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Article: Initial viral load and the outcomes of SARS

TitleInitial viral load and the outcomes of SARS
Authors
Issue Date2004
PublisherCanadian Medical Association. The Journal's web site is located at http://www.cmaj.ca
Citation
Cmaj, 2004, v. 171 n. 11, p. 1349-1352 How to Cite?
AbstractBackground: Severe acute respiratory syndrome (SARS) is caused by a novel coronavirus. It may progress to respiratory failure, and a significant proportion of patients die. Preliminary data suggest that a high viral load of the SARS coronavirus is associated with adverse outcomes in the intensive care unit, but the relation of viral load to survival is unclear. Methods: We prospeaively studied an inception cohort of 133 patients with virologically confirmed SARS who were admitted to 2 general acute care hospitals in Hong Kong from Mar. 24 to May 4, 2003. The patients were followed until death or for a minimum of 90 days. We used Cox proportional hazard modelling to analyze potential predictors of survival recorded at the time of presentation, including viral load from nasopharyngeal specimens (measured by quantitative reverse transcriptase polymerase chain reaction [PCR] of the SARS-associated coronavirus). Results: Thirty-two patients (24.1%) met the criteria for acute respiratory distress syndrome, and 24 patients (18.0%) died. The following baseline !actors were independently associated with worse survival: older age (61-80 years) (adjusted hazard ratio [HR] 5.24, 95% confidence interval [CI] 2.03-13.53), presence of an active comorbid condition (adjusted HR 3.36, 95% CI 1.44-7.82) and higher initial viral load of SARS coronavirus, according to quantitative PCR of nasopharyngeal specimens (adjusted HR 1.21 per log 10 increase in number of RNA copies per millilitre, 95% CI 1.06-1.39). Interpretation: We found preliminary evidence that higher initial viral load is independently associated with worse prognosis in SARS. Mortality dc.ta for patients with SARS should be interpreted in light of age, comorbidity and viral load. These considerations will be important in future studies of SARS.
Persistent Identifierhttp://hdl.handle.net/10722/49143
ISSN
2015 Impact Factor: 6.724
2015 SCImago Journal Rankings: 1.552
PubMed Central ID
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChu, CMen_HK
dc.contributor.authorPoon, LLMen_HK
dc.contributor.authorCheng, VCCen_HK
dc.contributor.authorChan, KSen_HK
dc.contributor.authorHung, IFNen_HK
dc.contributor.authorWong, MMLen_HK
dc.contributor.authorChan, KHen_HK
dc.contributor.authorLeung, WSen_HK
dc.contributor.authorTang, BSFen_HK
dc.contributor.authorChan, VLen_HK
dc.contributor.authorNg, WLen_HK
dc.contributor.authorSim, TCen_HK
dc.contributor.authorNg, PWen_HK
dc.contributor.authorLaw, KIen_HK
dc.contributor.authorTse, DMWen_HK
dc.contributor.authorPeiris, JSMen_HK
dc.contributor.authorYuen, KYen_HK
dc.date.accessioned2008-06-12T06:35:24Z-
dc.date.available2008-06-12T06:35:24Z-
dc.date.issued2004en_HK
dc.identifier.citationCmaj, 2004, v. 171 n. 11, p. 1349-1352en_HK
dc.identifier.issn0820-3946en_HK
dc.identifier.urihttp://hdl.handle.net/10722/49143-
dc.description.abstractBackground: Severe acute respiratory syndrome (SARS) is caused by a novel coronavirus. It may progress to respiratory failure, and a significant proportion of patients die. Preliminary data suggest that a high viral load of the SARS coronavirus is associated with adverse outcomes in the intensive care unit, but the relation of viral load to survival is unclear. Methods: We prospeaively studied an inception cohort of 133 patients with virologically confirmed SARS who were admitted to 2 general acute care hospitals in Hong Kong from Mar. 24 to May 4, 2003. The patients were followed until death or for a minimum of 90 days. We used Cox proportional hazard modelling to analyze potential predictors of survival recorded at the time of presentation, including viral load from nasopharyngeal specimens (measured by quantitative reverse transcriptase polymerase chain reaction [PCR] of the SARS-associated coronavirus). Results: Thirty-two patients (24.1%) met the criteria for acute respiratory distress syndrome, and 24 patients (18.0%) died. The following baseline !actors were independently associated with worse survival: older age (61-80 years) (adjusted hazard ratio [HR] 5.24, 95% confidence interval [CI] 2.03-13.53), presence of an active comorbid condition (adjusted HR 3.36, 95% CI 1.44-7.82) and higher initial viral load of SARS coronavirus, according to quantitative PCR of nasopharyngeal specimens (adjusted HR 1.21 per log 10 increase in number of RNA copies per millilitre, 95% CI 1.06-1.39). Interpretation: We found preliminary evidence that higher initial viral load is independently associated with worse prognosis in SARS. Mortality dc.ta for patients with SARS should be interpreted in light of age, comorbidity and viral load. These considerations will be important in future studies of SARS.en_HK
dc.format.extent386 bytes-
dc.format.mimetypetext/html-
dc.languageengen_HK
dc.languagefreen_HK
dc.publisherCanadian Medical Association. The Journal's web site is located at http://www.cmaj.caen_HK
dc.relation.ispartofCMAJen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshSARS Virus - isolation & purificationen_HK
dc.subject.meshSevere Acute Respiratory Syndrome - blood - mortality - virologyen_HK
dc.subject.meshViral Loaden_HK
dc.subject.meshComorbidityen_HK
dc.subject.meshHong Kong - epidemiologyen_HK
dc.titleInitial viral load and the outcomes of SARSen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0820-3946&volume=171&issue=11&spage=1349&epage=1352&date=2004&atitle=Initial+viral+load+and+the+outcomes+of+SARSen_HK
dc.identifier.emailPoon, LLM: llmpoon@hkucc.hku.hken_HK
dc.identifier.emailHung, IFN: ivanhung@hkucc.hku.hken_HK
dc.identifier.emailPeiris, JSM: malik@hkucc.hku.hken_HK
dc.identifier.emailYuen, KY: kyyuen@hkucc.hku.hken_HK
dc.identifier.authorityPoon, LLM=rp00484en_HK
dc.identifier.authorityHung, IFN=rp00508en_HK
dc.identifier.authorityPeiris, JSM=rp00410en_HK
dc.identifier.authorityYuen, KY=rp00366en_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.doi10.1503/cmaj.1040398en_HK
dc.identifier.pmid15557587-
dc.identifier.pmcidPMC527336en_HK
dc.identifier.scopuseid_2-s2.0-9644265365en_HK
dc.identifier.hkuros100206-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-9644265365&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume171en_HK
dc.identifier.issue11en_HK
dc.identifier.spage1349en_HK
dc.identifier.epage1352en_HK
dc.identifier.isiWOS:000225285200037-
dc.publisher.placeCanadaen_HK
dc.identifier.scopusauthoridChu, CM=7404345558en_HK
dc.identifier.scopusauthoridPoon, LLM=7005441747en_HK
dc.identifier.scopusauthoridCheng, VCC=23670479400en_HK
dc.identifier.scopusauthoridChan, KS=7406031627en_HK
dc.identifier.scopusauthoridHung, IFN=7006103457en_HK
dc.identifier.scopusauthoridWong, MML=9278575000en_HK
dc.identifier.scopusauthoridChan, KH=7406034307en_HK
dc.identifier.scopusauthoridLeung, WS=7201504471en_HK
dc.identifier.scopusauthoridTang, BSF=8908243000en_HK
dc.identifier.scopusauthoridChan, VL=7202655014en_HK
dc.identifier.scopusauthoridNg, WL=7401613401en_HK
dc.identifier.scopusauthoridSim, TC=36244502900en_HK
dc.identifier.scopusauthoridNg, PW=7201376949en_HK
dc.identifier.scopusauthoridLaw, KI=7202563012en_HK
dc.identifier.scopusauthoridTse, DMW=7101916534en_HK
dc.identifier.scopusauthoridPeiris, JSM=7005486823en_HK
dc.identifier.scopusauthoridYuen, KY=36078079100en_HK

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