title: Comparative study of patients with and without SARS who fulfilled the WHO SARS case definition.
abstract: To differentiate severe acute respiratory syndrome (SARS) from non-SARS illness, we retrospectively compared 53 patients with probable SARS and 31 patients with non-SARS who were admitted to Mackay Memorial Hospital from April 27 to June 16, 2003. Fever (> 38 degrees C) was the earliest symptom (50/53 SARS vs. 5/31 non-SARS, p < 0.0001), preceding cough by a mean of 4.5 days. The initial chest X-ray study was normal in 22/53 SARS cases versus 5/31 non-SARS cases. SARS patients with an initially normal chest X-ray study developed infiltrates at a mean of 5 +/- 3.44 days after onset of fever (21/22 SARS vs. 0/5 non-SARS). Rapid radiographic progression of unifocal involvement to multifocal infiltrates was seen in 22 of 24 SARS vs. 0 of 26 non-SARS patients (p < 0.0001). Pleural effusion was not present in any SARS patients but was seen in 6 of 26 non-SARS cases (p < 0.0001). Initial lymphopenia, thrombocytopenia, and elevated lactate dehydrogenase were all more common in SARS than non-SARS (p < 0.0001). They may help differentiate SARS from non-SARS if a reliable and rapid diagnostic test is not available.
authors.affiliation: Division of Chest Medicine, Department of Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Shang-Miao
authors.initials: SM
authors.lastname: Chang
authors.forename: Ching-Lung
authors.initials: CL
authors.lastname: Liu
authors.forename: Hsu-Tah
authors.initials: HT
authors.lastname: Kuo
authors.forename: Pei-Jan
authors.initials: PJ
authors.lastname: Chen
authors.forename: Chun Ming
authors.initials: CM
authors.lastname: Lee
authors.forename: Fung-J
authors.initials: FJ
authors.lastname: Lin
authors.forename: Ching-Chi
authors.initials: CC
authors.lastname: Lin
authors.forename: Chao-Hsien
authors.initials: CH
authors.lastname: Lee
authors.forename: Yen-Ta
authors.initials: YT
authors.lastname: Lu
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008231:Lymphopenia / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D045169:Severe Acute Respiratory Syndrome / Q000175:diagnosis*; D013921:Thrombocytopenia / Q000175:diagnosis; D014944:World Health Organization
chemical_list: D007770:L-Lactate Dehydrogenase