Clinical manifestations, laboratory findings, and treatment outcomes of SARS patients

Abstract

Clinical and laboratory data on severe acute respiratory syndrome (SARS), particularly on the temporal progression of abnormal laboratory findings, are limited. We conducted a prospective study on the clinical, radiologic, and hematologic findings of SARS patients with pneumonia, who were admitted to National Taiwan University Hospital from March 8 to June 15, 2003. Fever was the most frequent initial symptom, followed by cough, myalgia, dyspnea, and diarrhea. Twenty-four patients had various underlying diseases. Most patients had elevated C-reactive protein (CRP) levels and lymphopenia. Other common abnormal laboratory findings included leukopenia, thrombocytopenia, and elevated levels of aminotransferase, lactate dehydrogenase, and creatine kinase. These clinical and laboratory findings were exacerbated in most patients during the second week of disease. The overall case-fatality rate was 19.7%. By multivariate analysis, underlying disease and initial CRP level were predictive of death.

Figure

The time relationships between the time points of defervescence, initiation of steroid, and when chest radiographic finding as well as various laboratory parameters became most severe. Mean and standard deviation (days) are presented. CXR, chest radiography; ALT, alanine aminotransferase; LDH, lactate dehydrogenase; AST, aspartate aminotransferase; CRP, C-reactive protein; CK, creatine kinase.