PMID- 12781535
OWN - NLM
STAT- MEDLINE
DCOM- 20030613
LR  - 20221207
IS  - 0140-6736 (Print)
IS  - 1474-547X (Electronic)
IS  - 0140-6736 (Linking)
VI  - 361
IP  - 9371
DP  - 2003 May 24
TI  - Clinical progression and viral load in a community outbreak of 
      coronavirus-associated SARS pneumonia: a prospective study.
PG  - 1767-72
AB  - 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-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. 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.
FAU - Peiris, J S M
AU  - Peiris JS
AD  - Department of Microbiology, Queen Mary Hospital, University of Hong Kong, Hong 
      Kong, Special Administrative Region, China.
FAU - Chu, C M
AU  - Chu CM
FAU - Cheng, V C C
AU  - Cheng VC
FAU - Chan, K S
AU  - Chan KS
FAU - Hung, I F N
AU  - Hung IF
FAU - Poon, L L M
AU  - Poon LL
FAU - Law, K I
AU  - Law KI
FAU - Tang, B S F
AU  - Tang BS
FAU - Hon, T Y W
AU  - Hon TY
FAU - Chan, C S
AU  - Chan CS
FAU - Chan, K H
AU  - Chan KH
FAU - Ng, J S C
AU  - Ng JS
FAU - Zheng, B J
AU  - Zheng BJ
FAU - Ng, W L
AU  - Ng WL
FAU - Lai, R W M
AU  - Lai RW
FAU - Guan, Y
AU  - Guan Y
FAU - Yuen, K Y
AU  - Yuen KY
CN  - HKU/UCH SARS Study Group
LA  - eng
GR  - WT_/Wellcome Trust/United Kingdom
GR  - A195357/PHS HHS/United States
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - England
TA  - Lancet
JT  - Lancet (London, England)
JID - 2985213R
RN  - 74469-00-4 (Amoxicillin-Potassium Clavulanate Combination)
RN  - A4P49JAZ9H (Ofloxacin)
SB  - IM
CIN - J Infect. 2021 Jan;82(1):159-198. doi: 10.1016/j.jinf.2020.05.039. PMID: 32473230
MH  - Administration, Oral
MH  - Adult
MH  - Aged
MH  - Amoxicillin-Potassium Clavulanate Combination/administration & dosage
MH  - Disease Outbreaks/*statistics & numerical data
MH  - Disease Progression
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Infusions, Intravenous
MH  - Length of Stay
MH  - Lung/diagnostic imaging
MH  - Male
MH  - Middle Aged
MH  - Ofloxacin
MH  - Pregnancy
MH  - Pregnancy Complications, Infectious/diagnosis/therapy
MH  - Pulse Therapy, Drug
MH  - Radiography
MH  - Severe acute respiratory syndrome-related coronavirus/*isolation & purification
MH  - Severe Acute Respiratory Syndrome/*diagnosis/drug therapy/*epidemiology/virology
MH  - Survival Rate
MH  - Viral Load/*statistics & numerical data
PMC - PMC7112410
EDAT- 2003/06/05 05:00
MHDA- 2003/06/14 05:00
PMCR- 2003/05/22
CRDT- 2003/06/05 05:00
PHST- 2003/06/05 05:00 [pubmed]
PHST- 2003/06/14 05:00 [medline]
PHST- 2003/06/05 05:00 [entrez]
PHST- 2003/05/22 00:00 [pmc-release]
AID - S0140673603134125 [pii]
AID - S0140-6736(03)13412-5 [pii]
AID - 10.1016/s0140-6736(03)13412-5 [doi]
PST - ppublish
SO  - Lancet. 2003 May 24;361(9371):1767-72. doi: 10.1016/s0140-6736(03)13412-5.