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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Clinical Features and Outcomes of Severe Acute Respiratory Syndrome and Predictive Factors for Acute Respiratory Distress Syndrome</title>
<author><name sortKey="Chen, Cheng Yu" sort="Chen, Cheng Yu" uniqKey="Chen C" first="Cheng-Yu" last="Chen">Cheng-Yu Chen</name>
<affiliation><nlm:aff id="aff1">Chest Department, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff5">Institute of Emergency and Critical Medicine, Taipei, Taiwan, R.O.C.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lee, Chen Hsen" sort="Lee, Chen Hsen" uniqKey="Lee C" first="Chen-Hsen" last="Lee">Chen-Hsen Lee</name>
<affiliation><nlm:aff id="aff5">Institute of Emergency and Critical Medicine, Taipei, Taiwan, R.O.C.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Liu, Cheng Yi" sort="Liu, Cheng Yi" uniqKey="Liu C" first="Cheng-Yi" last="Liu">Cheng-Yi Liu</name>
<affiliation><nlm:aff id="aff2">Division of Infection, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff6">National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Wang, Jia Horng" sort="Wang, Jia Horng" uniqKey="Wang J" first="Jia-Horng" last="Wang">Jia-Horng Wang</name>
<affiliation><nlm:aff id="aff3">Department of Respiratory Therapy, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff6">National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Wang, Lee Min" sort="Wang, Lee Min" uniqKey="Wang L" first="Lee-Min" last="Wang">Lee-Min Wang</name>
<affiliation><nlm:aff id="aff4">Emergency Department, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff6">National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Perng, Reury Perng" sort="Perng, Reury Perng" uniqKey="Perng R" first="Reury-Perng" last="Perng">Reury-Perng Perng</name>
<affiliation><nlm:aff id="aff1">Chest Department, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff6">National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">15742856</idno>
<idno type="pmc">7129615</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7129615</idno>
<idno type="RBID">PMC:7129615</idno>
<idno type="doi">10.1016/S1726-4901(09)70124-8</idno>
<date when="2005">2005</date>
<idno type="wicri:Area/Pmc/Corpus">001112</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001112</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Clinical Features and Outcomes of Severe Acute Respiratory Syndrome and Predictive Factors for Acute Respiratory Distress Syndrome</title>
<author><name sortKey="Chen, Cheng Yu" sort="Chen, Cheng Yu" uniqKey="Chen C" first="Cheng-Yu" last="Chen">Cheng-Yu Chen</name>
<affiliation><nlm:aff id="aff1">Chest Department, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff5">Institute of Emergency and Critical Medicine, Taipei, Taiwan, R.O.C.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lee, Chen Hsen" sort="Lee, Chen Hsen" uniqKey="Lee C" first="Chen-Hsen" last="Lee">Chen-Hsen Lee</name>
<affiliation><nlm:aff id="aff5">Institute of Emergency and Critical Medicine, Taipei, Taiwan, R.O.C.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Liu, Cheng Yi" sort="Liu, Cheng Yi" uniqKey="Liu C" first="Cheng-Yi" last="Liu">Cheng-Yi Liu</name>
<affiliation><nlm:aff id="aff2">Division of Infection, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff6">National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Wang, Jia Horng" sort="Wang, Jia Horng" uniqKey="Wang J" first="Jia-Horng" last="Wang">Jia-Horng Wang</name>
<affiliation><nlm:aff id="aff3">Department of Respiratory Therapy, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff6">National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Wang, Lee Min" sort="Wang, Lee Min" uniqKey="Wang L" first="Lee-Min" last="Wang">Lee-Min Wang</name>
<affiliation><nlm:aff id="aff4">Emergency Department, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff6">National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Perng, Reury Perng" sort="Perng, Reury Perng" uniqKey="Perng R" first="Reury-Perng" last="Perng">Reury-Perng Perng</name>
<affiliation><nlm:aff id="aff1">Chest Department, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff6">National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">Journal of the Chinese Medical Association</title>
<idno type="ISSN">1726-4901</idno>
<idno type="eISSN">1728-7731</idno>
<imprint><date when="2005">2005</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>Severe acute respiratory syndrome (SARS) is an emerging infectious disease, and indeed, the SARS epidemic in Taiwan from March to July 2003 had a great impact. This study depicts the clinical characteristics and short-term outcomes of patients with SARS treated at Taipei Veterans General Hospital; potential predictive factors for acute respiratory distress syndrome (ARDS) are also analyzed.</p>
</sec>
<sec><title>Methods</title>
<p>This study retrospectively analyzed data for 67 SARS patients, who were grouped according to whether or not ARDS developed during the clinical course of SARS.</p>
</sec>
<sec><title>Results</title>
<p>There were 32 males (mean age, 50.3 years; range, 20–75 years) and 35 females (mean age, 51.1 years; range, 23–86 years). Twenty-five patients (37.3%) were health care workers. At admission, 50 patients (74.6%) had abnormal chest radiographs, and all patients developed pulmonary infiltrates during the following week. During hospitalization, lymphopenia was found in 57 patients (85.1%); and elevated levels of lactate dehydrogenase (LDH; <italic>n</italic>
= 55; 83.3%), C-reactive protein (<italic>n</italic>
= 55; 83.3%), aminotransferases (<italic>n</italic>
= 44; 65.7%), and creatine kinase (<italic>n</italic>
= 14; 20.9%) were also noted. ARDS developed in 33 patients (49.3%), who were generally older than the patients in whom ARDS did not develop, male, non-health care workers, and who generally had dyspnea at the time of diagnosis, and a history of diabetes mellitus, hypertension or cerebrovascular accident. Patients with, versus those without, ARDS also tended to present with more severe lymphopenia and leukocytosis, and with higher levels of LDH and aspartate aminotransferase. The overall mortality rate was 31.3% (21/67), whereas the rate for patients who developed ARDS was 63.6% (21/33). Multivariate analyses showed that age greater than 65 years (odds ratio, OR, 10.6; 95% confidence interval, CI, 2.1–54.1), pre-existing diabetes mellitus (OR, 13.7; 95% CI, 1.3–146.9), and elevated levels of LDH (OR, 8.4; 95% CI, 1.9–36.9) at admission, were independent predictors of ARDS.</p>
</sec>
<sec><title>Conclusion</title>
<p>The clinical manifestations of SARS showed high variability, and were related to the underlying health status of individual patients. Importantly, the development of ARDS was associated with significant mortality, despite aggressive therapy.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Chin Med Assoc</journal-id>
<journal-id journal-id-type="iso-abbrev">J Chin Med Assoc</journal-id>
<journal-title-group><journal-title>Journal of the Chinese Medical Association</journal-title>
</journal-title-group>
<issn pub-type="ppub">1726-4901</issn>
<issn pub-type="epub">1728-7731</issn>
<publisher><publisher-name>Elsevier. Published by Elsevier B.V.</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">15742856</article-id>
<article-id pub-id-type="pmc">7129615</article-id>
<article-id pub-id-type="publisher-id">S1726-4901(09)70124-8</article-id>
<article-id pub-id-type="doi">10.1016/S1726-4901(09)70124-8</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Clinical Features and Outcomes of Severe Acute Respiratory Syndrome and Predictive Factors for Acute Respiratory Distress Syndrome</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Chen</surname>
<given-names>Cheng-Yu</given-names>
</name>
<xref rid="aff1" ref-type="aff">a</xref>
<xref rid="aff5" ref-type="aff">e</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lee</surname>
<given-names>Chen-Hsen</given-names>
</name>
<xref rid="aff5" ref-type="aff">e</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Liu</surname>
<given-names>Cheng-Yi</given-names>
</name>
<xref rid="aff2" ref-type="aff">b</xref>
<xref rid="aff6" ref-type="aff">f</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Wang</surname>
<given-names>Jia-Horng</given-names>
</name>
<xref rid="aff3" ref-type="aff">c</xref>
<xref rid="aff6" ref-type="aff">f</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Wang</surname>
<given-names>Lee-Min</given-names>
</name>
<xref rid="aff4" ref-type="aff">d</xref>
<xref rid="aff6" ref-type="aff">f</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Perng</surname>
<given-names>Reury-Perng</given-names>
</name>
<email>rpperng@vghtpe.gov.tw</email>
<xref rid="aff1" ref-type="aff">a</xref>
<xref rid="aff6" ref-type="aff">f</xref>
<xref rid="cor1" ref-type="corresp">*</xref>
</contrib>
</contrib-group>
<aff id="aff1"><label>a</label>
Chest Department, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.</aff>
<aff id="aff2"><label>b</label>
Division of Infection, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.</aff>
<aff id="aff3"><label>c</label>
Department of Respiratory Therapy, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.</aff>
<aff id="aff4"><label>d</label>
Emergency Department, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.</aff>
<aff id="aff5"><label>e</label>
Institute of Emergency and Critical Medicine, Taipei, Taiwan, R.O.C.</aff>
<aff id="aff6"><label>f</label>
National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.</aff>
<author-notes><corresp id="cor1"><label>*</label>
Correspondence to: Dr. Reury-Perng Perng, Chest Department, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, R.O.C. <email>rpperng@vghtpe.gov.tw</email>
</corresp>
</author-notes>
<pub-date pub-type="pmc-release"><day>13</day>
<month>7</month>
<year>2009</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>1</month>
<year>2005</year>
</pub-date>
<pub-date pub-type="epub"><day>13</day>
<month>7</month>
<year>2009</year>
</pub-date>
<volume>68</volume>
<issue>1</issue>
<fpage>4</fpage>
<lpage>10</lpage>
<history><date date-type="received"><day>21</day>
<month>5</month>
<year>2004</year>
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<date date-type="accepted"><day>7</day>
<month>9</month>
<year>2004</year>
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<permissions><copyright-statement>© 2005 Elsevier</copyright-statement>
<copyright-year>2005</copyright-year>
<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><sec><title>Background</title>
<p>Severe acute respiratory syndrome (SARS) is an emerging infectious disease, and indeed, the SARS epidemic in Taiwan from March to July 2003 had a great impact. This study depicts the clinical characteristics and short-term outcomes of patients with SARS treated at Taipei Veterans General Hospital; potential predictive factors for acute respiratory distress syndrome (ARDS) are also analyzed.</p>
</sec>
<sec><title>Methods</title>
<p>This study retrospectively analyzed data for 67 SARS patients, who were grouped according to whether or not ARDS developed during the clinical course of SARS.</p>
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<sec><title>Results</title>
<p>There were 32 males (mean age, 50.3 years; range, 20–75 years) and 35 females (mean age, 51.1 years; range, 23–86 years). Twenty-five patients (37.3%) were health care workers. At admission, 50 patients (74.6%) had abnormal chest radiographs, and all patients developed pulmonary infiltrates during the following week. During hospitalization, lymphopenia was found in 57 patients (85.1%); and elevated levels of lactate dehydrogenase (LDH; <italic>n</italic>
= 55; 83.3%), C-reactive protein (<italic>n</italic>
= 55; 83.3%), aminotransferases (<italic>n</italic>
= 44; 65.7%), and creatine kinase (<italic>n</italic>
= 14; 20.9%) were also noted. ARDS developed in 33 patients (49.3%), who were generally older than the patients in whom ARDS did not develop, male, non-health care workers, and who generally had dyspnea at the time of diagnosis, and a history of diabetes mellitus, hypertension or cerebrovascular accident. Patients with, versus those without, ARDS also tended to present with more severe lymphopenia and leukocytosis, and with higher levels of LDH and aspartate aminotransferase. The overall mortality rate was 31.3% (21/67), whereas the rate for patients who developed ARDS was 63.6% (21/33). Multivariate analyses showed that age greater than 65 years (odds ratio, OR, 10.6; 95% confidence interval, CI, 2.1–54.1), pre-existing diabetes mellitus (OR, 13.7; 95% CI, 1.3–146.9), and elevated levels of LDH (OR, 8.4; 95% CI, 1.9–36.9) at admission, were independent predictors of ARDS.</p>
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<sec><title>Conclusion</title>
<p>The clinical manifestations of SARS showed high variability, and were related to the underlying health status of individual patients. Importantly, the development of ARDS was associated with significant mortality, despite aggressive therapy.</p>
</sec>
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<kwd-group><title>Key Words</title>
<kwd>acute respiratory distress syndrome</kwd>
<kwd>pneumonia</kwd>
<kwd>severe acute respiratory syndrome</kwd>
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