[Severe acute respiratory syndrome in 78 patients: a retrospective study].
OBJECTIVE
To analyze the clinical features of severe acute respiratory syndrome (SARS) and the diagnosis and treatment of the disease.


METHODS
Seventy-eight patients with SARS referred to the Guangzhou Institute of Respiratory Diseases (GIRD), China from December 22, 2002 to March 2003 were studied retrospectively. The data reviewed included those of clinical manifestations, laboratory investigation and roentgenology.


RESULTS
The patients consisted of 42 men and 36 women, aged 20 - 75 years (mean 37.5 +/- 11.6 years), including 44 infected health-care professionals. Clinical symptoms of these patients were fever (100%), coughing (88%), and dyspnea (80%). Routine blood test revealed WBCs <4.0 x 10(9)/L in 12 patients (15%), (4.0 -10.0) x 10(9)/L in 49 (63%), and over 10.0 x 10(9)/L in 17 (22%) [average (7.6 +/- 5.0) x 10(9)/L]. The level of neutrophilic granulocyte was 0.75 +/- 0.13 and that of lymphocyte was 0.18 +/- 0.11. Chest X-ray and CT scanning revealed changes related to pneumonia. The transmission of the disease was likely via close contact with contagious droplets. The prevalences of acute lung injury (ALI,37 patients) and acute respiratory distress syndrome (ARDS, 21 of the 37 patients) were considerably high among the patients. Seven patients who developed ARDS complicated with MODS died.


CONCLUSIONS
A history of close contact, fever, X-ray signs of pneumonia and normal or lowered WBC counts are favorable for the diagnosis of SARS. Recognition of ALI as the important index for critical SARS and comprehensive supportive management are of paramount importance in decreasing the mortality of patients with SARS.
Xiao
Zheng-lun
ZL
Guangzhou Institute of Respiratory Diseases, Guangzhou 510120, China.
Li
Yi-min
YM
Chen
Rong-chang
RC
Li
Shi-yue
SY
Zhong
Shu-qing
SQ
He
Guo-qing
GQ
Nong
Ling-bo
LB
Gu
Ying-ying
YY
Zhong
Nan-shan
NS
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D045169:Severe Acute Respiratory Syndrome / Q000175:diagnosis / Q000628:therapy*