| Title: |
Clinical Features and Short-term Outcomes of 144 Patients With SARS in the Greater Toronto Area. |
| Authors: |
Booth, Christopher M.; Matukas, Larissa M.; Tomlinson, George A.; Rachlis, Anita R.; Rose, David B.; Dwosh, Hy A.; Walmsley, Sharon L.; Mazzulli, Tony; Avendano, Monica; Derkach, Peter; Ephtimios, Issa E.; Kitai, Ian; Mederski, Barbara D.; Shadowitz, Steven B.; Gold, Wayne L.; Hawryluck, Laura A.; Rea, Elizabeth; Chenkin, Jordan S.; Cescon, David W.; Poutanen, Susan M. |
| Source: |
JAMA: Journal of the American Medical Association; 6/4/2003, Vol. 289 Issue 21, p2801, 9p, 3 Black and White Photographs, 6 Charts, 2 Graphs |
| Subject Terms: |
SARS disease; COMMUNICABLE diseases; HEALTH outcome assessment |
| Geographic Terms: |
TORONTO (Ont.); ONTARIO; CANADA |
| Abstract: |
Context: Severe acute respiratory syndrome (SARS) is an emerging infectious disease that first manifested in humans in China in November 2002 and has subsequently spread worldwide. Objectives: To describe the clinical characteristics and short-term outcomes of SARS in the first large group of patients in North America; to describe how these patients were treated and the variables associated with poor outcome. Design, Setting, and Patients: Retrospective case series involving 144 adult patients admitted to 10 academic and community hospitals in the greater Toronto, Ontario, area between March 7 and April 10, 2003, with a diagnosis of suspected or probable SARS. Patients were included if they had fever, a known exposure to SARS, and respiratory symptoms or infiltrates observed on chest radiograph. Patients were excluded if an alternative diagnosis was determined. Main Outcome Measures: Location of exposure to SARS; features of the history, physical examination, and laboratory tests at admission to the hospital; and 21-day outcomes such as death or intensive care unit (ICU) admission with or without mechanical ventilation. Results: Of the 144 patients, 111 (77%) were exposed to SARS in the hospital setting. Features of the clinical examination most commonly found in these patients at admission were self-reported fever (99%), documented elevated temperature (85%), nonproductive cough (69%), myalgia (49%), and dyspnea (42%). Common laboratory features included elevated lactate dehydrogenase (87%), hypocalcemia (60%), and lymphopenia (54%). Only 2% of patients had rhinorrhea. A total of 126 patients (88%) were treated with ribavirin, although its use was associated with significant toxicity, including hemolysis (in 76%) and decrease in hemoglobin of 2 g/dL (in 49%). Twenty-nine patients (20%) were admitted to the ICU with or without mechanical ventilation, and 8 patients died (21-day mortality, 6.5%; 95% confidence interval [CI], 1.9%-11.8%). Multivariable analysis... [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |