title: Clinical and laboratory findings of SARS in Singapore.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Singapore General Hospital, Singapore. hoe_nam@yahoo.com.sg
authors.forename: Hoe-Nam
authors.initials: HN
authors.lastname: Leong
authors.forename: Kwai-Peng
authors.initials: KP
authors.lastname: Chan
authors.forename: Lynette L E
authors.initials: LL
authors.lastname: Oon
authors.forename: Evelyn  S C
authors.initials: E
authors.lastname: Koay
authors.forename: Lee-Ching
authors.initials: LC
authors.lastname: Ng
authors.forename: May-Ann
authors.initials: MA
authors.lastname: Lee
authors.forename: Timothy
authors.initials: T
authors.lastname: Barkham
authors.forename: Mark I C
authors.initials: MI
authors.lastname: Chen
authors.forename: Bee-Hoon
authors.initials: BH
authors.lastname: Heng
authors.forename: Ai-Ee
authors.initials: AE
authors.lastname: Ling
authors.forename: Yee-Sin
authors.initials: YS
authors.lastname: Leo
mesh_terms: 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
chemical_list: D000914:Antibodies, Viral; D004279:DNA, Viral