Severe acute respiratory syndrome in children: Experience in a regional hospital in Hong Kong*

Chiu, Wa-Keung; Cheung, P.W.; Ng, Kenneth W.; Ip, Patricia; Sugunan, V. K.; Luk, David C K; Louis, Coeurlida; Chan, Bill H B; Lo, Kitty L.; Lai, Wei‐Shu

doi:10.1097/01.pcc.0000077079.42302.81

Cited by 106 publications

(153 citation statements)

References 5 publications

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“…[2][3][4] Although the validity of the multivariate analysis is limited by the small number of children in our cohort, it seems that sore throat, high neutrophil count at presentation, and peak neutrophilia are independent prognostic indicators for severe illness in terms of requirements for oxygen and intensive care. Furthermore, children Ͼ12 years of age are more likely to require methylprednisolone treatment because of severe illness.…”

Section: Discussionmentioning

confidence: 99%

“…6,8,[13][14][15] In pediatric series, including the present cohort, cough is a presenting feature for 43% to 91% of children and shortness of breath for 9% to 40%. [2][3][4] The WHO case definitions would have excluded 34% of the children with laboratory-confirmed SARS in the present cohort, which is the largest single-center, pediatric case series reported to date. The lack of sensitivity of the WHO case definitions for both adult and pediatric patients is disturbing, with respect to the effects on case management at the point of care.…”

Section: Discussionmentioning

confidence: 99%

“…Definitive virologic data, prognostic indicators, and short-term to medium-term follow-up information were lacking in those preliminary reports. [2][3][4] We prospectively monitored a cohort of 44 children with laboratory confirmation of SARS who were treated at a referral center for pediatric infectious diseases that admitted the largest number of pediatric patients with SARS in Hong Kong. Their epidemiologic links; clinical, laboratory, and radiologic features; and outcomes 3 to 6 months after disease onset are reported.…”

mentioning

confidence: 99%

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Severe Acute Respiratory Syndrome Among Children

Leung¹,

Kwan²,

et al. 2004

Pediatrics

120

152

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ABSTRACT. Objective. To study the epidemiologic, clinical, laboratory, and radiologic features, prognostic indicators, and short-term to medium-term outcomes for children with severe acute respiratory syndrome (SARS) and to validate the performance characteristics of a clinical case definition, calculated with respect to SARSassociated coronavirus (SARS-CoV) seroconversion.Methods. Children <18 years of age, from a singlesite outbreak, who satisfied a clinical case definition for SARS, with subsequent serologic confirmation, were treated according to a standard protocol and prospectively monitored.Results. Forty-four children were included. The median age was 12 years. Forty-two children (95.5%) demonstrated an epidemiologic link. Fever, cough, malaise, coryza, sputum production, headache, myalgia, lymphopenia, and elevated lactate dehydrogenase levels were common presenting features. Radiographic findings were nonspecific, but high-resolution computed tomography of the thorax was an early diagnostic aid. A specific reverse transcription-polymerase chain reaction assay for SARS-CoV yielded positive results for <50% of children. Of 9 children who developed hypoxemia, 8 were treated with methylprednisolone. Of 5 children who received intensive care, 3 required assisted ventilation. All children recovered, and serious adverse events in response to treatment were not observed. The outcomes at 3 to 6 months after disease onset, including exercise tolerance, pulmonary functions, and psychologic status, were favorable. An age of >12 years was associated with methylprednisolone therapy for severe illness. After exclusion of the only infant, an age of >12 years was associated with oxygen requirements. Sore throat, high neutrophil count at presentation, and peak neutrophilia were independent factors predicting severe illness. The clinical case definition demonstrated good sensitivity, specificity, and positive and negative predictive values (97.8%, 92.7%, 88%, and 98.7%, respectively) for diagnostic accuracy.Conclusions. 1 Although the majority were adults, 121 children (6.9%) Ͻ18 years of age were registered, yielding an age-specific attack rate of 8.9 cases per 100 000 persons Ͻ18 years of age and a case fatality rate of 0%. A total of 89 hospitalized children in Hong Kong demonstrated serologic evidence of infection by the SARS-associated coronavirus (SARS-CoV) (e-SARS database, Hospital Authority, Hong Kong Special Administrative Region, data on file).Published articles on pediatric SARS have focused on reporting the demographic, clinical, laboratory, and radiologic characteristics. Definitive virologic data, prognostic indicators, and short-term to medium-term follow-up information were lacking in those preliminary reports. [2][3][4] We prospectively monitored a cohort of 44 children with laboratory confirmation of SARS who were treated at a referral center for pediatric infectious diseases that admitted the largest number of pediatric patients with SARS in Hong Kong. Their epidemiologic links; clinical, laboratory,...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Severe Acute Respiratory Syndrome Among Children

Leung¹,

Kwan²,

et al. 2004

Pediatrics

120

152

View full text Add to dashboard Cite

show abstract

“…Although most existing reports have focused on adult SARS patients, recent reports revealed that the clinical course was less severe in pediatric SARS patients than in adult SARS patients (8,9 ). On the whole, the outcomes of pediatric SARS patients have been favorable.…”

mentioning

confidence: 96%

“…Recent studies have reported that the clinical course is less severe in pediatric SARS patients than in adult SARS patients (8,9 ). A logical question would be whether the plasma SARS-CoV viral load in pediatric SARS patients is different from that in adult SARS patients.…”

mentioning

confidence: 99%