Clinical and laboratory findings of SARS in Singapore.
BACKGROUND
Singapore was one of 29 countries worldwide affected by severe acute respiratory syndrome (SARS) in 2003.


METHODS
There were 238 cases identified during the outbreak. We performed a retrospective analysis of the clinical and laboratory data of 234 patients admitted to Tan Tock Seng Hospital and Singapore General Hospital.


RESULTS
The mean age of patients was 21 years, 31.6% of patients were males and 41.8% were healthcare workers. At presentation, the common symptoms were fever, myalgia, cough and headache; rhinorrhoea was uncommon. On admission, 21% had leukopenia, 18% had thrombocytopaenia, 29% had hyponatraemia, 31% had hypokalaemia, 21% had transaminitis. Polymerase chain reaction (PCR) testing of respiratory and stool samples provided the best yield at the end of the first week of illness. Thirty-two patients were initially not recognised as probable SARS and were reclassified when the serology test results were available. The chief reasons for not identifying these patients early were persistently normal chest X-rays (68.8%), very mild presentation (43.8%) and the presence of a concomitant illness (12.5%). Overall, 12% of the patients were probable SARS with atypical presentations. Overall mortality was 11.8%.


CONCLUSIONS
Patients infected with the SARS coronavirus had a wide clinical presentation with non-specific symptoms.
Leong
Hoe-Nam
HN
Department of Internal Medicine, Singapore General Hospital, Singapore. hoe_nam@yahoo.com.sg
Chan
Kwai-Peng
KP
Oon
Lynette L E
LL
Koay
Evelyn  S C
E
Ng
Lee-Ching
LC
Lee
May-Ann
MA
Barkham
Timothy
T
Chen
Mark I C
MI
Heng
Bee-Hoon
BH
Ling
Ai-Ee
AE
Leo
Yee-Sin
YS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000914:Antibodies, Viral / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000032:analysis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D045473:Severe acute respiratory syndrome-related coronavirus / Q000235:genetics* / Q000276:immunology*; D045169:Severe Acute Respiratory Syndrome / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D012720:Severity of Illness Index; D012846:Singapore / Q000453:epidemiology
D000914:Antibodies, Viral; D004279:DNA, Viral