[Clinical features of 96 patients with severe acute respiratory syndrome from a hospital outbreak].
OBJECTIVE
To describe a hospital outbreak of severe acute respiratory syndrome (SARS) and summarize the clinical features and therapeutic approaches.


METHODS
Clinical data in this cohort were collected prospectively as they were identified.


RESULTS
The outbreak started with a SARS patient from the community on 30 January 2003, followed by a total of 96 people [76 women and 20 men; mean age (29.5 +/- 10.3) years; 93.8% of whom were health care workers] infected in a short period of time after their exposure to this source patient. The incubation period ranged from 1 to 20 days, with a mean of (5.9 +/- 3.5) days. The initial temperature was (38.3 +/- 0.6) degrees C, while the highest was (39.2 +/- 0.6) degrees C (P < 0.001), with a mean fever duration of (9.0 +/- 4.2) days. Other common symptoms included fatigue, cough, mild sputum production, chills, headache, general malaise and myalgia. The radiographic changes were predominantly bilateral and in the middle or lower lung zones. Leukopenia was observed in 67.7% of this cohort. The mean lowest oxygen saturation was (94.8 +/- 3.1)% with supplementary oxygen through a nasal cannula. 68.8% of the patients were treated with methylprednisolone for a mean period l of (4.9 +/- 2.4) days. The initial dose was (67.3 +/- 28.2) mg/d and the maximal dose was (82.4 +/- 30.5) mg/d. Ninety-five patients (99.0%) had a complete clinical recovery, and 1 patient died of progressive acute respiratory distress syndrome. The mean hospitalized duration was (17.2 +/- 8.0) days.


CONCLUSIONS
SARS appears to be highly contagious and potentially lethal among health care workers, characterized by acute onset and rapid progression. Corticosteroids, antibiotics, human gamma-globulin, interferon-alpha, and antiviral drugs, although used empirically, might be of some benefits in shortening the clinical course.
Wu
Wei
W
The SARS Working Group, The Second Affiliated Hospital, Sun Yat-sen University, Guangzhou 510120, China.
Wang
Jing-feng
JF
Liu
Pin-ming
PM
Chen
Wei-xian
WX
Yin
Song-mei
SM
Jiang
Shan-ping
SP
Yan
Li
L
Zhan
Jun
J
Chen
Xi-long
XL
Huang
Zi-tong
ZT
Xu
Jian-xing
JX
Li
Jian-guo
JG
Ma
Li-ping
LP
Huang
Hong-zhang
HZ
D000293:Adolescent; D000328:Adult; D003428:Cross Infection / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D045169:Severe Acute Respiratory Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy