SrasV1, PascalFrancis, Corpus, bibRecord, 000976

Clinical progression and viral load in a community outbreak of coronavirus-associated SARS pneumonia: a prospective study

Identifieur interne : 000976 ( PascalFrancis/Corpus ); précédent : 000975; suivant : 000977

Clinical progression and viral load in a community outbreak of coronavirus-associated SARS pneumonia: a prospective study

Auteurs : J. S. M. Peiris ; C. M. Chu ; V. C. C. Cheng ; K. S. Chan ; I. F. N. Hung ; L. L. M. Poon ; K. I. Law ; B. S. F. Tang ; T. Y. W. Hon ; C. S. Chan ; K. H. Chan ; J. S. C. Ng ; B. J. Zheng ; W. L. Ng ; R. W. M. Lai ; Y. Guan ; K. Y. Yuen

Source :

Lancet : (British edition) [ 0140-6736 ] ; 2003.

RBID : Pascal:03-0368163

Descripteurs français

Pascal (Inist)
- Pneumopathie, Aigu, Syndrome, Homme, Epidémiologie, Chine, Evolution, Facteur risque, Pronostic, Diagnostic.

English descriptors

KwdEn :
- Acute, China, Diagnosis, Epidemiology, Evolution, Human, Pneumopathy, Prognosis, Risk factor, Syndrome.

Abstract

Background We investigated the temporal progression of the clinical, radiological, and virological changes in a community outbreak of severe acute respiratory syndrome (SARS). Methods We followed up 75 patients for 3 weeks managed with a standard treatment protocol of ribavirin and corticosteroids, and assessed the pattern of clinical disease, viral load, risk factors for poor clinical outcome, and the usefulness of virological diagnostic methods. Findings Fever and pneumonia initially improved but 64 (85%) patients developed recurrent fever after a mean of 8.9 (SD 3.1) days, 55 (73%) had watery diarrhoea after 7.5 (2.3) days, 60 (80%) had radiological worsening after 7.4 (2.2) days, and respiratory symptoms worsened in 34 (45%) after 8-6 (3.0) days. In 34 (45%) patients, improvement of initial pulmonary lesions was associated with appearance of new radiological lesions at other sites. Nine (12%) patients developed spontaneous pneumomediastinum and 15 (20%) developed acute respiratory distress syndrome (ARDS) in week 3. Quantitative reverse-transcdptase (RT) PCR of nasopharyngeal aspirates in 14 patients (four with ARDS) showed peak viral load at day 10, and at day 15 a load lower than at admission. Age and chronic hepatitis B virus infection treated with lamivudine were independent significant risk factors for progression to ARDS (p=0.001). SARS associated coronavirus in faeces was seen on RT-PCR in 65 (97%) of 67 patients at day 14. The mean time to seroconversion was 20 days. Interpretation The consistent clinical progression, shifting radiological infiltrates, and an inverted V viral-load profile suggest that worsening in week 2 is unrelated to uncontrolled viral replication but may be related to immunopathological damage.

Notice en format standard (ISO 2709)

Pour connaître la documentation sur le format Inist Standard.

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A14	`02`			`@1 Department of Medicine, Intensive Care, Radiology, and Pathology, United Christian Hospital @3 HKG @Z 2 aut. @Z 4 aut. @Z 7 aut. @Z 9 aut. @Z 10 aut. @Z 12 aut. @Z 14 aut. @Z 15 aut.`
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Format Inist (serveur)

NO :	PASCAL 03-0368163 INIST
ET :	Clinical progression and viral load in a community outbreak of coronavirus-associated SARS pneumonia: a prospective study
AU :	PEIRIS (J. S. M.); CHU (C. M.); CHENG (V. C. C.); CHAN (K. S.); HUNG (I. F. N.); POON (L. L. M.); LAW (K. I.); TANG (B. S. F.); HON (T. Y. W.); CHAN (C. S.); CHAN (K. H.); NG (J. S. C.); ZHENG (B. J.); NG (W. L.); LAI (R. W. M.); GUAN (Y.); YUEN (K. Y.)
AF :	Departments of Microbiology and Medicine, Queen Mary Hospital, University of Hong Kong, Special Administrative Region/Hong-Kong (1 aut., 3 aut., 5 aut., 6 aut., 8 aut., 11 aut., 13 aut., 16 aut., 17 aut.); Department of Medicine, Intensive Care, Radiology, and Pathology, United Christian Hospital/Hong-Kong (2 aut., 4 aut., 7 aut., 9 aut., 10 aut., 12 aut., 14 aut., 15 aut.)
DT :	Publication en série; Niveau analytique
SO :	Lancet : (British edition); ISSN 0140-6736; Coden LANCAO; Royaume-Uni; Da. 2003; Vol. 361; No. 9371; Pp. 1767-1772; Bibl. 18 ref.
LA :	Anglais
EA :	Background We investigated the temporal progression of the clinical, radiological, and virological changes in a community outbreak of severe acute respiratory syndrome (SARS). Methods We followed up 75 patients for 3 weeks managed with a standard treatment protocol of ribavirin and corticosteroids, and assessed the pattern of clinical disease, viral load, risk factors for poor clinical outcome, and the usefulness of virological diagnostic methods. Findings Fever and pneumonia initially improved but 64 (85%) patients developed recurrent fever after a mean of 8.9 (SD 3.1) days, 55 (73%) had watery diarrhoea after 7.5 (2.3) days, 60 (80%) had radiological worsening after 7.4 (2.2) days, and respiratory symptoms worsened in 34 (45%) after 8-6 (3.0) days. In 34 (45%) patients, improvement of initial pulmonary lesions was associated with appearance of new radiological lesions at other sites. Nine (12%) patients developed spontaneous pneumomediastinum and 15 (20%) developed acute respiratory distress syndrome (ARDS) in week 3. Quantitative reverse-transcdptase (RT) PCR of nasopharyngeal aspirates in 14 patients (four with ARDS) showed peak viral load at day 10, and at day 15 a load lower than at admission. Age and chronic hepatitis B virus infection treated with lamivudine were independent significant risk factors for progression to ARDS (p=0.001). SARS associated coronavirus in faeces was seen on RT-PCR in 65 (97%) of 67 patients at day 14. The mean time to seroconversion was 20 days. Interpretation The consistent clinical progression, shifting radiological infiltrates, and an inverted V viral-load profile suggest that worsening in week 2 is unrelated to uncontrolled viral replication but may be related to immunopathological damage.
CC :	002B05C02C; 235
FD :	Pneumopathie; Aigu; Syndrome; Homme; Epidémiologie; Chine; Evolution; Facteur risque; Pronostic; Diagnostic
FG :	Asie; Appareil respiratoire pathologie; Poumon pathologie; Virose; Infection
ED :	Pneumopathy; Acute; Syndrome; Human; Epidemiology; China; Evolution; Risk factor; Prognosis; Diagnosis
EG :	Asia; Respiratory disease; Lung disease; Viral disease; Infection
SD :	Neumopatía; Agudo; Síndrome; Hombre; Epidemiología; China; Evolución; Factor riesgo; Pronóstico; Diagnóstico
LO :	INIST-5004.354000111172990050
ID :	03-0368163

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Pascal:03-0368163

Le document en format XML

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<affiliation><inist:fA14 i1="02"><s1>Department of Medicine, Intensive Care, Radiology, and Pathology, United Christian Hospital</s1>
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<author><name sortKey="Ng, W L" sort="Ng, W L" uniqKey="Ng W" first="W. L." last="Ng">W. L. Ng</name>
<affiliation><inist:fA14 i1="02"><s1>Department of Medicine, Intensive Care, Radiology, and Pathology, United Christian Hospital</s1>
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<front><div type="abstract" xml:lang="en">Background We investigated the temporal progression of the clinical, radiological, and virological changes in a community outbreak of severe acute respiratory syndrome (SARS). Methods We followed up 75 patients for 3 weeks managed with a standard treatment protocol of ribavirin and corticosteroids, and assessed the pattern of clinical disease, viral load, risk factors for poor clinical outcome, and the usefulness of virological diagnostic methods. Findings Fever and pneumonia initially improved but 64 (85%) patients developed recurrent fever after a mean of 8.9 (SD 3.1) days, 55 (73%) had watery diarrhoea after 7.5 (2.3) days, 60 (80%) had radiological worsening after 7.4 (2.2) days, and respiratory symptoms worsened in 34 (45%) after 8-6 (3.0) days. In 34 (45%) patients, improvement of initial pulmonary lesions was associated with appearance of new radiological lesions at other sites. Nine (12%) patients developed spontaneous pneumomediastinum and 15 (20%) developed acute respiratory distress syndrome (ARDS) in week 3. Quantitative reverse-transcdptase (RT) PCR of nasopharyngeal aspirates in 14 patients (four with ARDS) showed peak viral load at day 10, and at day 15 a load lower than at admission. Age and chronic hepatitis B virus infection treated with lamivudine were independent significant risk factors for progression to ARDS (p=0.001). SARS associated coronavirus in faeces was seen on RT-PCR in 65 (97%) of 67 patients at day 14. The mean time to seroconversion was 20 days. Interpretation The consistent clinical progression, shifting radiological infiltrates, and an inverted V viral-load profile suggest that worsening in week 2 is unrelated to uncontrolled viral replication but may be related to immunopathological damage.</div>
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<fA14 i1="01"><s1>Departments of Microbiology and Medicine, Queen Mary Hospital, University of Hong Kong, Special Administrative Region</s1>
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<fC01 i1="01" l="ENG"><s0>Background We investigated the temporal progression of the clinical, radiological, and virological changes in a community outbreak of severe acute respiratory syndrome (SARS). Methods We followed up 75 patients for 3 weeks managed with a standard treatment protocol of ribavirin and corticosteroids, and assessed the pattern of clinical disease, viral load, risk factors for poor clinical outcome, and the usefulness of virological diagnostic methods. Findings Fever and pneumonia initially improved but 64 (85%) patients developed recurrent fever after a mean of 8.9 (SD 3.1) days, 55 (73%) had watery diarrhoea after 7.5 (2.3) days, 60 (80%) had radiological worsening after 7.4 (2.2) days, and respiratory symptoms worsened in 34 (45%) after 8-6 (3.0) days. In 34 (45%) patients, improvement of initial pulmonary lesions was associated with appearance of new radiological lesions at other sites. Nine (12%) patients developed spontaneous pneumomediastinum and 15 (20%) developed acute respiratory distress syndrome (ARDS) in week 3. Quantitative reverse-transcdptase (RT) PCR of nasopharyngeal aspirates in 14 patients (four with ARDS) showed peak viral load at day 10, and at day 15 a load lower than at admission. Age and chronic hepatitis B virus infection treated with lamivudine were independent significant risk factors for progression to ARDS (p=0.001). SARS associated coronavirus in faeces was seen on RT-PCR in 65 (97%) of 67 patients at day 14. The mean time to seroconversion was 20 days. Interpretation The consistent clinical progression, shifting radiological infiltrates, and an inverted V viral-load profile suggest that worsening in week 2 is unrelated to uncontrolled viral replication but may be related to immunopathological damage.</s0>
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<server><NO>PASCAL 03-0368163 INIST</NO>
<ET>Clinical progression and viral load in a community outbreak of coronavirus-associated SARS pneumonia: a prospective study</ET>
<AU>PEIRIS (J. S. M.); CHU (C. M.); CHENG (V. C. C.); CHAN (K. S.); HUNG (I. F. N.); POON (L. L. M.); LAW (K. I.); TANG (B. S. F.); HON (T. Y. W.); CHAN (C. S.); CHAN (K. H.); NG (J. S. C.); ZHENG (B. J.); NG (W. L.); LAI (R. W. M.); GUAN (Y.); YUEN (K. Y.)</AU>
<AF>Departments of Microbiology and Medicine, Queen Mary Hospital, University of Hong Kong, Special Administrative Region/Hong-Kong (1 aut., 3 aut., 5 aut., 6 aut., 8 aut., 11 aut., 13 aut., 16 aut., 17 aut.); Department of Medicine, Intensive Care, Radiology, and Pathology, United Christian Hospital/Hong-Kong (2 aut., 4 aut., 7 aut., 9 aut., 10 aut., 12 aut., 14 aut., 15 aut.)</AF>
<DT>Publication en série; Niveau analytique</DT>
<SO>Lancet : (British edition); ISSN 0140-6736; Coden LANCAO; Royaume-Uni; Da. 2003; Vol. 361; No. 9371; Pp. 1767-1772; Bibl. 18 ref.</SO>
<LA>Anglais</LA>
<EA>Background We investigated the temporal progression of the clinical, radiological, and virological changes in a community outbreak of severe acute respiratory syndrome (SARS). Methods We followed up 75 patients for 3 weeks managed with a standard treatment protocol of ribavirin and corticosteroids, and assessed the pattern of clinical disease, viral load, risk factors for poor clinical outcome, and the usefulness of virological diagnostic methods. Findings Fever and pneumonia initially improved but 64 (85%) patients developed recurrent fever after a mean of 8.9 (SD 3.1) days, 55 (73%) had watery diarrhoea after 7.5 (2.3) days, 60 (80%) had radiological worsening after 7.4 (2.2) days, and respiratory symptoms worsened in 34 (45%) after 8-6 (3.0) days. In 34 (45%) patients, improvement of initial pulmonary lesions was associated with appearance of new radiological lesions at other sites. Nine (12%) patients developed spontaneous pneumomediastinum and 15 (20%) developed acute respiratory distress syndrome (ARDS) in week 3. Quantitative reverse-transcdptase (RT) PCR of nasopharyngeal aspirates in 14 patients (four with ARDS) showed peak viral load at day 10, and at day 15 a load lower than at admission. Age and chronic hepatitis B virus infection treated with lamivudine were independent significant risk factors for progression to ARDS (p=0.001). SARS associated coronavirus in faeces was seen on RT-PCR in 65 (97%) of 67 patients at day 14. The mean time to seroconversion was 20 days. Interpretation The consistent clinical progression, shifting radiological infiltrates, and an inverted V viral-load profile suggest that worsening in week 2 is unrelated to uncontrolled viral replication but may be related to immunopathological damage.</EA>
<CC>002B05C02C; 235</CC>
<FD>Pneumopathie; Aigu; Syndrome; Homme; Epidémiologie; Chine; Evolution; Facteur risque; Pronostic; Diagnostic</FD>
<FG>Asie; Appareil respiratoire pathologie; Poumon pathologie; Virose; Infection</FG>
<ED>Pneumopathy; Acute; Syndrome; Human; Epidemiology; China; Evolution; Risk factor; Prognosis; Diagnosis</ED>
<EG>Asia; Respiratory disease; Lung disease; Viral disease; Infection</EG>
<SD>Neumopatía; Agudo; Síndrome; Hombre; Epidemiología; China; Evolución; Factor riesgo; Pronóstico; Diagnóstico</SD>
<LO>INIST-5004.354000111172990050</LO>
<ID>03-0368163</ID>
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Clinical progression and viral load in a community outbreak of coronavirus-associated SARS pneumonia: a prospective study

Clinical progression and viral load in a community outbreak of coronavirus-associated SARS pneumonia: a prospective study

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