The spectrum of severe acute respiratory syndrome: Associated coronavirus infection
Identifieur interne : 000745 ( PascalFrancis/Checkpoint ); précédent : 000744; suivant : 000746The spectrum of severe acute respiratory syndrome: Associated coronavirus infection
Auteurs : Timothy H. Rainer [Hong Kong] ; Paul K. S. Chan [Hong Kong] ; Margaret Ip [Hong Kong] ; Nelson Lee [Hong Kong] ; David S. Hui [Hong Kong] ; Devilliers Smit [Hong Kong] ; Alan Wu [Hong Kong] ; Anil T. Ahuja [Hong Kong] ; John S. Tam [Hong Kong] ; Joseph J. Y. Sung [Hong Kong] ; Peter Cameron [Hong Kong]Source :
- Annals of internal medicine [ 0003-4819 ] ; 2004.
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Abstract
Background: Whether subclinical or atypical presentations of severe acute respiratory syndrome (SARS) occur and whether clinical judgment is accurate in detecting SARS are unknown. Objectives: To describe the spectrum of SARS coronavirus infection in a large outbreak and to compare diagnoses based on clinical judgment with the SARS coronavirus test. Design: Secondary analysis of prospectively collected clinical data and archived serum. Setting: A SARS screening clinic of a university hospital in the New Territories of Hong Kong. Patients: 1221 patients attending the clinic between 12 March 2003 and 12 May 2003. Measurements: SARS coronavirus serology. Results: 145 of 553 (26%) patients had serologic evidence of SARS coronavirus infection. Of 910 patients who were managed without hospitalization, only 6 had serologic evidence of SARS. Five of the six patients had normal chest radiographs, and four had symptoms such as myalgia, chills, coughing, and feeling feverish. With the SARS coronavirus serologic test as the gold standard, the clinical diagnosis of probable SARS at hospitalization had a sensitivity of 0.96 (95% Cl, 0.91 to 0.98) and a specificity of 0.96 (Cl, 0.92 to 0.97). Limitations: Follow-up serologic samples were not obtained from almost half of the patients because they declined further testing. Some people living in the community who were infected but who had minor or no symptoms might not have visited the clinic. Conclusions: There is little evidence of widespread subclinical or mild forms of SARS coronavirus infection. Clinical diagnoses during the outbreak were reasonable and resulted in appropriate triaging.
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<term>Hong Kong</term>
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<keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Hong Kong</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Médecine</term>
<term>Homme</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">Background: Whether subclinical or atypical presentations of severe acute respiratory syndrome (SARS) occur and whether clinical judgment is accurate in detecting SARS are unknown. Objectives: To describe the spectrum of SARS coronavirus infection in a large outbreak and to compare diagnoses based on clinical judgment with the SARS coronavirus test. Design: Secondary analysis of prospectively collected clinical data and archived serum. Setting: A SARS screening clinic of a university hospital in the New Territories of Hong Kong. Patients: 1221 patients attending the clinic between 12 March 2003 and 12 May 2003. Measurements: SARS coronavirus serology. Results: 145 of 553 (26%) patients had serologic evidence of SARS coronavirus infection. Of 910 patients who were managed without hospitalization, only 6 had serologic evidence of SARS. Five of the six patients had normal chest radiographs, and four had symptoms such as myalgia, chills, coughing, and feeling feverish. With the SARS coronavirus serologic test as the gold standard, the clinical diagnosis of probable SARS at hospitalization had a sensitivity of 0.96 (95% Cl, 0.91 to 0.98) and a specificity of 0.96 (Cl, 0.92 to 0.97). Limitations: Follow-up serologic samples were not obtained from almost half of the patients because they declined further testing. Some people living in the community who were infected but who had minor or no symptoms might not have visited the clinic. Conclusions: There is little evidence of widespread subclinical or mild forms of SARS coronavirus infection. Clinical diagnoses during the outbreak were reasonable and resulted in appropriate triaging.</div>
</front>
</TEI>
<inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0003-4819</s0>
</fA01>
<fA02 i1="01"><s0>AIMEAS</s0>
</fA02>
<fA03 i2="1"><s0>Ann. intern. med.</s0>
</fA03>
<fA05><s2>140</s2>
</fA05>
<fA06><s2>8</s2>
</fA06>
<fA08 i1="01" i2="1" l="ENG"><s1>The spectrum of severe acute respiratory syndrome: Associated coronavirus infection</s1>
</fA08>
<fA11 i1="01" i2="1"><s1>RAINER (Timothy H.)</s1>
</fA11>
<fA11 i1="02" i2="1"><s1>CHAN (Paul K. S.)</s1>
</fA11>
<fA11 i1="03" i2="1"><s1>IP (Margaret)</s1>
</fA11>
<fA11 i1="04" i2="1"><s1>LEE (Nelson)</s1>
</fA11>
<fA11 i1="05" i2="1"><s1>HUI (David S.)</s1>
</fA11>
<fA11 i1="06" i2="1"><s1>SMIT (Devilliers)</s1>
</fA11>
<fA11 i1="07" i2="1"><s1>WU (Alan)</s1>
</fA11>
<fA11 i1="08" i2="1"><s1>AHUJA (Anil T.)</s1>
</fA11>
<fA11 i1="09" i2="1"><s1>TAM (John S.)</s1>
</fA11>
<fA11 i1="10" i2="1"><s1>SUNG (Joseph J. Y.)</s1>
</fA11>
<fA11 i1="11" i2="1"><s1>CAMERON (Peter)</s1>
</fA11>
<fA14 i1="01"><s1>The Chinese University of Hong Kong</s1>
<s3>HKG</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>3 aut.</sZ>
<sZ>4 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>6 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>8 aut.</sZ>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>11 aut.</sZ>
</fA14>
<fA20><s1>614-619</s1>
</fA20>
<fA21><s1>2004</s1>
</fA21>
<fA23 i1="01"><s0>ENG</s0>
</fA23>
<fA43 i1="01"><s1>INIST</s1>
<s2>2014</s2>
<s5>354000111638710030</s5>
</fA43>
<fA44><s0>0000</s0>
<s1>© 2004 INIST-CNRS. All rights reserved.</s1>
</fA44>
<fA45><s0>21 ref.</s0>
</fA45>
<fA47 i1="01" i2="1"><s0>04-0542965</s0>
</fA47>
<fA60><s1>P</s1>
</fA60>
<fA61><s0>A</s0>
</fA61>
<fA64 i1="01" i2="1"><s0>Annals of internal medicine</s0>
</fA64>
<fA66 i1="01"><s0>USA</s0>
</fA66>
<fC01 i1="01" l="ENG"><s0>Background: Whether subclinical or atypical presentations of severe acute respiratory syndrome (SARS) occur and whether clinical judgment is accurate in detecting SARS are unknown. Objectives: To describe the spectrum of SARS coronavirus infection in a large outbreak and to compare diagnoses based on clinical judgment with the SARS coronavirus test. Design: Secondary analysis of prospectively collected clinical data and archived serum. Setting: A SARS screening clinic of a university hospital in the New Territories of Hong Kong. Patients: 1221 patients attending the clinic between 12 March 2003 and 12 May 2003. Measurements: SARS coronavirus serology. Results: 145 of 553 (26%) patients had serologic evidence of SARS coronavirus infection. Of 910 patients who were managed without hospitalization, only 6 had serologic evidence of SARS. Five of the six patients had normal chest radiographs, and four had symptoms such as myalgia, chills, coughing, and feeling feverish. With the SARS coronavirus serologic test as the gold standard, the clinical diagnosis of probable SARS at hospitalization had a sensitivity of 0.96 (95% Cl, 0.91 to 0.98) and a specificity of 0.96 (Cl, 0.92 to 0.97). Limitations: Follow-up serologic samples were not obtained from almost half of the patients because they declined further testing. Some people living in the community who were infected but who had minor or no symptoms might not have visited the clinic. Conclusions: There is little evidence of widespread subclinical or mild forms of SARS coronavirus infection. Clinical diagnoses during the outbreak were reasonable and resulted in appropriate triaging.</s0>
</fC01>
<fC02 i1="01" i2="X"><s0>002B05C02C</s0>
</fC02>
<fC03 i1="01" i2="X" l="FRE"><s0>Infection</s0>
<s2>NM</s2>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="ENG"><s0>Infection</s0>
<s2>NM</s2>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="SPA"><s0>Infección</s0>
<s2>NM</s2>
<s5>01</s5>
</fC03>
<fC03 i1="02" i2="X" l="FRE"><s0>Syndrome respiratoire aigu sévère</s0>
<s2>NM</s2>
<s5>03</s5>
</fC03>
<fC03 i1="02" i2="X" l="ENG"><s0>Severe acute respiratory syndrome</s0>
<s2>NM</s2>
<s5>03</s5>
</fC03>
<fC03 i1="02" i2="X" l="SPA"><s0>Síndrome respiratorio agudo severo</s0>
<s2>NM</s2>
<s5>03</s5>
</fC03>
<fC03 i1="03" i2="X" l="FRE"><s0>Coronavirus</s0>
<s2>NW</s2>
<s5>05</s5>
</fC03>
<fC03 i1="03" i2="X" l="ENG"><s0>Coronavirus</s0>
<s2>NW</s2>
<s5>05</s5>
</fC03>
<fC03 i1="03" i2="X" l="SPA"><s0>Coronavirus</s0>
<s2>NW</s2>
<s5>05</s5>
</fC03>
<fC03 i1="04" i2="X" l="FRE"><s0>Médecine</s0>
<s5>06</s5>
</fC03>
<fC03 i1="04" i2="X" l="ENG"><s0>Medicine</s0>
<s5>06</s5>
</fC03>
<fC03 i1="04" i2="X" l="SPA"><s0>Medicina</s0>
<s5>06</s5>
</fC03>
<fC03 i1="05" i2="X" l="FRE"><s0>Symptomatologie</s0>
<s5>07</s5>
</fC03>
<fC03 i1="05" i2="X" l="ENG"><s0>Symptomatology</s0>
<s5>07</s5>
</fC03>
<fC03 i1="05" i2="X" l="SPA"><s0>Sintomatología</s0>
<s5>07</s5>
</fC03>
<fC03 i1="06" i2="X" l="FRE"><s0>Forme clinique</s0>
<s5>08</s5>
</fC03>
<fC03 i1="06" i2="X" l="ENG"><s0>Clinical form</s0>
<s5>08</s5>
</fC03>
<fC03 i1="06" i2="X" l="SPA"><s0>Forma clínica</s0>
<s5>08</s5>
</fC03>
<fC03 i1="07" i2="X" l="FRE"><s0>Analyse statistique</s0>
<s5>09</s5>
</fC03>
<fC03 i1="07" i2="X" l="ENG"><s0>Statistical analysis</s0>
<s5>09</s5>
</fC03>
<fC03 i1="07" i2="X" l="SPA"><s0>Análisis estadístico</s0>
<s5>09</s5>
</fC03>
<fC03 i1="08" i2="X" l="FRE"><s0>Diagnostic</s0>
<s5>10</s5>
</fC03>
<fC03 i1="08" i2="X" l="ENG"><s0>Diagnosis</s0>
<s5>10</s5>
</fC03>
<fC03 i1="08" i2="X" l="SPA"><s0>Diagnóstico</s0>
<s5>10</s5>
</fC03>
<fC03 i1="09" i2="X" l="FRE"><s0>Précision</s0>
<s5>11</s5>
</fC03>
<fC03 i1="09" i2="X" l="ENG"><s0>Accuracy</s0>
<s5>11</s5>
</fC03>
<fC03 i1="09" i2="X" l="SPA"><s0>Precisión</s0>
<s5>11</s5>
</fC03>
<fC03 i1="10" i2="X" l="FRE"><s0>Homme</s0>
<s5>12</s5>
</fC03>
<fC03 i1="10" i2="X" l="ENG"><s0>Human</s0>
<s5>12</s5>
</fC03>
<fC03 i1="10" i2="X" l="SPA"><s0>Hombre</s0>
<s5>12</s5>
</fC03>
<fC03 i1="11" i2="X" l="FRE"><s0>Hong Kong</s0>
<s2>NG</s2>
<s5>13</s5>
</fC03>
<fC03 i1="11" i2="X" l="ENG"><s0>Hong Kong</s0>
<s2>NG</s2>
<s5>13</s5>
</fC03>
<fC03 i1="11" i2="X" l="SPA"><s0>Hong Kong</s0>
<s2>NG</s2>
<s5>13</s5>
</fC03>
<fC07 i1="01" i2="X" l="FRE"><s0>Virose</s0>
<s2>NM</s2>
</fC07>
<fC07 i1="01" i2="X" l="ENG"><s0>Viral disease</s0>
<s2>NM</s2>
</fC07>
<fC07 i1="01" i2="X" l="SPA"><s0>Virosis</s0>
<s2>NM</s2>
</fC07>
<fC07 i1="02" i2="X" l="FRE"><s0>Coronaviridae</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="02" i2="X" l="ENG"><s0>Coronaviridae</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="02" i2="X" l="SPA"><s0>Coronaviridae</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="03" i2="X" l="FRE"><s0>Nidovirales</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="03" i2="X" l="ENG"><s0>Nidovirales</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="03" i2="X" l="SPA"><s0>Nidovirales</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="04" i2="X" l="FRE"><s0>Virus</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="04" i2="X" l="ENG"><s0>Virus</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="04" i2="X" l="SPA"><s0>Virus</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="05" i2="X" l="FRE"><s0>Chine</s0>
<s2>NG</s2>
</fC07>
<fC07 i1="05" i2="X" l="ENG"><s0>China</s0>
<s2>NG</s2>
</fC07>
<fC07 i1="05" i2="X" l="SPA"><s0>China</s0>
<s2>NG</s2>
</fC07>
<fC07 i1="06" i2="X" l="FRE"><s0>Asie</s0>
<s2>NG</s2>
</fC07>
<fC07 i1="06" i2="X" l="ENG"><s0>Asia</s0>
<s2>NG</s2>
</fC07>
<fC07 i1="06" i2="X" l="SPA"><s0>Asia</s0>
<s2>NG</s2>
</fC07>
<fC07 i1="07" i2="X" l="FRE"><s0>Appareil respiratoire pathologie</s0>
<s5>37</s5>
</fC07>
<fC07 i1="07" i2="X" l="ENG"><s0>Respiratory disease</s0>
<s5>37</s5>
</fC07>
<fC07 i1="07" i2="X" l="SPA"><s0>Aparato respiratorio patología</s0>
<s5>37</s5>
</fC07>
<fC07 i1="08" i2="X" l="FRE"><s0>Poumon pathologie</s0>
<s5>38</s5>
</fC07>
<fC07 i1="08" i2="X" l="ENG"><s0>Lung disease</s0>
<s5>38</s5>
</fC07>
<fC07 i1="08" i2="X" l="SPA"><s0>Pulmón patología</s0>
<s5>38</s5>
</fC07>
<fN21><s1>306</s1>
</fN21>
<fN44 i1="01"><s1>OTO</s1>
</fN44>
<fN82><s1>OTO</s1>
</fN82>
</pA>
</standard>
</inist>
<affiliations><list><country><li>Hong Kong</li>
</country>
<settlement><li>Sha Tin</li>
</settlement>
<orgName><li>Université chinoise de Hong Kong</li>
</orgName>
</list>
<tree><country name="Hong Kong"><noRegion><name sortKey="Rainer, Timothy H" sort="Rainer, Timothy H" uniqKey="Rainer T" first="Timothy H." last="Rainer">Timothy H. Rainer</name>
</noRegion>
<name sortKey="Ahuja, Anil T" sort="Ahuja, Anil T" uniqKey="Ahuja A" first="Anil T." last="Ahuja">Anil T. Ahuja</name>
<name sortKey="Cameron, Peter" sort="Cameron, Peter" uniqKey="Cameron P" first="Peter" last="Cameron">Peter Cameron</name>
<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="Hui, David S" sort="Hui, David S" uniqKey="Hui D" first="David S." last="Hui">David S. Hui</name>
<name sortKey="Ip, Margaret" sort="Ip, Margaret" uniqKey="Ip M" first="Margaret" last="Ip">Margaret Ip</name>
<name sortKey="Lee, Nelson" sort="Lee, Nelson" uniqKey="Lee N" first="Nelson" last="Lee">Nelson Lee</name>
<name sortKey="Smit, Devilliers" sort="Smit, Devilliers" uniqKey="Smit D" first="Devilliers" last="Smit">Devilliers Smit</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="Tam, John S" sort="Tam, John S" uniqKey="Tam J" first="John S." last="Tam">John S. Tam</name>
<name sortKey="Wu, Alan" sort="Wu, Alan" uniqKey="Wu A" first="Alan" last="Wu">Alan Wu</name>
</country>
</tree>
</affiliations>
</record>
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