Clinical progression and viral load in a community outbreak of coronavirus-associated SARS pneumonia: a prospective study.
Identifieur interne : 003361 ( PubMed/Corpus ); précédent : 003360; suivant : 003362Clinical 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 YuenSource :
- Lancet (London, England) [ 0140-6736 ] ; 2003.
English descriptors
- KwdEn :
- Administration, Oral, Adult, Aged, Amoxicillin-Potassium Clavulanate Combination (administration & dosage), Disease Outbreaks (statistics & numerical data), Disease Progression, Female, Follow-Up Studies, Humans, Infusions, Intravenous, Length of Stay, Lung (diagnostic imaging), Male, Middle Aged, Ofloxacin, Pregnancy, Pregnancy Complications, Infectious (diagnosis), Pregnancy Complications, Infectious (therapy), Pulse Therapy, Drug, Radiography, SARS Virus (isolation & purification), Severe Acute Respiratory Syndrome (diagnosis), Severe Acute Respiratory Syndrome (drug therapy), Severe Acute Respiratory Syndrome (epidemiology), Severe Acute Respiratory Syndrome (virology), Survival Rate, Viral Load (statistics & numerical data).
- MESH :
- chemical , administration & dosage : Amoxicillin-Potassium Clavulanate Combination.
- diagnosis : Pregnancy Complications, Infectious, Severe Acute Respiratory Syndrome.
- diagnostic imaging : Lung.
- drug therapy : Severe Acute Respiratory Syndrome.
- epidemiology : Severe Acute Respiratory Syndrome.
- isolation & purification : SARS Virus.
- statistics & numerical data : Disease Outbreaks, Viral Load.
- therapy : Pregnancy Complications, Infectious.
- virology : Severe Acute Respiratory Syndrome.
- Administration, Oral, Adult, Aged, Disease Progression, Female, Follow-Up Studies, Humans, Infusions, Intravenous, Length of Stay, Male, Middle Aged, Ofloxacin, Pregnancy, Pulse Therapy, Drug, Radiography, Survival Rate.
Abstract
We investigated the temporal progression of the clinical, radiological, and virological changes in a community outbreak of severe acute respiratory syndrome (SARS).
DOI: 10.1016/s0140-6736(03)13412-5
PubMed: 12781535
Links to Exploration step
pubmed:12781535Le document en format XML
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<front><div type="abstract" xml:lang="en">We investigated the temporal progression of the clinical, radiological, and virological changes in a community outbreak of severe acute respiratory syndrome (SARS).</div>
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<ArticleTitle>Clinical progression and viral load in a community outbreak of coronavirus-associated SARS pneumonia: a prospective study.</ArticleTitle>
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<Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">We investigated the temporal progression of the clinical, radiological, and virological changes in a community outbreak of severe acute respiratory syndrome (SARS).</AbstractText>
<AbstractText Label="METHODS" NlmCategory="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.</AbstractText>
<AbstractText Label="FINDINGS" NlmCategory="RESULTS">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-transcriptase (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.</AbstractText>
<AbstractText Label="INTERPRETATION" NlmCategory="CONCLUSIONS">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.</AbstractText>
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