Severe acute respiratory syndrome: relationship between radiologic and clinical parameters.
OBJECTIVE
To quantify severity of severe acute respiratory syndrome (SARS) on chest radiographs and to determine its relationship with clinical parameters.


METHODS
Forty patients (mean age, 42.90 years +/- 14.01 [SD]; median age, 41.5 years; age range, 25-82 years) with clinically diagnosed SARS were evaluated. Heart rate, oxygen saturation, temperature, and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were recorded daily. Severity of lung changes on chest radiographs was scored according to percentage of involved lung. Radiographic scores at days of admission, treatment, and maximal radiographic score were extracted for statistical analysis with clinical parameters. Time to maximal radiographic score from admission and days between onset and beginning of treatment were determined. Correlations between radiographic and clinical parameters were evaluated with Spearman rank correlation. Sex differences with respect to clinical and radiographic parameters were evaluated with Mann-Whitney test.


RESULTS
Median chest radiographic scores peaked 5 days after beginning of treatment before they declined. Maximal and treatment radiographic scores were inversely related to oxygen saturation (r = -0.67, P <.001; r = -0.35, P =.03). Admission radiographic score was correlated with admission AST level (r = 0.53, P =.003); treatment radiographic score, with treatment ALT and AST levels (r = 0.43, P =.007; r = 0.42, P =.019); and time to maximal radiographic score, with AST level at maximal radiographic score (r = -0.45, P =.006), admission radiographic score (r = -0.55, P <.001), treatment radiographic score (r = -0.58, P <.001), and admission ALT and AST levels (r = -0.44, P =.007; r = -0.58, P =.001). Treatment delay was associated with AST level at maximal radiographic score (r = 0.53, P =.001), treatment radiographic score (r = 0.60, P <.001), and time to maximal radiographic score (r = -0.36, P =.02). No sex differences occurred with respect to radiographic and clinical parameters (P >.05).


CONCLUSIONS
Severity of lung abnormalities quantified on chest radiographs correlates with clinical and laboratory parameters.
Ooi
Clara G C
CG
Department of Diagnostic Radiology, University of Hong Kong, Rm 405, Block K, Queen Mary Hospital, Pokfulam Road, Hong Kong Special Administrative Region, China. cgcooi@hkucc.hku.hk
Khong
Pek L
PL
Lam
Bing
B
Ho
James C M
JC
Yiu
Wai C
WC
Wong
Wai-Man
WM
Wang
Teresa
T
Ho
Pak L
PL
Wong
Poon C
PC
Chan
Raymond H
RH
Lam
Wah K
WK
Lai
Kar N
KN
Tsang
Kenneth W T
KW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001831:Body Temperature; D005260:Female; D006339:Heart Rate; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011859:Radiography; D045169:Severe Acute Respiratory Syndrome / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000628:therapy
D015415:Biomarkers; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D010100:Oxygen