Clinical Description of a Completed Outbreak of SARS in Vietnam, February–May, 2003

Abstract

We investigated the clinical manifestations and course of all probable severe acute respiratory syndrome (SARS) patients in the Vietnam outbreak. Probable SARS cases were defined by using the revised World Health Organization criteria. We systematically reviewed medical records and undertook descriptive statistical analyses. All 62 patients were hospitalized. On admission, the most prominent symptoms were malaise (82.3%) and fever (79.0%). Cough, chest pain, and shortness of breath were present in approximately one quarter of the patients; 79.0% had lymphopenia; 40.3% had thrombocytopenia; 19.4% had leukopenia; and 75.8% showed changes on chest radiograph. Fever developed on the first day of illness onset, and both respiratory symptoms and radiographic changes occurred on day 4. On average, maximal radiographic changes were observed on day 10, and fevers subsided by day 13. Symptoms on admission were nonspecific, although fever, malaise, and lymphopenia were common. The complications of SARS included invasive intubation and ventilation (11.3%) and death (9.7%).

Prognostication in severe acute respiratory syndrome: A retrospective time‐course analysis of 1312 laboratory‐confirmed patients in Hong Kong

“…While prognostic factors may simply serve as severity or surrogate markers of the viral insult and/or host response, the possible pathogenic role of platelets needs to be considered. This study showed thrombocytopaenia in 36% and deranged APTT in 26% of the cohort on presentation; the former seen in 40% in the Vietnamese cohort 31 and the latter in 42.8% of Yang’s cohort 32 . Based on the finding of an elevated d ‐dimer in 45% 5 and of disseminated intravascular coagulopathy in 2.5% 33 of a smaller Hong Kong cohort, the mechanism of the observed thrombocytopaenia is likely to be consumptive in nature.…”

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

“…The use of ribavirin in adults and children has been reported by groups of investigators worldwide. 1,6,[21][22][23][24][28][29][30]35,[77][78][79][80][81][82] Ribavirin was empirically chosen in SARS because of its broad-spectrum of activities against DNA and RNA viruses. Ribavirin was also known to be effective in the treatment of fulminant murine hepatitis, which is caused by an animal coronavirus.…”

Clinical management and infection control of SARS: Lessons learned

“…The overall accuracy of the WHO guidelines for identifying suspected SARS was found to be 83% with an negative predictive value of 86% (Rainer et al, 2003). Fan et al, 2006;Hsu et al, 2003;Jang et al, 2004;Lee et al, 2003;Liang et al, 2004;Peiris et al, 2003a;Peiris et al, 2003b;Rainer et al, 2003;So et al, 2003;Tsang et al, 2003a;Tsang et al, 2003b;Vu et al, 2004;Yeh et al, 2005;Zhao et al, 2003). References for SARS in North America are Booth et al, 2003;Poutanen et al, 2003).…”