Prognostic Factors for Severe Acute Respiratory Syndrome: A Clinical Analysis of 165 Cases

Zou, Zhengsheng; Yang, Yongkang; Chen, Jumei; Xin, Shaojie; Zhang, Wei; Zhou, Xianzhi; Mao, Yuanli; Hu, Lina; Liu, Daojian; Chang, Binxia; Chang, W.I.; Liu, Yan-Ping; Xiang, Ma; Wang, Yedong; Liu, Xiqing

doi:10.1086/380973

Cited by 54 publications

(57 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In adults, the risk factors for severe illness are advanced age, high initial absolute neutrophil counts, low platelet counts, high initial or peak lactate dehydrogenase levels and positive RT-PCR results for NPA specimens. 6,[106][107][108][109] Only one paediatric series has identified risk factors for severe illness in terms of requirements for oxygen and intensive care. These include a sore throat, a high neutrophil count at presentation, and peak neutrophilia.…”

Section: Prognosismentioning

confidence: 99%

Clinical picture, diagnosis, treatment and outcome of severe acute respiratory syndrome (SARS) in children

Leung

Chiu

2004

Paediatric Respiratory Reviews

View full text Add to dashboard Cite

Children are susceptible to infection by SARS-associated coronavirus (SARS-CoV) but the clinical picture of SARS is milder than in adults. Teenagers resemble adults in presentation and disease progression and may develop severe illness requiring intensive care and assisted ventilation. Fever, malaise, cough, coryza, chills or rigor, sputum production, headache, myalgia, leucopaenia, lymphopaenia, thrombocytopaenia, mildly prolonged activated partial thromboplastin times and elevated lactate dehydrogenase levels are common presenting features. Radiographic findings are non-specific but high-resolution computed tomography of the thorax in clinically suspected cases may be an early diagnostic aid when initial chest radiographs appear normal. The improved reverse transcription-polymerase chain reaction (RT-PCR) assays are critical in the early diagnosis of SARS, with sensitivity approaching 80% in the first 3 days of illness when performed on nasopharyngeal aspirates, the preferred specimens. Absence of seroconversion to SARS-CoV beyond 28 days from disease onset generally excludes the diagnosis. The best treatment strategy for SARS among children remains to be determined. No case fatality has been reported in children and the short- to medium-term outcome appears to be good. The importance of continued monitoring for any long-term complications due to the disease or its empiric treatment, cannot be overemphasised.

show abstract

Section: Prognosismentioning

confidence: 99%

Clinical picture, diagnosis, treatment and outcome of severe acute respiratory syndrome (SARS) in children

Leung

Chiu

2004

Paediatric Respiratory Reviews

View full text Add to dashboard Cite

show abstract

“…In addition, we screened the expression of SARS-CoV receptor angiotensin-converting enzyme 2 (ACE2) on both peripheral DC and lymphocyte populations, and examined associations between DC number and specific antibody generation. [20]. Among these patients, thirtyone are males and forty-three are females.…”

Section: Introductionmentioning

confidence: 98%

Longitudinal alteration of circulating dendritic cell subsets and its correlation with steroid treatment in patients with severe acute respiratory syndrome

Zhang

et al. 2005

Clinical Immunology

Self Cite

View full text Add to dashboard Cite

In this study, we found that 74 patients with severe acute respiratory syndrome (SARS) exhibited a rapid, dramatic decrease in numbers of circulating myeloid and plasmacytoid dendritic cells (mDCs and pDCs) during the first 2 weeks of illness (5.3- and 28.4-fold reductions for mDCs and pDCs compared with 25 healthy individuals, respectively), with slow return to normal cell numbers during convalescence (weeks 5-7 of illness on average). In addition, numbers of circulating CD4 and CD8 T cells exhibited milder reductions (2.1- and 1.8-fold at week 1) and earlier return to normal at a mean of weeks 3 and 4, respectively. A significant inverse correlation was found between numbers of DC and T-cell subsets and high-dose steroid treatment. Our novel findings thus suggest that the acute SARS-coronavirus infection probably contributes to the initial reduction of DC and T-cell subsets in blood, and that high-dose steroid administration may subsequently exacerbate and prolong low expression of the cell subsets. These findings will aid the framing of further studies of the immunopathogenesis of SARS.

show abstract

“…It has been reported that for patients with SARS, old age and comorbities are more likely to be associated with a high mortality (17-20). In patients with SARS, the mortality rate for patients over the age of 50 years was 13 times higher than for patients younger than 50 years (17).…”

Section: Discussionmentioning

confidence: 99%

“…Actually, 55-61% of the patients with SARS had thrombocytopenia initially, and 35-49% of victims had reactive thrombocytosis in the late stage (17). In our series, the lowest (mean 91.00/mm 3 ± 23.06) and highest (mean 487.13/mm 3 ± 60.52) platelet count was observed at the mean on day 16 and day 23 after the onset of fever, respectively.…”

Section: Discussionmentioning

confidence: 99%

A Correlation between the Severity of Lung Lesions on Radiographs and Clinical Findings in Patients with Severe Acute Respiratory Syndrome

et al. 2007

View full text Add to dashboard Cite

ObjectiveThe purpose of this study was to quantify lesions on chest radiographs in patients with severe acute respiratory syndrome (SARS) and analyze the severity of the lesions with clinical parameters.Materials and MethodsTwo experienced radiologists reviewed chest radiographs of 28 patients with SARS. Each lung was divided into upper, middle, and lower zones. A SARS-related lesion in each zone was scored using a four-point scale: zero to three. The mean and maximal radiographic scores were analyzed statistically to determine if the scorings were related to the laboratory data and clinical course.ResultsForward stepwise multiple linear regression showed that the mean radiographic score correlated most significantly with the number of hospitalized days (p < 0.001). The second most significant factor was the absolute lymphocyte count (p < 0.001) and the third most significant factor was the number of days of intubation (p = 0.025). The maximal radiographic score correlated best with the percentage of lymphocytes in a leukocyte count (p < 0.001), while the second most significant factor was the number of hospitalized days (p < 0.001) and the third most significant factor was the absolute lymphocyte count (p = 0.013). The mean radiographic scores of the patients who died, with comorbidities and without a comorbidity were 11.1, 6.3 and 2.9, respectively (p = 0.032). The corresponding value for maximal radiographic scores were 17.7, 9.7 and 6.0, respectively (p = 0.033).ConclusionThe severity of abnormalities quantified on chest radiographs in patients with SARS correlates with the clinical parameters.

show abstract

Prognostic Factors for Severe Acute Respiratory Syndrome: A Clinical Analysis of 165 Cases

Cited by 54 publications

References 6 publications

Clinical picture, diagnosis, treatment and outcome of severe acute respiratory syndrome (SARS) in children

Clinical picture, diagnosis, treatment and outcome of severe acute respiratory syndrome (SARS) in children

Longitudinal alteration of circulating dendritic cell subsets and its correlation with steroid treatment in patients with severe acute respiratory syndrome

A Correlation between the Severity of Lung Lesions on Radiographs and Clinical Findings in Patients with Severe Acute Respiratory Syndrome

Contact Info

Product

Resources

About