Serveur d'exploration SRAS

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

Identifieur interne : 003361 ( PubMed/Curation ); précédent : 003360; suivant : 003362

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

Auteurs : J S M. Peiris [République populaire de Chine] ; 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 :

RBID : pubmed:12781535

Descripteurs français

English descriptors

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

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pubmed:12781535

Le document en format XML

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<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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<DateCompleted>
<Year>2003</Year>
<Month>06</Month>
<Day>13</Day>
</DateCompleted>
<DateRevised>
<Year>2020</Year>
<Month>04</Month>
<Day>07</Day>
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<ISSN IssnType="Print">0140-6736</ISSN>
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<Volume>361</Volume>
<Issue>9371</Issue>
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<Month>May</Month>
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<Title>Lancet (London, England)</Title>
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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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<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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