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. 2009 Nov;14 Suppl 1(Suppl 1):21-7.
doi: 10.1111/j.1365-3156.2008.02147.x. Epub 2009 Apr 17.

Case fatality of SARS in mainland China and associated risk factors

Na Jia  1 , Dan Feng, Li-Qun Fang, Jan Hendrik Richardus, Xiao-Na Han, Wu-Chun Cao, Sake J de Vlas
Affiliations

Case fatality of SARS in mainland China and associated risk factors

Na Jia et al. Trop Med Int Health. 2009 Nov.

Abstract

Objective: To analyse the case fatality ratio (CFR) and its risk factors for severe acute respiratory syndrome (SARS) in mainland China by using a comprehensive dataset of all probable cases.

Methods: The data of all probable SARS cases were derived from the Infectious Disease Reporting System of the Center of Diseases Control and Hospital Information Systems, during the 2003 epidemic in mainland China. The definition of probable SARS case was consistent with the definition for clinically confirmed SARS issued by the Ministry of Health of the People's Republic of China. We performed univariate and multivariate logistic regression analysis to determine the association of CFR with age, sex, residence location, occupation, the period of the epidemic and the duration from symptom onset to admission into hospital.

Results: The overall CFR was 6.4% among 5327 probable SARS cases in mainland China. Old age, being a patient during the early period of a local outbreak, and being from Tianjin led to a relatively higher CFR than young age, late stage of a local outbreak and cases from Beijing. Guangdong Province resulted in an even lower CFR compared with Beijing.

Conclusions: Because of their deteriorated health status and apparent complications, SARS patients aged >60 years had a much higher risk of dying than younger patients. At the early stage of local outbreaks, lack of experience in patient care and perhaps treatment also led to a relatively higher CFR. The Tianjin SARS outbreak happened mainly within a hospital, leading to a high impact of co-morbidity. The relatively young age of the cases partly explains the low CFR in mainland China compared with other countries and areas affected by SARS.

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Conflict of interest statement

The authors have declared that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Comparison of the case fatality ratios for SARS patients in Beijing, Guangdong and Tianjin with age. Intervals indicate 90% binomially distributed confidence intervals.
Figure 2
Figure 2
Comparison of the case fatality ratios for SARS patients in different locations with the number of months since the first SARS case emerged in mainland China (i.e. 16 November 2002). Every marker has been based on at least 40 SARS cases and represents a half‐month period, or somewhat longer for the end points of some lines.
See this image and copyright information in PMC

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