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Article: Severe acute respiratory syndrome among children.

TitleSevere acute respiratory syndrome among children.
Authors
Issue Date2004
PublisherAmerican Academy of Pediatrics. The Journal's web site is located at http://pediatrics.aappublications.org/
Citation
Pediatrics, 2004, v. 113 n. 6, p. e535-543 How to Cite?
AbstractOBJECTIVE: To study the epidemiologic, clinical, laboratory, and radiologic features, prognostic indicators, and short-term to medium-term outcomes for children with severe acute respiratory syndrome (SARS) and to validate the performance characteristics of a clinical case definition, calculated with respect to SARS-associated coronavirus (SARS-CoV) seroconversion. METHODS: Children <18 years of age, from a single-site outbreak, who satisfied a clinical case definition for SARS, with subsequent serologic confirmation, were treated according to a standard protocol and prospectively monitored. RESULTS: Forty-four children were included. The median age was 12 years. Forty-two children (95.5%) demonstrated an epidemiologic link. Fever, cough, malaise, coryza, sputum production, headache, myalgia, lymphopenia, and elevated lactate dehydrogenase levels were common presenting features. Radiographic findings were nonspecific, but high-resolution computed tomography of the thorax was an early diagnostic aid. A specific reverse transcription-polymerase chain reaction assay for SARS-CoV yielded positive results for <50% of children. Of 9 children who developed hypoxemia, 8 were treated with methylprednisolone. Of 5 children who received intensive care, 3 required assisted ventilation. All children recovered, and serious adverse events in response to treatment were not observed. The outcomes at 3 to 6 months after disease onset, including exercise tolerance, pulmonary functions, and psychologic status, were favorable. An age of >12 years was associated with methylprednisolone therapy for severe illness. After exclusion of the only infant, an age of >12 years was associated with oxygen requirements. Sore throat, high neutrophil count at presentation, and peak neutrophilia were independent factors predicting severe illness. The clinical case definition demonstrated good sensitivity, specificity, and positive and negative predictive values (97.8%, 92.7%, 88%, and 98.7%, respectively) for diagnostic accuracy. CONCLUSIONS: Children are susceptible to SARS-CoV infection. Teenagers resemble adults with respect to disease progression and may develop severe illness. The short-term to medium-term outcomes are good. Sore throat and initial and peak neutrophilia seem to be predictors of severe illness. Our clinical case definition performed well in the epidemic.
Persistent Identifierhttp://hdl.handle.net/10722/79109
ISSN
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLeung, CWen_HK
dc.contributor.authorKwan, YWen_HK
dc.contributor.authorKo, PWen_HK
dc.contributor.authorChiu, SSen_HK
dc.contributor.authorLoung, PYen_HK
dc.contributor.authorFong, NCen_HK
dc.contributor.authorLee, LPen_HK
dc.contributor.authorHui, YWen_HK
dc.contributor.authorLaw, HKen_HK
dc.contributor.authorWong, WHen_HK
dc.contributor.authorChan, KHen_HK
dc.contributor.authorPeiris, JSen_HK
dc.contributor.authorLim, WWen_HK
dc.contributor.authorLau, YLen_HK
dc.contributor.authorChiu, MCen_HK
dc.date.accessioned2010-09-06T07:50:42Z-
dc.date.available2010-09-06T07:50:42Z-
dc.date.issued2004en_HK
dc.identifier.citationPediatrics, 2004, v. 113 n. 6, p. e535-543en_HK
dc.identifier.issn1098-4275en_HK
dc.identifier.urihttp://hdl.handle.net/10722/79109-
dc.description.abstractOBJECTIVE: To study the epidemiologic, clinical, laboratory, and radiologic features, prognostic indicators, and short-term to medium-term outcomes for children with severe acute respiratory syndrome (SARS) and to validate the performance characteristics of a clinical case definition, calculated with respect to SARS-associated coronavirus (SARS-CoV) seroconversion. METHODS: Children <18 years of age, from a single-site outbreak, who satisfied a clinical case definition for SARS, with subsequent serologic confirmation, were treated according to a standard protocol and prospectively monitored. RESULTS: Forty-four children were included. The median age was 12 years. Forty-two children (95.5%) demonstrated an epidemiologic link. Fever, cough, malaise, coryza, sputum production, headache, myalgia, lymphopenia, and elevated lactate dehydrogenase levels were common presenting features. Radiographic findings were nonspecific, but high-resolution computed tomography of the thorax was an early diagnostic aid. A specific reverse transcription-polymerase chain reaction assay for SARS-CoV yielded positive results for <50% of children. Of 9 children who developed hypoxemia, 8 were treated with methylprednisolone. Of 5 children who received intensive care, 3 required assisted ventilation. All children recovered, and serious adverse events in response to treatment were not observed. The outcomes at 3 to 6 months after disease onset, including exercise tolerance, pulmonary functions, and psychologic status, were favorable. An age of >12 years was associated with methylprednisolone therapy for severe illness. After exclusion of the only infant, an age of >12 years was associated with oxygen requirements. Sore throat, high neutrophil count at presentation, and peak neutrophilia were independent factors predicting severe illness. The clinical case definition demonstrated good sensitivity, specificity, and positive and negative predictive values (97.8%, 92.7%, 88%, and 98.7%, respectively) for diagnostic accuracy. CONCLUSIONS: Children are susceptible to SARS-CoV infection. Teenagers resemble adults with respect to disease progression and may develop severe illness. The short-term to medium-term outcomes are good. Sore throat and initial and peak neutrophilia seem to be predictors of severe illness. Our clinical case definition performed well in the epidemic.en_HK
dc.languageengen_HK
dc.publisherAmerican Academy of Pediatrics. The Journal's web site is located at http://pediatrics.aappublications.org/en_HK
dc.relation.ispartofPediatricsen_HK
dc.titleSevere acute respiratory syndrome among children.en_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1120-7507&volume=113&issue=6&spage=e535&epage=e543&date=2004&atitle=Severe+acute+respiratory+syndrome+among+childrenen_HK
dc.identifier.emailChiu, SS: ssschiu@hku.hken_HK
dc.identifier.emailPeiris, JS: malik@hkucc.hku.hken_HK
dc.identifier.emailLau, YL: lauylung@hku.hken_HK
dc.identifier.authorityChiu, SS=rp00421en_HK
dc.identifier.authorityPeiris, JS=rp00410en_HK
dc.identifier.authorityLau, YL=rp00361en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.pmid15173534-
dc.identifier.scopuseid_2-s2.0-3042516020en_HK
dc.identifier.hkuros88807en_HK
dc.identifier.volume113en_HK
dc.identifier.issue6en_HK
dc.identifier.spagee535en_HK
dc.identifier.epage543en_HK
dc.identifier.isiWOS:000221781500067-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLeung, CW=7402612619en_HK
dc.identifier.scopusauthoridKwan, YW=8596853200en_HK
dc.identifier.scopusauthoridKo, PW=8239413300en_HK
dc.identifier.scopusauthoridChiu, SS=7202291500en_HK
dc.identifier.scopusauthoridLoung, PY=6504053635en_HK
dc.identifier.scopusauthoridFong, NC=7005458457en_HK
dc.identifier.scopusauthoridLee, LP=15757694900en_HK
dc.identifier.scopusauthoridHui, YW=18339782900en_HK
dc.identifier.scopusauthoridLaw, HK=7101939394en_HK
dc.identifier.scopusauthoridWong, WH=13310222200en_HK
dc.identifier.scopusauthoridChan, KH=7406034307en_HK
dc.identifier.scopusauthoridPeiris, JS=7005486823en_HK
dc.identifier.scopusauthoridLim, WW=16205075400en_HK
dc.identifier.scopusauthoridLau, YL=7201403380en_HK
dc.identifier.scopusauthoridChiu, MC=7101866205en_HK

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