Temporal relationship of viral load, ribavirin, interleukin (IL)-6, IL-8, and clinical progression in patients with severe acute respiratory syndrome.
Although viral replication and overwhelming immune responses are believed to contribute to the progression of severe acute respiratory syndrome (SARS), little is known about the temporal relationship between viral load, ribavirin, proinflammatory cytokines, and clinical progression. We report that ribavirin was not effective in reducing the SARS coronavirus load in 3 of 8 probable cases studied and that elevated levels of interleukin (IL)-6 and IL-8 subsequent to the peak viral load were found in 8 and 6 cases, respectively. The nadir lymphocyte count during lymphopenia, the peak level of lactate dehydrogenase, and the peak density of pulmonary infiltrates lag further behind the peak viral load by a median of 4, 5, and 3.5 days, respectively. These findings provide important information for therapeutic strategies to treat SARS.
Wang
Wei-Kung
WK
Institute of Microbiology, College of Medicine, National Taiwan University, Taipei, Taiwan.
Chen
Shey-Ying
SY
Liu
I-Jung
IJ
Kao
Chuan-Liang
CL
Chen
Hui-Ling
HL
Chiang
Bor-Liang
BL
Wang
Jann-Tay
JT
Sheng
Wang-Hwei
WH
Hsueh
Po-Ren
PR
Yang
Chao-Fu
CF
Yang
Pan-Chyr
PC
Chang
Shan-Chwen
SC
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D016209:Interleukin-8 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012254:Ribavirin / Q000627:therapeutic use*; D045473:Severe acute respiratory syndrome-related coronavirus; D045169:Severe Acute Respiratory Syndrome / Q000188:drug therapy*; D013997:Time Factors; D019562:Viral Load
D000998:Antiviral Agents; D015850:Interleukin-6; D016209:Interleukin-8; D012254:Ribavirin