[Clinical features of severe acute respiratory syndrome in forty-one confirmed health care workers].
OBJECTIVE
To investigate the clinical features of severe acute respiratory syndrome (SARS).


METHODS
Forty-one medical care workers (aged 23 - 55 years, with a average of 32 years; men/women = 8/32) who were admitted to our hospital and diagnosed with SARS during March and April, 2003 were retrospectively analyzed.


RESULTS
Thirteen of all the patients were physicians and the rest were nurses. The disease was mainly transmitted through air droplet in a short distance, and overwork induced tiredness was involved in disease stimulation. Seventy-three percent of the patients presented fever as their first symptom. Ten patients complained inertia and myalgia. One patient showed no clinical symptoms, and bilateral infiltrates was found in his chest X-ray. Among the 41 cases, 6 (15%) were diagnosed as severe type. At the first week, the counts of white blood cells (WBCs), lymphocyte and platelets were (4.4 +/- 1.5) x 10(9)/L, 0.22 +/- 0.12 and (143 +/- 37) x 10(9)/L, which were significantly lower when compared with those at the 2nd to 4th week. Abnormal liver function was found in 27 cases (mostly with elevated serum ALT), with 70% occurred at the 3rd or 4th week. In terms of CT, 30 patients (73%) showed pathological changes in lungs, and bilateral lung involvement was found in 35.59%. Of 36 cases treated with steroids, 86% received middle or low dosage (80 - 240 mg/d). Artificial ventilation was used for twenty-seven patients, and air pipe mechanical ventilation was used for 1 case. Mortality in this study was 5%.


CONCLUSIONS
Inertia and myalgia may be the earlier symptoms of health care workers with SARS include, which are parallel to CT manifestations. There is no objective index for the assessment of the severity of the disease at early stage. The medicine associated toxicities may be the main reason of liver lesions. damages. Middle or low dosage of steroid was reasonable to be used as early as possible.
Meng
Qing-hua
QH
Department of Infections Diseases, Beijing Youan Hospital, Affiliated of Capital University of Medical Science, Beijing 100054, China.
Zhao
Chun-hui
CH
Dong
Pei-ling
PL
Hu
Zhong-jie
ZJ
Hou
Wei
W
Zhang
Ke
K
Liang
Lian-chun
LC
Huang
Chun
C
D000328:Adult; D005260:Female; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D009726:Nurses; D010820:Physicians; D012121:Respiration, Artificial; D012189:Retrospective Studies; D045169:Severe Acute Respiratory Syndrome / Q000175:diagnosis* / Q000628:therapy / Q000635:transmission
D008775:Methylprednisolone