Haematological manifestations in patients with severe acute respiratory syndrome: retrospective analysis
Identifieur interne : 006267 ( Main/Exploration ); précédent : 006266; suivant : 006268Haematological manifestations in patients with severe acute respiratory syndrome: retrospective analysis
Auteurs : Raymond S M. Wong [République populaire de Chine] ; Alan Wu [République populaire de Chine] ; K F To [Hong Kong] ; Nelson Lee [République populaire de Chine] ; Christopher W K. Lam [Hong Kong] ; C K Wong [Hong Kong] ; Paul K S. Chan [Hong Kong] ; Margaret H L. Ng [Hong Kong] ; L M Yu [Hong Kong] ; David S. Hui [République populaire de Chine] ; John S. Tam [Hong Kong] ; Gregory Cheng [République populaire de Chine] ; Joseph J Y. Sung [République populaire de Chine]Source :
- BMJ [ 0959-8138 ] ; 2003-06-21.
English descriptors
- Teeft :
- Absolute neutrophil count, Administrative region, Adverse outcome, Adverse outcomes, Bacterial infections, Cell count, Cell counts, Cellular pathology, Chest radiograph, Chinese university, Coronavirus, Data collection, Different time points, Direct effect, Disease activity, Early course, Early phase, Engl, Exact test, Female patients, First week, Haematological, Haematological disorders, Haematological findings, Haematological variables, Haemoglobin, Haemoglobin count, Haemoglobin counts, High concentration, Hong kong, Human immunodeficiency virus infection, Immunocompetent adult, Independent predictors, Intensive care, Intravascular coagulation, Laboratory characteristics, Lactate dehydrogenase, Lancet peiris, Leucocyte count, Lymphocyte, Lymphocyte count, Lymphocyte counts, Lymphocyte subsets, Lymphopenia, Major outbreak, Multivariate analysis, Neutrophilia, Normal range, Novel coronavirus, Partial thromboplastin time, Patient management, Peripheral blood, Peripheral blood lymphocytes, Platelet, Platelet count, Possible cause, Postmortem examination, Postmortem findings, Prothrombin time, Reactive haemophagocytic syndrome, Reactive thrombocytosis, Respiratory syndrome, Ribavirin, Sars, Statistical analysis, Subset, Syndrome, Third week, Thrombocytopenia, Thromboplastin, Univariate analysis, Venous thromboembolism, Wales hospital, World health organization.
Abstract
Objectives To evaluate the haematological findings of patients with severe acute respiratory syndrome (SARS). Design Analysis of the demographic, clinical, and laboratory characteristics of patients with SARS. Setting Prince of Wales Hospital, Hong Kong. Subjects All patients with a diagnosis of SARS between 11 March and 29 March 2003 who had no pre-existing haematological disorders. Main outcome measures Clinical end points included the need for intensive care and death. Univariate and multivariate analyses were performed to examine factors associated with adverse outcome. Results 64 male and 93 female patients were included in this study. The most common findings included lymphopenia in 153 (98%) of the 157 patients, neutrophilia in 129 (82%), thrombocytopenia in 87 patients (55%), followed by thrombocytosis in 77 (49%), and isolated prolonged activated partial thromboplastin time in 96 patients (63%). The haemoglobin count dropped by more than 20 g/l from baseline in 95 (61%) patients. Four patients (2.5%) developed disseminated intravascular coagulation. Lymphopenia was shown in haemato-lymphoid organs at postmortem examination. Multivariate analysis showed that advanced age and a high concentration of lactate dehydrogenase at presentation were independent predictors of an adverse outcome. Subsets of peripheral blood lymphocytes were analysed in 31 patients. The counts of CD4 positive and CD8 positive T cells fell early in the course of illness. Low counts of CD4 and CD8 cells at presentation were associated with adverse outcomes. Conclusions Abnormal haematological variables were common among patients with SARS. Lymphopenia and the depletion of T lymphocyte subsets may be associated with disease activity.
Url:
DOI: 10.1136/bmj.326.7403.1358
Affiliations:
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Tam</name><affiliation wicri:level="4"><country>Hong Kong</country><placeName><settlement type="city">Sha Tin</settlement></placeName><orgName type="university">Université chinoise de Hong Kong</orgName></affiliation></author><author><name sortKey="Cheng, Gregory" sort="Cheng, Gregory" uniqKey="Cheng G" first="Gregory" last="Cheng">Gregory Cheng</name><affiliation wicri:level="4"><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong Special Administrative Region</wicri:regionArea><orgName type="university">Université chinoise de Hong Kong</orgName><placeName><settlement type="city">Sha Tin</settlement></placeName></affiliation></author><author><name sortKey="Sung, Joseph J Y" sort="Sung, Joseph J Y" uniqKey="Sung J" first="Joseph J Y" last="Sung">Joseph J Y. Sung</name><affiliation wicri:level="4"><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong Special Administrative Region</wicri:regionArea><orgName type="university">Université chinoise de Hong Kong</orgName><placeName><settlement type="city">Sha Tin</settlement></placeName></affiliation><affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">BMJ</title><title level="j" type="abbrev">BMJ</title><idno type="ISSN">0959-8138</idno><idno type="eISSN">1468-5833</idno><imprint><publisher>British Medical Journal Publishing Group</publisher><date type="published" when="2003-06-21">2003-06-21</date><biblScope unit="volume">326</biblScope><biblScope unit="issue">7403</biblScope><biblScope unit="page" from="1358">1358</biblScope></imprint><idno type="ISSN">0959-8138</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0959-8138</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Absolute neutrophil count</term><term>Administrative region</term><term>Adverse outcome</term><term>Adverse outcomes</term><term>Bacterial infections</term><term>Cell count</term><term>Cell counts</term><term>Cellular pathology</term><term>Chest radiograph</term><term>Chinese university</term><term>Coronavirus</term><term>Data collection</term><term>Different time points</term><term>Direct effect</term><term>Disease activity</term><term>Early course</term><term>Early phase</term><term>Engl</term><term>Exact test</term><term>Female patients</term><term>First week</term><term>Haematological</term><term>Haematological disorders</term><term>Haematological findings</term><term>Haematological variables</term><term>Haemoglobin</term><term>Haemoglobin count</term><term>Haemoglobin counts</term><term>High concentration</term><term>Hong kong</term><term>Human immunodeficiency virus infection</term><term>Immunocompetent adult</term><term>Independent predictors</term><term>Intensive care</term><term>Intravascular coagulation</term><term>Laboratory characteristics</term><term>Lactate dehydrogenase</term><term>Lancet peiris</term><term>Leucocyte count</term><term>Lymphocyte</term><term>Lymphocyte count</term><term>Lymphocyte counts</term><term>Lymphocyte subsets</term><term>Lymphopenia</term><term>Major outbreak</term><term>Multivariate analysis</term><term>Neutrophilia</term><term>Normal range</term><term>Novel coronavirus</term><term>Partial thromboplastin time</term><term>Patient management</term><term>Peripheral blood</term><term>Peripheral blood lymphocytes</term><term>Platelet</term><term>Platelet count</term><term>Possible cause</term><term>Postmortem examination</term><term>Postmortem findings</term><term>Prothrombin time</term><term>Reactive haemophagocytic syndrome</term><term>Reactive thrombocytosis</term><term>Respiratory syndrome</term><term>Ribavirin</term><term>Sars</term><term>Statistical analysis</term><term>Subset</term><term>Syndrome</term><term>Third week</term><term>Thrombocytopenia</term><term>Thromboplastin</term><term>Univariate analysis</term><term>Venous thromboembolism</term><term>Wales hospital</term><term>World health organization</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objectives To evaluate the haematological findings of patients with severe acute respiratory syndrome (SARS). Design Analysis of the demographic, clinical, and laboratory characteristics of patients with SARS. Setting Prince of Wales Hospital, Hong Kong. Subjects All patients with a diagnosis of SARS between 11 March and 29 March 2003 who had no pre-existing haematological disorders. Main outcome measures Clinical end points included the need for intensive care and death. Univariate and multivariate analyses were performed to examine factors associated with adverse outcome. Results 64 male and 93 female patients were included in this study. The most common findings included lymphopenia in 153 (98%) of the 157 patients, neutrophilia in 129 (82%), thrombocytopenia in 87 patients (55%), followed by thrombocytosis in 77 (49%), and isolated prolonged activated partial thromboplastin time in 96 patients (63%). The haemoglobin count dropped by more than 20 g/l from baseline in 95 (61%) patients. Four patients (2.5%) developed disseminated intravascular coagulation. Lymphopenia was shown in haemato-lymphoid organs at postmortem examination. Multivariate analysis showed that advanced age and a high concentration of lactate dehydrogenase at presentation were independent predictors of an adverse outcome. Subsets of peripheral blood lymphocytes were analysed in 31 patients. The counts of CD4 positive and CD8 positive T cells fell early in the course of illness. Low counts of CD4 and CD8 cells at presentation were associated with adverse outcomes. Conclusions Abnormal haematological variables were common among patients with SARS. Lymphopenia and the depletion of T lymphocyte subsets may be associated with disease activity.</div></front></TEI><affiliations><list><country><li>Hong Kong</li><li>République populaire de Chine</li></country><settlement><li>Sha Tin</li></settlement><orgName><li>Université chinoise de Hong Kong</li></orgName></list><tree><country name="République populaire de Chine"><noRegion><name sortKey="Wong, Raymond S M" sort="Wong, Raymond S M" uniqKey="Wong R" first="Raymond S M" last="Wong">Raymond S M. Wong</name></noRegion><name sortKey="Cheng, Gregory" sort="Cheng, Gregory" uniqKey="Cheng G" first="Gregory" last="Cheng">Gregory Cheng</name><name sortKey="Hui, David S" sort="Hui, David S" uniqKey="Hui D" first="David S" last="Hui">David S. Hui</name><name sortKey="Lee, Nelson" sort="Lee, Nelson" uniqKey="Lee N" first="Nelson" last="Lee">Nelson Lee</name><name sortKey="Sung, Joseph J Y" sort="Sung, Joseph J Y" uniqKey="Sung J" first="Joseph J Y" last="Sung">Joseph J Y. Sung</name><name sortKey="Wu, Alan" sort="Wu, Alan" uniqKey="Wu A" first="Alan" last="Wu">Alan Wu</name></country><country name="Hong Kong"><noRegion><name sortKey="To, K F" sort="To, K F" uniqKey="To K" first="K F" last="To">K F To</name></noRegion><name sortKey="Chan, Paul K S" sort="Chan, Paul K S" uniqKey="Chan P" first="Paul K S" last="Chan">Paul K S. Chan</name><name sortKey="Lam, Christopher W K" sort="Lam, Christopher W K" uniqKey="Lam C" first="Christopher W K" last="Lam">Christopher W K. Lam</name><name sortKey="Ng, Margaret H L" sort="Ng, Margaret H L" uniqKey="Ng M" first="Margaret H L" last="Ng">Margaret H L. Ng</name><name sortKey="Tam, John S" sort="Tam, John S" uniqKey="Tam J" first="John S" last="Tam">John S. Tam</name><name sortKey="Wong, C K" sort="Wong, C K" uniqKey="Wong C" first="C K" last="Wong">C K Wong</name><name sortKey="Yu, L M" sort="Yu, L M" uniqKey="Yu L" first="L M" last="Yu">L M Yu</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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