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

Identifieur interne : 000B97 ( Ncbi/Merge ); précédent : 000B96; suivant : 000B98

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

Auteurs : C. W. Leung [République populaire de Chine] ; W. K. Chiu [République populaire de Chine]

Source :

RBID : PMC:7106106

Abstract

Summary

Children are susceptible to infection by SARS-associated coronavirus (SARS-CoV) but the clinical picture of SARS is milder than in adults. Teenagers resemble adults in presentation and disease progression and may develop severe illness requiring intensive care and assisted ventilation. Fever, malaise, cough, coryza, chills or rigor, sputum production, headache, myalgia, leucopaenia, lymphopaenia, thrombocytopaenia, mildly prolonged activated partial thromboplastin times and elevated lactate dehydrogenase levels are common presenting features. Radiographic findings are non-specific but high-resolution computed tomography of the thorax in clinically suspected cases may be an early diagnostic aid when initial chest radiographs appear normal. The improved reverse transcription-polymerase chain reaction (RT-PCR) assays are critical in the early diagnosis of SARS, with sensitivity approaching 80% in the first 3 days of illness when performed on nasopharyngeal aspirates, the preferred specimens. Absence of seroconversion to SARS-CoV beyond 28 days from disease onset generally excludes the diagnosis. The best treatment strategy for SARS among children remains to be determined. No case fatality has been reported in children and the short- to medium-term outcome appears to be good. The importance of continued monitoring for any long-term complications due to the disease or its empiric treatment, cannot be overemphasised.


Url:
DOI: 10.1016/j.prrv.2004.07.010
PubMed: 15531251
PubMed Central: 7106106

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PMC:7106106

Le document en format XML

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<p>Children are susceptible to infection by SARS-associated coronavirus (SARS-CoV) but the clinical picture of SARS is milder than in adults. Teenagers resemble adults in presentation and disease progression and may develop severe illness requiring intensive care and assisted ventilation. Fever, malaise, cough, coryza, chills or rigor, sputum production, headache, myalgia, leucopaenia, lymphopaenia, thrombocytopaenia, mildly prolonged activated partial thromboplastin times and elevated lactate dehydrogenase levels are common presenting features. Radiographic findings are non-specific but high-resolution computed tomography of the thorax in clinically suspected cases may be an early diagnostic aid when initial chest radiographs appear normal. The improved reverse transcription-polymerase chain reaction (RT-PCR) assays are critical in the early diagnosis of SARS, with sensitivity approaching 80% in the first 3 days of illness when performed on nasopharyngeal aspirates, the preferred specimens. Absence of seroconversion to SARS-CoV beyond 28 days from disease onset generally excludes the diagnosis. The best treatment strategy for SARS among children remains to be determined. No case fatality has been reported in children and the short- to medium-term outcome appears to be good. The importance of continued monitoring for any long-term complications due to the disease or its empiric treatment, cannot be overemphasised.</p>
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</TEI>
<pmc article-type="research-article">
<pmc-dir>properties open_access</pmc-dir>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">Paediatr Respir Rev</journal-id>
<journal-id journal-id-type="iso-abbrev">Paediatr Respir Rev</journal-id>
<journal-title-group>
<journal-title>Paediatric Respiratory Reviews</journal-title>
</journal-title-group>
<issn pub-type="ppub">1526-0542</issn>
<issn pub-type="epub">1526-0550</issn>
<publisher>
<publisher-name>Elsevier Ltd.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">15531251</article-id>
<article-id pub-id-type="pmc">7106106</article-id>
<article-id pub-id-type="publisher-id">S1526-0542(04)00079-X</article-id>
<article-id pub-id-type="doi">10.1016/j.prrv.2004.07.010</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Article</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Clinical picture, diagnosis, treatment and outcome of severe acute respiratory syndrome (SARS) in children</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Leung</surname>
<given-names>C.W.</given-names>
</name>
<email>leungcw@ha.org.hk</email>
<xref rid="aff1" ref-type="aff">1</xref>
<xref rid="cor1" ref-type="corresp">*</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Chiu</surname>
<given-names>W.K.</given-names>
</name>
<xref rid="aff2" ref-type="aff">2</xref>
</contrib>
</contrib-group>
<aff id="aff1">
<label>1</label>
Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, 2–10 Princess Margaret Hospital Road, Lai Chi Kok, Kowloon, Hong Kong Special Administrative Region, China</aff>
<aff id="aff2">
<label>2</label>
Department of Paediatrics and Adolescent Medicine, United Christian Hospital, Hong Kong Special Administrative Region, China</aff>
<author-notes>
<corresp id="cor1">
<label>*</label>
Correspondence to: C.W. Leung.
<email>leungcw@ha.org.hk</email>
</corresp>
</author-notes>
<pub-date pub-type="pmc-release">
<day>5</day>
<month>11</month>
<year>2004</year>
</pub-date>
<pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="ppub">
<month>12</month>
<year>2004</year>
</pub-date>
<pub-date pub-type="epub">
<day>5</day>
<month>11</month>
<year>2004</year>
</pub-date>
<volume>5</volume>
<issue>4</issue>
<fpage>275</fpage>
<lpage>288</lpage>
<permissions>
<copyright-statement>Copyright © 2004 Elsevier Ltd. All rights reserved.</copyright-statement>
<copyright-year>2004</copyright-year>
<copyright-holder>Elsevier Ltd</copyright-holder>
<license>
<license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p>
</license>
</permissions>
<abstract>
<title>Summary</title>
<p>Children are susceptible to infection by SARS-associated coronavirus (SARS-CoV) but the clinical picture of SARS is milder than in adults. Teenagers resemble adults in presentation and disease progression and may develop severe illness requiring intensive care and assisted ventilation. Fever, malaise, cough, coryza, chills or rigor, sputum production, headache, myalgia, leucopaenia, lymphopaenia, thrombocytopaenia, mildly prolonged activated partial thromboplastin times and elevated lactate dehydrogenase levels are common presenting features. Radiographic findings are non-specific but high-resolution computed tomography of the thorax in clinically suspected cases may be an early diagnostic aid when initial chest radiographs appear normal. The improved reverse transcription-polymerase chain reaction (RT-PCR) assays are critical in the early diagnosis of SARS, with sensitivity approaching 80% in the first 3 days of illness when performed on nasopharyngeal aspirates, the preferred specimens. Absence of seroconversion to SARS-CoV beyond 28 days from disease onset generally excludes the diagnosis. The best treatment strategy for SARS among children remains to be determined. No case fatality has been reported in children and the short- to medium-term outcome appears to be good. The importance of continued monitoring for any long-term complications due to the disease or its empiric treatment, cannot be overemphasised.</p>
</abstract>
<kwd-group>
<title>Abbreviations</title>
<kwd>SARS, severe acute respiratory syndrome</kwd>
<kwd>SARS-CoV, SARS-associated coronavirus</kwd>
<kwd>RSV, respiratory syncytial virus</kwd>
<kwd>ARDS, acute respiratory distress syndrome</kwd>
<kwd>CXR, chest radiograph</kwd>
<kwd>HRCT, high-resolution computed tomography</kwd>
<kwd>BOOP, bronchiolitis obliterans-organising pneumonia</kwd>
<kwd>NPA, nasopharyngeal aspirate</kwd>
<kwd>RT-PCR, reverse transcription-polymerase chain reaction</kwd>
<kwd>IFA, immunofluorescence assay</kwd>
<kwd>ELISA, enzyme-linked immunosorbant assay</kwd>
</kwd-group>
<kwd-group>
<title>Keywords</title>
<kwd>severe acute respiratory syndrome</kwd>
<kwd>SARS</kwd>
<kwd>children</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
<affiliations>
<list>
<country>
<li>République populaire de Chine</li>
</country>
</list>
<tree>
<country name="République populaire de Chine">
<noRegion>
<name sortKey="Leung, C W" sort="Leung, C W" uniqKey="Leung C" first="C. W." last="Leung">C. W. Leung</name>
</noRegion>
<name sortKey="Chiu, W K" sort="Chiu, W K" uniqKey="Chiu W" first="W. K." last="Chiu">W. K. Chiu</name>
</country>
</tree>
</affiliations>
</record>

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