Severe acute respiratory syndrome: clinical outcome and prognostic correlates

Emerg Infect Dis. 2003 Sep;9(9):1064-9. doi: 10.3201/eid0909.030362.

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.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antiviral Agents / therapeutic use*
  • Communicable Diseases, Emerging / complications
  • Communicable Diseases, Emerging / drug therapy*
  • Communicable Diseases, Emerging / physiopathology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pneumonia / etiology
  • Prognosis
  • Respiration, Artificial
  • Retrospective Studies
  • Ribavirin / therapeutic use*
  • Severe Acute Respiratory Syndrome / complications
  • Severe Acute Respiratory Syndrome / drug therapy*
  • Severe Acute Respiratory Syndrome / physiopathology
  • Treatment Outcome

Substances

  • Antiviral Agents
  • Ribavirin