Severe Acute Respiratory Syndrome: Clinical and Laboratory Manifestations
Identifieur interne : 001652 ( Pmc/Curation ); précédent : 001651; suivant : 001653Severe Acute Respiratory Syndrome: Clinical and Laboratory Manifestations
Auteurs : Christopher W K. Lam ; Michael H M. Chan ; Chun K. WongSource :
- The Clinical Biochemist Reviews [ 0159-8090 ] ; 2004.
Abstract
Severe acute respiratory syndrome (SARS) is a recently emerged infectious disease with significant morbidity and mortality. An epidemic in 2003 affected 8,098 patients in 29 countries with 774 deaths. The aetiological agent is a new coronavirus spread by droplet transmission. Clinical and general laboratory manifestations included fever, chills, rigor, myalgia, malaise, diarrhoea, cough, dyspnoea, pneumonia, lymphopenia, neutrophilia, thrombocytopenia, and elevated serum lactate dehydrogenase (LD), alanine aminotransferase (ALT) and creatine kinase (CK) activities. Treatment has been empirical; initial potent antibiotic cover, followed by simultaneous ribavirin and corticosteroids, with or without pulse high-dose methylprednisolone, have been used. The postulated disease progression comprises (1) active viral infection, (2) hyperactive immune response, and (3) recovery or pulmonary destruction and death. We investigated serum LD isoenzymes and blood lymphocyte subsets of SARS patients, and found LD1 activity as the best biochemical prognostic indicator for death, while CD3+, CD4+, CD8+ and natural killer cell counts were promising predictors for intensive care unit (ICU) admission. Plasma cytokine and chemokine profiles showed markedly elevated Th1 cytokine interferon (IFN)-γ, inflammatory cytokines interleukin (IL)-1β, IL-6 and IL-12, neutrophil chemokine IL-8, monocyte chemoattractant protein-1 (MCP-1), and Th1 chemokine IFN-γ-inducible protein-10 (IP-10) for at least two weeks after disease onset, but there was no significant elevation of inflammatory cytokine tumor necrosis factor (TNF)-α and anti-inflammatory cytokine IL-10. Corticosteroid reduced IL-8, MCP-1 and IP-10 concentrations from 5–8 days after treatment. Measurement of biochemical markers of bone metabolism demonstrated significant but transient increase in bone resorption from Day 28–44 after onset of fever, when pulse steroid was most frequently given. With tapering down of steroid therapy, there was a decrease in bone resorption marker together with an increase in bone formation markers round Day 50, suggesting that some of the bone loss might be reversed. Our research studies on the chemical pathology and clinical immunology of SARS should have implications for the pathophysiology and therapy of this potentially lethal infection.
Url:
PubMed: 18458712
PubMed Central: 1904416
Links toward previous steps (curation, corpus...)
- to stream Pmc, to step Corpus: Pour aller vers cette notice dans l'étape Curation :001652
Links to Exploration step
PMC:1904416Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Severe Acute Respiratory Syndrome: Clinical and Laboratory Manifestations</title>
<author><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>
</author>
<author><name sortKey="Chan, Michael H M" sort="Chan, Michael H M" uniqKey="Chan M" first="Michael H M" last="Chan">Michael H M. Chan</name>
</author>
<author><name sortKey="Wong, Chun K" sort="Wong, Chun K" uniqKey="Wong C" first="Chun K" last="Wong">Chun K. Wong</name>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">18458712</idno>
<idno type="pmc">1904416</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1904416</idno>
<idno type="RBID">PMC:1904416</idno>
<date when="2004">2004</date>
<idno type="wicri:Area/Pmc/Corpus">001652</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001652</idno>
<idno type="wicri:Area/Pmc/Curation">001652</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">001652</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Severe Acute Respiratory Syndrome: Clinical and Laboratory Manifestations</title>
<author><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>
</author>
<author><name sortKey="Chan, Michael H M" sort="Chan, Michael H M" uniqKey="Chan M" first="Michael H M" last="Chan">Michael H M. Chan</name>
</author>
<author><name sortKey="Wong, Chun K" sort="Wong, Chun K" uniqKey="Wong C" first="Chun K" last="Wong">Chun K. Wong</name>
</author>
</analytic>
<series><title level="j">The Clinical Biochemist Reviews</title>
<idno type="ISSN">0159-8090</idno>
<imprint><date when="2004">2004</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><p>Severe acute respiratory syndrome (SARS) is a recently emerged infectious disease with significant morbidity and mortality. An epidemic in 2003 affected 8,098 patients in 29 countries with 774 deaths. The aetiological agent is a new coronavirus spread by droplet transmission. Clinical and general laboratory manifestations included fever, chills, rigor, myalgia, malaise, diarrhoea, cough, dyspnoea, pneumonia, lymphopenia, neutrophilia, thrombocytopenia, and elevated serum lactate dehydrogenase (LD), alanine aminotransferase (ALT) and creatine kinase (CK) activities. Treatment has been empirical; initial potent antibiotic cover, followed by simultaneous ribavirin and corticosteroids, with or without pulse high-dose methylprednisolone, have been used. The postulated disease progression comprises (1) active viral infection, (2) hyperactive immune response, and (3) recovery or pulmonary destruction and death. We investigated serum LD isoenzymes and blood lymphocyte subsets of SARS patients, and found LD1 activity as the best biochemical prognostic indicator for death, while CD3+, CD4+, CD8+ and natural killer cell counts were promising predictors for intensive care unit (ICU) admission. Plasma cytokine and chemokine profiles showed markedly elevated Th1 cytokine interferon (IFN)-γ, inflammatory cytokines interleukin (IL)-1β, IL-6 and IL-12, neutrophil chemokine IL-8, monocyte chemoattractant protein-1 (MCP-1), and Th1 chemokine IFN-γ-inducible protein-10 (IP-10) for at least two weeks after disease onset, but there was no significant elevation of inflammatory cytokine tumor necrosis factor (TNF)-α and anti-inflammatory cytokine IL-10. Corticosteroid reduced IL-8, MCP-1 and IP-10 concentrations from 5–8 days after treatment. Measurement of biochemical markers of bone metabolism demonstrated significant but transient increase in bone resorption from Day 28–44 after onset of fever, when pulse steroid was most frequently given. With tapering down of steroid therapy, there was a decrease in bone resorption marker together with an increase in bone formation markers round Day 50, suggesting that some of the bone loss might be reversed. Our research studies on the chemical pathology and clinical immunology of SARS should have implications for the pathophysiology and therapy of this potentially lethal infection.</p>
</div>
</front>
</TEI>
<pmc article-type="review-article" xml:lang="EN"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Clin Biochem Rev</journal-id>
<journal-title>The Clinical Biochemist Reviews</journal-title>
<issn pub-type="ppub">0159-8090</issn>
<publisher><publisher-name>The Australian Association of Clinical Biochemists</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">18458712</article-id>
<article-id pub-id-type="pmc">1904416</article-id>
<article-id pub-id-type="publisher-id">cbr25_2p121</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Mini Review</subject>
</subj-group>
</article-categories>
<title-group><article-title>Severe Acute Respiratory Syndrome: Clinical and Laboratory Manifestations</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Lam</surname>
<given-names>Christopher W K</given-names>
</name>
<xref ref-type="corresp" rid="c1-cbr25_2p121">*</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Chan</surname>
<given-names>Michael H M</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Wong</surname>
<given-names>Chun K</given-names>
</name>
</contrib>
<aff id="af1-cbr25_2p121">Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong</aff>
</contrib-group>
<author-notes><corresp id="c1-cbr25_2p121">*For correspondence: Professor C W K Lam E-mail:
<email>waikeilam@cuhk.edu.hk</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><month>5</month>
<year>2004</year>
</pub-date>
<volume>25</volume>
<issue>2</issue>
<fpage>121</fpage>
<lpage>132</lpage>
<copyright-statement>The contents of articles or advertisements in The Clinical Biochemist – Reviews are not to be construed as official statements, evaluations or endorsements by the AACB, its official bodies or its agents. Statements of opinion in AACB publications are those of the contributors. Print Post Approved - PP255003/01665. Copyright © 2005 The Australasian Association of Clinical Biochemists Inc. No literary matter in The Clinical Biochemist – Reviews is to be reproduced, stored in a retrieval system or transmitted in any form by electronic or mechanical means, photocopying or recording, without permission. Requests to do so should be addressed to the Editor. ISSN 0159 – 8090</copyright-statement>
<copyright-year>2004</copyright-year>
<abstract><p>Severe acute respiratory syndrome (SARS) is a recently emerged infectious disease with significant morbidity and mortality. An epidemic in 2003 affected 8,098 patients in 29 countries with 774 deaths. The aetiological agent is a new coronavirus spread by droplet transmission. Clinical and general laboratory manifestations included fever, chills, rigor, myalgia, malaise, diarrhoea, cough, dyspnoea, pneumonia, lymphopenia, neutrophilia, thrombocytopenia, and elevated serum lactate dehydrogenase (LD), alanine aminotransferase (ALT) and creatine kinase (CK) activities. Treatment has been empirical; initial potent antibiotic cover, followed by simultaneous ribavirin and corticosteroids, with or without pulse high-dose methylprednisolone, have been used. The postulated disease progression comprises (1) active viral infection, (2) hyperactive immune response, and (3) recovery or pulmonary destruction and death. We investigated serum LD isoenzymes and blood lymphocyte subsets of SARS patients, and found LD1 activity as the best biochemical prognostic indicator for death, while CD3+, CD4+, CD8+ and natural killer cell counts were promising predictors for intensive care unit (ICU) admission. Plasma cytokine and chemokine profiles showed markedly elevated Th1 cytokine interferon (IFN)-γ, inflammatory cytokines interleukin (IL)-1β, IL-6 and IL-12, neutrophil chemokine IL-8, monocyte chemoattractant protein-1 (MCP-1), and Th1 chemokine IFN-γ-inducible protein-10 (IP-10) for at least two weeks after disease onset, but there was no significant elevation of inflammatory cytokine tumor necrosis factor (TNF)-α and anti-inflammatory cytokine IL-10. Corticosteroid reduced IL-8, MCP-1 and IP-10 concentrations from 5–8 days after treatment. Measurement of biochemical markers of bone metabolism demonstrated significant but transient increase in bone resorption from Day 28–44 after onset of fever, when pulse steroid was most frequently given. With tapering down of steroid therapy, there was a decrease in bone resorption marker together with an increase in bone formation markers round Day 50, suggesting that some of the bone loss might be reversed. Our research studies on the chemical pathology and clinical immunology of SARS should have implications for the pathophysiology and therapy of this potentially lethal infection.</p>
</abstract>
</article-meta>
</front>
<floats-wrap><fig id="f1-cbr25_2p121" position="float"><label>Figure 1</label>
<caption><p>Multiple ROC curve comparison of age, serum total LD activity, serum LD1 activity, serum LD1/LD2 ratio, blood haemoglobin concentration, and blood total lymphocyte count for the prediction of death.</p>
</caption>
<graphic xlink:href="cbr25_2p126f1"></graphic>
</fig>
<fig id="f2-cbr25_2p121" position="float"><label>Figure 2</label>
<caption><p>Immunopathogenesis of SARS and therapeutic strategies.</p>
</caption>
<graphic xlink:href="cbr25_2p128f2"></graphic>
</fig>
<fig id="f3-cbr25_2p121" position="float"><label>Figure 3</label>
<caption><p>Box-and-whisker plot of serum biochemical markers of bone metabolism at different time periods of SARS infection. X-axis: day from onset of fever (Day 1); y-axis: (a) serum C-terminal telopeptide; (b) serum OC; and (c) serum BALP. The line inside the boxes marks the median, while the boxes and whiskers respectively denote the 25–75th and 10–90th percentile intervals. Non-parametric Wilcoxon rank sum test was used for data comparison; p values <0.05 (*) and <0.01 (**) are shown. Our reference ranges for serum C-terminal telopeptide, osteocalcin, and BALP concentrations are respectively <0.38 μg/L, <20 μg/L, and <18 μg/L for both men and pre-menopausal women.</p>
</caption>
<graphic xlink:href="cbr25_2p129f3a"></graphic>
<graphic xlink:href="cbr25_2p129f3b"></graphic>
<graphic xlink:href="cbr25_2p129f3c"></graphic>
</fig>
<table-wrap id="t1-cbr25_2p121" position="float"><label>Table 1</label>
<caption><p>Summary of SARS cases with onset of illness from 1 November 2002 to 31 July 2003.<xref ref-type="bibr" rid="b12-cbr25_2p121">12</xref>
</p>
</caption>
<table frame="box" rules="all"><thead><tr><th rowspan="2" align="left" colspan="1">Area</th>
<th rowspan="2" align="center" colspan="1">Number of Cases</th>
<th colspan="2" align="center" rowspan="1">Sex</th>
<th rowspan="2" align="center" colspan="1">Median age (range)</th>
<th rowspan="2" align="center" colspan="1">Number of Deaths (%)</th>
<th rowspan="2" align="center" colspan="1">Number of HCW<xref ref-type="table-fn" rid="tfn1-cbr25_2p121">*</xref>
infected (%)</th>
<th rowspan="2" align="center" colspan="1">Date onset of first probable case</th>
<th rowspan="2" align="center" colspan="1">Date onset of last probable case</th>
</tr>
<tr><th align="center" rowspan="1" colspan="1">M</th>
<th align="center" rowspan="1" colspan="1">F</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1">Australia</td>
<td align="center" rowspan="1" colspan="1">6</td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" rowspan="1" colspan="1">4</td>
<td align="center" rowspan="1" colspan="1">15 (1–45)</td>
<td align="center" rowspan="1" colspan="1">0 (0)</td>
<td align="center" rowspan="1" colspan="1">1 (16)</td>
<td align="center" rowspan="1" colspan="1">26 Feb 03</td>
<td align="center" rowspan="1" colspan="1">1 Apr 03</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Canada</td>
<td align="center" rowspan="1" colspan="1">251</td>
<td align="center" rowspan="1" colspan="1">100</td>
<td align="center" rowspan="1" colspan="1">151</td>
<td align="center" rowspan="1" colspan="1">49 (1–98)</td>
<td align="center" rowspan="1" colspan="1">43 (17)</td>
<td align="center" rowspan="1" colspan="1">109 (43)</td>
<td align="center" rowspan="1" colspan="1">23 Feb 03</td>
<td align="center" rowspan="1" colspan="1">12 Jun 03</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">China</td>
<td align="center" rowspan="1" colspan="1">5281</td>
<td align="center" rowspan="1" colspan="1">2607</td>
<td align="center" rowspan="1" colspan="1">2674</td>
<td align="center" rowspan="1" colspan="1">Pending</td>
<td align="center" rowspan="1" colspan="1">349 (6.6)</td>
<td align="center" rowspan="1" colspan="1">1002 (19)</td>
<td align="center" rowspan="1" colspan="1">16 Nov 02</td>
<td align="center" rowspan="1" colspan="1">3 Jun 03</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Hong Kong</td>
<td align="center" rowspan="1" colspan="1">1755</td>
<td align="center" rowspan="1" colspan="1">778</td>
<td align="center" rowspan="1" colspan="1">977</td>
<td align="center" rowspan="1" colspan="1">40 (0–100)</td>
<td align="center" rowspan="1" colspan="1">299 (17)</td>
<td align="center" rowspan="1" colspan="1">386 (22)</td>
<td align="center" rowspan="1" colspan="1">15 Feb 03</td>
<td align="center" rowspan="1" colspan="1">31 May 03</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Singapore</td>
<td align="center" rowspan="1" colspan="1">238</td>
<td align="center" rowspan="1" colspan="1">77</td>
<td align="center" rowspan="1" colspan="1">161</td>
<td align="center" rowspan="1" colspan="1">35 (1–90)</td>
<td align="center" rowspan="1" colspan="1">33 (14)</td>
<td align="center" rowspan="1" colspan="1">97 (41)</td>
<td align="center" rowspan="1" colspan="1">25 Feb 03</td>
<td align="center" rowspan="1" colspan="1">5 May 03</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Taiwan</td>
<td align="center" rowspan="1" colspan="1">346</td>
<td align="center" rowspan="1" colspan="1">128</td>
<td align="center" rowspan="1" colspan="1">218</td>
<td align="center" rowspan="1" colspan="1">42 (0–93)</td>
<td align="center" rowspan="1" colspan="1">37 (11)</td>
<td align="center" rowspan="1" colspan="1">68 (20)</td>
<td align="center" rowspan="1" colspan="1">25 Feb 03</td>
<td align="center" rowspan="1" colspan="1">15 Jun 03</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Others</td>
<td align="center" rowspan="1" colspan="1">221</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">13 (5.9)</td>
<td align="center" rowspan="1" colspan="1">44 (17)</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"><bold>Total</bold>
</td>
<td align="center" rowspan="1" colspan="1"><bold>8098</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"><bold>774 (9.6)</bold>
</td>
<td align="center" rowspan="1" colspan="1"><bold>1707 (21)</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn id="tfn1-cbr25_2p121"><label>*</label>
<p>HCW = healthcare workers.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="t2-cbr25_2p121" position="float"><label>Table 2</label>
<caption><p>Clinical and general laboratory manifestations of SARS in adult patients.</p>
</caption>
<table frame="box" rules="all"><thead><tr><th align="left" rowspan="1" colspan="1"></th>
<th align="left" rowspan="1" colspan="1">The Chinese University of Hong Kong<xref ref-type="bibr" rid="b27-cbr25_2p121">27</xref>
</th>
<th align="left" rowspan="1" colspan="1">The University of Hong Kong<xref ref-type="bibr" rid="b28-cbr25_2p121">28</xref>
</th>
<th align="left" rowspan="1" colspan="1">Canadian SARS Study Team<xref ref-type="bibr" rid="b5-cbr25_2p121">5</xref>
</th>
<th align="left" rowspan="1" colspan="1">Princess Margaret Hospital, Hong Kong<xref ref-type="bibr" rid="b29-cbr25_2p121">29</xref>
</th>
<th align="left" rowspan="1" colspan="1">Queen Elizabeth Hospital, Hong Kong<xref ref-type="bibr" rid="b30-cbr25_2p121">30</xref>
</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1">Patient population</td>
<td align="left" rowspan="1" colspan="1">66 men, 72 women
<break></break>
69 healthcare workers, Mean ± SD age = 39 ± 17 years</td>
<td align="left" rowspan="1" colspan="1">5 men, 5 women
<break></break>
Mean ± SD age = 53 ± 11 years</td>
<td align="left" rowspan="1" colspan="1">6 men, 4 women
<break></break>
Age: 24–78 years</td>
<td align="left" rowspan="1" colspan="1">5 men, 152 women
<break></break>
Median (range) age: 39 (18–96) years</td>
<td align="left" rowspan="1" colspan="1">45 men, 106 women
<break></break>
Mean ± SD age = 41 ± 15 years</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Incubation period</td>
<td align="left" rowspan="1" colspan="1">2–16 days (median 6 days)</td>
<td align="left" rowspan="1" colspan="1">2–11 days</td>
<td align="left" rowspan="1" colspan="1">3–10 days</td>
<td align="left" rowspan="1" colspan="1">-</td>
<td align="left" rowspan="1" colspan="1">-</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Clinical presentations</td>
<td align="left" rowspan="1" colspan="1">Fever (100%)
<break></break>
Chills ± rigor (73.2%)
<break></break>
Myalgia (60.9%)
<break></break>
Cough (57.3%)
<break></break>
Headache (55.8%)
<break></break>
Dizziness (42.8%)
<break></break>
Sputum production (29.0%)
<break></break>
Sore throat (23.2%)
<break></break>
Coryza (22.5%)
<break></break>
Nausea and vomiting (19.6%)
<break></break>
Diarrhoea (19.6%)</td>
<td align="left" rowspan="1" colspan="1">Fever (100%)
<break></break>
Rigor (90%)
<break></break>
Cough (80%)
<break></break>
Headache (70%)
<break></break>
Malaise (70%)
<break></break>
Dyspnoea (60%)
<break></break>
Myalgia (50%)
<break></break>
Pleurisy (30%)
<break></break>
Sputum production (10%)</td>
<td align="left" rowspan="1" colspan="1">Fever (100%)
<break></break>
Non-productive cough (100%)
<break></break>
Dyspnoea (80%
<break></break>
Malaise (70%)
<break></break>
Diarrhoea (50%)
<break></break>
Chest pain (30%)
<break></break>
Headache (30%)
<break></break>
Sore throat (30%)
<break></break>
Myalgia (20%)
<break></break>
Vomiting (10%)</td>
<td align="left" rowspan="1" colspan="1">Fever (99%)
<break></break>
Chills (74%)
<break></break>
Myalgia (52%)
<break></break>
Cough (43%)
<break></break>
Rigor (41%)
<break></break>
Headache (33%)
<break></break>
Shortness of breath (20%)
<break></break>
Sputum (20%)
<break></break>
Diarrhoea (15%)</td>
<td align="left" rowspan="1" colspan="1">Fever (100%)
<break></break>
Chills (55%)
<break></break>
Cough (46%)
<break></break>
Myalgia (38%)
<break></break>
Malaise (35%)
<break></break>
Sputum (15%)
<break></break>
Headache (11%)
<break></break>
Diarrhoea (11%)
<break></break>
Dyspnoea (10%)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Radiological findings</td>
<td align="left" rowspan="1" colspan="1">At the onset of fever, 78.3% had abnormal chest X-ray (CXR) (air-space consolidation) 54.6% unilateral focal involvement, 45.4% either unilateral multifocal or bilateral involvement</td>
<td align="left" rowspan="1" colspan="1">Progressive air-space disease (90%)</td>
<td align="left" rowspan="1" colspan="1">Infiltrate on CXR (100%)</td>
<td align="left" rowspan="1" colspan="1">On admission, 96% patients had pneumonia on CXR, remaining 4% detected by thoracic computer tomography. (CT)</td>
<td align="left" rowspan="1" colspan="1">At presentation, 87% patients had infiltrate on CXR, remaining 13% detected by thoracic CT.</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">General Laboratory findings</td>
<td align="left" rowspan="1" colspan="1">Lymphopenia (69.6%)
<break></break>
Thrombocytopenia (44.8%)
<break></break>
Prolonged APTT (42.8%)
<break></break>
↑D-dimer (45.0%)
<break></break>
↑ALT (23.4%)
<break></break>
↑LD (71.0%)
<break></break>
↑CK (32.1%)
<break></break>
Hyponatremia (20.3%)
<break></break>
Hypokalemia (25.2%)</td>
<td align="left" rowspan="1" colspan="1">Lymphopenia (90%)
<break></break>
↑ALT (40%)</td>
<td align="left" rowspan="1" colspan="1">Oxygen saturation on room air <95% (78%)
<break></break>
Leucopenia (22%)
<break></break>
Lymphopenia (89%)
<break></break>
Thrombocytopenia (33%)
<break></break>
↑ALT (56%)
<break></break>
↑AST<sup>a</sup>
(78%)
<break></break>
↑LD (80%)
<break></break>
↑CK (56%)</td>
<td align="left" rowspan="1" colspan="1">Lymphopenia (73%)
<break></break>
Thrombocytopenia (50%)
<break></break>
Leukopenia (27%)
<break></break>
Prolonged APTT (18%)
<break></break>
Hyponatraemia (60%)
<break></break>
Hypokalaemia (47%)
<break></break>
↑LD (47%)
<break></break>
↑ALT (31%)
<break></break>
↑CK (19%)</td>
<td align="left" rowspan="1" colspan="1">Lymphopenia (common)
<break></break>
↑LD (common)
<break></break>
Thrombocytopenia (mild)
<break></break>
↑ALT (uncommon)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Admission to ICU</td>
<td align="left" rowspan="1" colspan="1">32 patients (23.2%)</td>
<td align="left" rowspan="1" colspan="1">-</td>
<td align="left" rowspan="1" colspan="1">-</td>
<td align="left" rowspan="1" colspan="1">69 patients (26%)</td>
<td align="left" rowspan="1" colspan="1">39 patients (34%)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Independent predictors of adverse outcome</td>
<td align="left" rowspan="1" colspan="1">Advanced age (odds ratio (OR) 1.8)
<break></break>
High peak LD (OR 2.1)
<break></break>
High absolute neutrophil count on presentation (OR 1.6)</td>
<td align="left" rowspan="1" colspan="1">-</td>
<td align="left" rowspan="1" colspan="1">-</td>
<td align="left" rowspan="1" colspan="1">Mortality 12%
<break></break>
Age>60 years (OR 5.1
<break></break>
LD>3.8 μkat/L (OR 2.2)</td>
<td align="left" rowspan="1" colspan="1">Mortality 15.7%
<break></break>
Age>60 years (hazards ratio (HR) 6.8) co- morbidity (HR 9.0) L
<break></break>
LD>450 U/L (HR 4.8)</td>
</tr>
</tbody>
</table>
</table-wrap>
</floats-wrap>
</pmc>
</record>
Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Sante/explor/SrasV1/Data/Pmc/Curation
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 001652 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Pmc/Curation/biblio.hfd -nk 001652 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien |wiki= Sante |area= SrasV1 |flux= Pmc |étape= Curation |type= RBID |clé= PMC:1904416 |texte= Severe Acute Respiratory Syndrome: Clinical and Laboratory Manifestations }}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Curation/RBID.i -Sk "pubmed:18458712" \ | HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Curation/biblio.hfd \ | NlmPubMed2Wicri -a SrasV1
![]() | This area was generated with Dilib version V0.6.33. | ![]() |