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Clinical and laboratory features in the early stage of severe acute respiratory syndrome.
J Microbiol Immunol Infect. 2006 Feb; 39(1):45-53.JM

Abstract

BACKGROUND AND PURPOSE

To characterize the clinical and laboratory features of severe acute respiratory syndrome (SARS) in the early stage and to compare them with those of patients initially suspected of having SARS who were later determined to have other febrile diseases.

METHODS

Between March and June 2003, 122 patients with possible SARS were admitted to the isolation ward of Tri-Service General Hospital. SARS was diagnosed according to the modified World Health Organization case definition (May 1, 2003). Among them, 43 were classified as probable SARS cases and a SARS etiology was excluded in 32 patients.

RESULTS

Presenting symptoms on admission included fever (97.7% of probable cases, 84.4% of excluded cases), chills (39.5% vs 18.8%), cough with sputum production (16.3% vs 40.6%), dry cough (23.3% vs 9.4%), dyspnea (18.6% vs 9.4%), diarrhea (14.0% vs none), rhinorrhea (2.3% vs none), and myalgia (7.0% vs 6.6%). Common laboratory features included lymphopenia and elevated aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, C-reactive protein and creatine kinase values. Intubation and mechanical ventilation were required in 12 probable cases and 6 excluded cases. Five patients with probable SARS (11.6%) died. A scoring system which was developed to differentiate SARS patients from other febrile patients in the emergency room could differentiate probable cases from excluded cases with a sensitivity of 36.4% and a specificity of 70.6%.

CONCLUSIONS

The clinical presentation and laboratory features at the early stage do not allow differentiation of patients with SARS-CoV infection from other febrile patients. Thus, it is mandatory for all healthcare workers to strictly follow standard isolation precautions during an outbreak to minimize disease transmission.

Authors+Show Affiliations

Department of Internal Medicine, Tao-Yuan Armed Forces General Hospital, Tao-Yuan County, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16440123

Citation

Fan, Cheng Kuo, et al. "Clinical and Laboratory Features in the Early Stage of Severe Acute Respiratory Syndrome." Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi, vol. 39, no. 1, 2006, pp. 45-53.
Fan CK, Yieh KM, Peng MY, et al. Clinical and laboratory features in the early stage of severe acute respiratory syndrome. J Microbiol Immunol Infect. 2006;39(1):45-53.
Fan, C. K., Yieh, K. M., Peng, M. Y., Lin, J. C., Wang, N. C., & Chang, F. Y. (2006). Clinical and laboratory features in the early stage of severe acute respiratory syndrome. Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi, 39(1), 45-53.
Fan CK, et al. Clinical and Laboratory Features in the Early Stage of Severe Acute Respiratory Syndrome. J Microbiol Immunol Infect. 2006;39(1):45-53. PubMed PMID: 16440123.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical and laboratory features in the early stage of severe acute respiratory syndrome. AU - Fan,Cheng Kuo, AU - Yieh,Kuo Ming, AU - Peng,Ming Yieh, AU - Lin,Jung Chung, AU - Wang,Ning Chi, AU - Chang,Feng Yee, PY - 2006/1/28/pubmed PY - 2006/3/31/medline PY - 2006/1/28/entrez SP - 45 EP - 53 JF - Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi JO - J Microbiol Immunol Infect VL - 39 IS - 1 N2 - BACKGROUND AND PURPOSE: To characterize the clinical and laboratory features of severe acute respiratory syndrome (SARS) in the early stage and to compare them with those of patients initially suspected of having SARS who were later determined to have other febrile diseases. METHODS: Between March and June 2003, 122 patients with possible SARS were admitted to the isolation ward of Tri-Service General Hospital. SARS was diagnosed according to the modified World Health Organization case definition (May 1, 2003). Among them, 43 were classified as probable SARS cases and a SARS etiology was excluded in 32 patients. RESULTS: Presenting symptoms on admission included fever (97.7% of probable cases, 84.4% of excluded cases), chills (39.5% vs 18.8%), cough with sputum production (16.3% vs 40.6%), dry cough (23.3% vs 9.4%), dyspnea (18.6% vs 9.4%), diarrhea (14.0% vs none), rhinorrhea (2.3% vs none), and myalgia (7.0% vs 6.6%). Common laboratory features included lymphopenia and elevated aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, C-reactive protein and creatine kinase values. Intubation and mechanical ventilation were required in 12 probable cases and 6 excluded cases. Five patients with probable SARS (11.6%) died. A scoring system which was developed to differentiate SARS patients from other febrile patients in the emergency room could differentiate probable cases from excluded cases with a sensitivity of 36.4% and a specificity of 70.6%. CONCLUSIONS: The clinical presentation and laboratory features at the early stage do not allow differentiation of patients with SARS-CoV infection from other febrile patients. Thus, it is mandatory for all healthcare workers to strictly follow standard isolation precautions during an outbreak to minimize disease transmission. SN - 1684-1182 UR - https://www.unboundmedicine.com/medline/citation/16440123/Clinical_and_laboratory_features_in_the_early_stage_of_severe_acute_respiratory_syndrome_ DB - PRIME DP - Unbound Medicine ER -