Initial viral load and the outcomes of SARS
| Autor: | Doris M.W. Tse, Kin Ip Law, Kin Sang Chan, Ivan Hung, Kwok-Hung Chan, Bone S.F. Tang, Ping Wing Ng, Leo L.M. Poon, Kwok-Yung Yuen, Veronica L. Chan, Joseph S. M. Peiris, Maureen M.L. Wong, Chung-Ming Chu, Wah Shing Leung, Vincent C.C. Cheng, Woon Leung Ng, Tiong Chee Sim |
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| Jazyk: | angličtina |
| Rok vydání: | 2004 |
| Předmět: |
Adult
Male medicine.medical_specialty SARS Virus - isolation & purification Hong Kong - epidemiology Comorbidity medicine.disease_cause Severe Acute Respiratory Syndrome law.invention law Internal medicine Nasopharynx medicine Humans Prospective Studies Severe Acute Respiratory Syndrome - blood - mortality - virology Prospective cohort study Survival analysis Coronavirus Aged Proportional Hazards Models Aged 80 and over Proportional hazards model business.industry Research Hazard ratio Age Factors General Medicine Middle Aged Viral Load Intensive care unit Survival Analysis Respiratory failure Severe acute respiratory syndrome-related coronavirus Immunology Multivariate Analysis Hong Kong RNA Viral Female business Viral load |
| Zdroj: | Canadian Medical Association Journal |
| Popis: | Background: 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. published_or_final_version |
| Databáze: | OpenAIRE |
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