rapidly in the remaining patients. Sixty-seven (21%) patients required intensive care, and 42 (13%) required ventilator support. Advanced age, high admission neutrophil count, and high initial lactate dehydrogenase level were independent correlates of an adverse clinical outcome. SARS-associated coronavirus caused severe illnesses in most patients, despite early treatment with ribavirin and steroid. This study has identified three independent pretreatment prognostic correlates.
Highlights
Severe acute respiratory syndrome (SARS) poses a major threat to the health of people worldwide
The outbreak of severe acute respiratory syndrome (SARS) in Hong Kong was caused by a novel virus belonging to the family Coronaviridae [1,2]
The recommended treatment regime at the time of the Amoy Gardens outbreak consisted of antibiotics, ribavirin, and steroid combination therapy
Summary
Severe acute respiratory syndrome (SARS) poses a major threat to the health of people worldwide. SARS-associated coronavirus caused severe illnesses in most patients, despite early treatment with ribavirin and steroid. The outbreak of severe acute respiratory syndrome (SARS) in Hong Kong was caused by a novel virus belonging to the family Coronaviridae [1,2]. The second wave of spread in the community was started by an infected patient with renal disease and amplified by the sewage system of Amoy Gardens, a densely populated condominium in Hong Kong [5]. The recommended treatment regime at the time of the Amoy Gardens outbreak consisted of antibiotics, ribavirin, and steroid combination therapy. Patients without known epidemiologic contact with SARS patients were treated with antibiotics that would prevent both communityacquired pneumonia and hospital infections. Lai led and fine tuned the research from hypothesis generation to writing the paper
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