A cluster of cases of severe acute respiratory syndrome in Hong Kong.

By K. Tsang, P. Ho, G. Ooi, W. K. Yee, Teresa S. Wang, M. Chan-Yeung, W. Lam, W. Seto, L. Yam, Thomas M T Cheung and 6 more. New England Journal of Medicine, 2003

1,069 citations recorded by the source corpus.

BACKGROUND Information on the clinical features of the severe acute respiratory syndrome (SARS) will be of value to physicians caring for patients suspected of having this disorder. METHODS We abstracted data on the clinical presentation and course of disease in 10 epidemiologically linked Chinese patients (5 men and 5 women 38 to 72 years old) in whom SARS was diagnosed between February 22, 2003, and March 22, 2003, at our hospitals in Hong Kong, China. RESULTS Exposure between the source patient and subsequent patients ranged from minimal to that between patient and health care provider. The incubation period ranged from 2 to 11 days. All patients presented with fever (temperature, >38 degrees C for over 24 hours), and most presented with rigor, dry cough, dyspnea, malaise, headache, and hypoxemia. Physical examination of the chest revealed crackles and percussion dullness. Lymphopenia was observed in nine patients, and most patients had mildly elevated aminotransferase levels but normal serum creatinine levels. Serial chest radiographs showed progressive air-space disease. Two patients died of progressive respiratory failure; histologic analysis of their lungs showed diffuse alveolar damage. There was no evidence of infection by Mycoplasma pneumoniae, Chlamydia pneumoniae, or Legionella pneumophila. All patients received corticosteroid and ribavirin therapy a mean (+/-SD) of 9.6+/-5.42 days after the onset of symptoms, and eight were treated earlier with a combination of beta-lactams and macrolide for 4+/-1.9 days, with no clinical or radiologic efficacy. CONCLUSIONS SARS appears to be infectious in origin. Fever followed by rapidly progressive respiratory compromise is the key complex of signs and symptoms from which the syndrome derives its name. The microbiologic origins of SARS remain unclear.

Subfields: Epidemiology, Infectious Diseases

View Paper: https://www.semanticscholar.org/paper/1519cd8df875882c62e8ebc8a215949622dc79ed

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In Epidemiology

1. J. Peiris
2. Alex J. Bowers

In Infectious Diseases

1. S. Weiss
2. Christian Drosten
3. J. Leibowitz
4. S. Perlman

Citations in the corpus

• The clinical pathology of severe acute respiratory syndrome (SARS): a report from China (2003, background): “This disease has resulted in a severe epidemic outbreak in 27 countries and regions and it has been termed severe acute respiratory syndrome (SARS) by the World Health Organisation (WHO) [1] [2] [3] .”
• Epidemiology and cause of severe acute respiratory syndrome (SARS) in Guangdong, People's Republic of China, in February, 2003 (2003, neutral): “3, 4 The disease was severe, transmissible from person to person, and seemed to cause clusters of disease in health-care workers.”
• Newly discovered coronavirus as the primary cause of severe acute respiratory syndrome (2003, positive): “The pulmonary lesions in SARS-CoV-infected macaques are comparable to those in SARS patients, 2, 4, 5, 7, 8 and to those in other respiratory coronavirus infections, such as sialodacryoadenitis virus infection in rats, 25 N D 3 ----4 - ”
• A DNA vaccine induces SARS coronavirus neutralization and protective immunity in mice (2004, background): “Public health measures have successfully identified and contained outbreaks of the severe acute respiratory syndrome (SARS) coronavirus (SARS-CoV) [1] [2] [3] [4] [5] , but concerns remain over the possibility of future recurrences.”
• Sentiments and emotions evoked by news headlines of coronavirus disease (COVID-19) outbreak (2020, background): “In 2003, SARS-CoV cases were reported first in Guangdong province with a likelihood of earlier infections occurring in Guangdong, Hong Kong, Hanoi, Toronto and Singapore (Tsang et al., 2003; Lee et al., 2003; Hsu et al., 2003) etc.”
• Coronavirus Pathogenesis (2011, background): “SARS is a novel infectious disorder that was first diagnosed in China in November 2002 and subsequently spread worldwide (Booth et al., 2003; Dwosh et al., 2003; Holmes, 2003; Ksiazek et al., 2003; Lee et al., 2003; Peiris et al., 2003b; Poutanen et al., 2003; Tsang et al., 2003; Varia et al., 2003;”
• Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome (2004, background): “SARS is a new disease caused by a novel coronavirus(2,3) that causes atypical pneumonia, which may progress to respiratory failure.(4) It appeared that the SARS outbreak was currently under controlled, though the problemmay re-emerge during the winter.”
• Clinical features and short-term outcomes of 144 patients with SARS in the greater Toronto area. (2003, background): “With cough or dyspnea 15 (11) With other combinations 9 (6) Prodrome alone 19 (13) Cough or dyspnea alone 13 (9)”
• SARS and MERS: recent insights into emerging coronaviruses (2016, neutral): “Common early symptoms are fever, chills, coughing, malaise, myalgia and headache, and less common symptoms include diarrhoea, vomiting and nausea 2 , 6 , 39 , 89 , 90 , 92 , 95 , 144 , 146–148 .”