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. 2003 May 10;361(9369):1615-7.
doi: 10.1016/s0140-6736(03)13265-5.

Development of a standard treatment protocol for severe acute respiratory syndrome

Loletta K-Y So  1 , Arthur C W Lau, Loretta Y C Yam, Thomas M T Cheung, Edwin Poon, Raymond W H Yung, K Y Yuen
Affiliations

Development of a standard treatment protocol for severe acute respiratory syndrome

Loletta K-Y So et al. Lancet. .

Abstract

A series of 31 patients with probable SARS, diagnosed from WHO criteria, were treated according to a treatment protocol consisting of antibacterials and a combination of ribavirin and methylprednisolone. Through experience with the first 11 patients, we were able to finalise standard dose regimens, including pulsed methylprednisolone. One patient recovered on antibacterial treatment alone, 17 showed rapid and sustained responses, and 13 achieved improvement with step-up or pulsed methylprednisolone. Four patients required short periods of non-invasive ventilation. No patient required intubation or mechanical ventilation. There was no mortality or treatment morbidity in this series.

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Figures

Figure
Figure
Patterns of disease progression and response to different corticosteroid doses in three patients A=rapid and sustained response to ribavirin and methylprednisolone 3 mg/kg daily. B=extensive disease requiring early pulsed methylprednisolone to achieve response. C=early step down of methylprednisolone dose resulted in rebound of SARS; the patient responded later to pulsed methylprednisolone.
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