A Retrospective Study on Clinical Features of and Treatment Methods for 77 Severe Cases of SARS

Abstract

In this retrospective study, clinical data including clinical manifestations, routine blood tests, chest radiographic imaging from 77 severe cases of SARS treated with integrated Chinese and Western medicine were collected and statistically analyzed. Twenty-nine (37.6%) patients were admitted to the intensive care unit, non-invasive ventilation was used in 40 (51.9%) cases, and invasive ventilatory procedure was performed in eight (10.3%) cases. Seventy (90.9%) patients were clinically cured and seven (9.0%) died. The duration of defervescence was 8.3 +/- 5.0 days after admission. In the early stage, normal leucocyte count was seen in 46 (75.4%) of the 61 patients tested, decreased leucocyte count in 13 (21.3%) and elevated leucocyte count in only two (3.2%) cases. A decreased lymphocyte count was also seen in 23 (37.7%) cases of the 61 patients tested on admission, and by day 14, the number of patients with decreased lymphocyte count (1.11 +/- 0.66 x 10(9)) increased to 32 (47.7%) in 67 cases examined. Neutral granulocyte count was normal or decreased in 58 (95.0%) patients on admission, but elevated from the 7th day onward and peaked on day 21 in 32 (65.3%) of the 49 cases tested. All of the blood abnormalities returned to normal in the convalescent stage. Twenty-nine (37.6%) of the 77 severe cases of SARS patients demonstrated an extensive lung involvement. In comparison with the non-severe SARS cases, this group of patients showed significantly more pneumonic air-space opacities and ground glass-like changes on the chest radiographs (p < 0.05, chi2 test). The role Chinese medicine played in the treatment of SARS was discussed.

Noninvasive mechanical ventilation in high-risk pulmonary infections: a clinical review

“…Currently, available recommendations are mainly based on published studies and experiences from the first SARS epidemic in 2003 [8,[11][12][13][14][15][16][17]. The pivotal study arguing that NIV poses a high risk for spread of infection is based on the assessment of particle dispersion using an experimental model.…”

“…During the SARS pandemic, nearly half of all SARS victims were healthcare workers, highlighting the occupational risks associated with the care of infectious pneumonias and pandemic infections [11][12][13][14]. Evidence related to airborne transmission of the SARS virus and the potential risk of aerosol generation with the use of NIV in SARS still remain controversial [8,9,[11][12][13][14][15][16][17].…”

“…Evidence related to airborne transmission of the SARS virus and the potential risk of aerosol generation with the use of NIV in SARS still remain controversial [8,9,[11][12][13][14][15][16][17].…”

“…in SARS patients [8,9,[11][12][13][14][15][16][17]. It is well known that ETI is associated with higher risk of disease transmission and associated complications.…”

The Efficacy of Chinese Medicine for SARS: A Review of Chinese Publications After the Crisis

“…These parameters included mortality, fever, chest radiography, steroid consumption, secondary infections, etc. (Lin et al, 2003). Other outcome measures included complications induced by steroids, remission time of symptoms of lower respiratory tract pathology (cough and shortness of breath), adverse events, laboratory parameters like loss of SARS-COV in cell cultures and PCR tests, and T-lymphocyte subset counts including CD3, CD4, CD5 and CD8 (Wu et al, 2004).…”