Investigational use of ribavirin in the treatment of severe acute respiratory syndrome, Singapore, 2003.
OBJECTIVE
Ribavirin is a broad spectrum nucleoside analogue efficacious in the treatment of several viral infections. In the recent severe acute respiratory syndrome (SARS) outbreak, ribavirin was used in various countries against this novel coronavirus. We conducted a retrospective analysis to assess the efficacy of ribavirin in the treatment of SARS in Singapore.


METHODS
A total of 229 cases were analysed. Ninety-seven (42.4%) patients received ribavirin at a mean of 6.4 days of illness. Clinical and laboratory parameters taken at the start of ribavirin treatment were compared with day 5, 6 or 7 parameters of those patients not on treatment. The two groups were compared using Fisher's exact test and Student's t-test. Multivariate analysis was performed using Cox regression model with death as the outcome of interest.


RESULTS
The treatment group had younger women with more symptoms of myalgia (P < 0.001). The crude death rate was 12.9% in the control and 10.3% (P = 0.679) in the treatment group. After correction for age, male sex, lactate dehydrogenase levels and steroid use, the hazard ratio was 1.03 (95% CI: 0.44-2.41, P = 0.939).


CONCLUSIONS
In this retrospective, uncontrolled cohort analysis, use of ribavirin did not appear to confer any benefit for patients with SARS.
Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore. hoe_nam@yahoo.com.sg
Hoe-Nam
HN
Leong
Brenda
B
Ang
Arul
A
Earnest
Cindy
C
Teoh
Wei
W
Xu
Yee-Sin
YS
Leo
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use*; D045169:Severe Acute Respiratory Syndrome / Q000188:drug therapy*; D016896:Treatment Outcome
D000998:Antiviral Agents; D012254:Ribavirin