Severe Acute Respiratory Syndrome

Aka: Severe Acute Respiratory Syndrome, SARS

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II. Epidemiology

  1. Asia has been epicenter of SARS outbreaks

III. Pathophysiology

  1. Coronavirus spread by respiratory droplet transmission

IV. Symptoms

  1. Fever (Temperature over 100.4 F or 38 C)
  2. Chills
  3. Myalgias
  4. Non-productive Cough
  5. Headache
  6. Dizziness

V. Radiology

  1. Chest XRay (abnormal in 75% of cases at presentation)
    1. Patchy consolidation in peripheral lung fields
  2. Chest CT
    1. Peripheral "ground-glass" opacifications

VI. Labs: Complete Blood Count with Platelets

  1. Lymphocyte Count >4000/uL or <1500/uL
  2. Neutrophil Count <2000/uL
  3. Platelet Count <150,000/mm3

VII. Management

  1. Cover differential diagnosis
    1. Empiric treatment for Bacterial Pneumonia
  2. Non-specific measures used in SARS cases
    1. Indications
      1. Fever >48 hours
      2. Thrombocytopenia
      3. Leukopenia
    2. Management
      1. Ribavirin
      2. Methylprednisolone

VIII. Course

  1. Incubation Period: 2-16 days (mean 5-6 days)
  2. ICU admission rate: 23%
  3. Mechanical Ventilation required: 13.8%
  4. Mortality: 3.6%
    1. Associated with major comorbidities
  5. Time at which further hospital transmission unlikely
    1. Twenty days from last known SARS case onset

IX. Prevention

  1. Respiratory protection
    1. N95 or equivalent mask
  2. SARS Vaccine
    1. WHO trials of Vaccine due to start winter of 2004

X. Risk Factors

  1. Close contact to infected patients
    1. Household contacts
    2. Healthcare workers
  2. Highest risk transmission to unmasked healthcare worker
    1. BiPap or CPAP administration
    2. Nebulizer administration
    3. Intubation
    4. Bronchoscopy

XI. Prognosis: Predictors of worse prognosis

  1. Advanced age
  2. Lactate Dehydrogenase (LDH) increased
  3. Neutrophilia

XII. References

  1. Lee (2003) N Engl J Med 348:1986-94 [PubMed]
  2. Varia (2003) CMAJ 169(4):285-92 [PubMed]

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Related Studies

Ontology: SARS coronavirus (C1175743)

Definition (NCI_CDISC) Any viral organism that can be assigned to the species SARS coronavirus.
Definition (NCI) A species of enveloped, spherical or pleomorphic, kidney-shaped or rod-shaped viruses in the Coronaviridae family and Coronavirus genus. The genome is composed of linear, single-stranded, positive-sense RNA. SARS coronaviruses are found in humans and cause severe acute respiratory syndrome (SARS). SARS coronaviruses are transmitted via direct person-to-person contact with infected secretions or excretions, and aerosols of respiratory droplets.
Definition (CSP) species of coronavirus causing atypical respiratory disease (Severe Acute Respiratory Syndrome) in humans; organism is believed to have first emerged in Guangdong Province, China, in 2002.
Definition (MSH) A species of CORONAVIRUS causing atypical respiratory disease (SEVERE ACUTE RESPIRATORY SYNDROME) in humans. The organism is believed to have first emerged in Guangdong Province, China, in 2002. The natural host is the Chinese horseshoe bat, RHINOLOPHUS sinicus.
Concepts Virus (T005)
MSH D045473
SnomedCT 415360003
LNC LP71047-2, LP35807-4, MTHU044721
English SARS coronavirus (organism), Severe acute respiratory syndrome (SARS) coronavirus, Severe acute respiratory syndrome (SARS) coronavirus (organism), SARS virus, SARS ASSOC CORONAVIRUS, SARS RELAT CORONAVIRUS, URBANI SARS ASSOC CORONAVIRUS, sars-cov, virus SARS, coronavirus SARS, Severe acute respiratory syndrome-related coronavirus (organism), Severe acute respiratory syndrome coronavirus (organism), Severe acute respiratory syndrome-related coronavirus, SARS CORONAVIRUS, Severe Acute Respiratory Syndrome Coronavirus, HCoV-SARS, Severe Acute Respiratory Syndrome Virus, Coronavirus, SARS, Coronavirus, Urbani SARS-Associated, SARS Associated Coronavirus, SARS Related Coronavirus, SARS Virus, SARS-Associated Coronavirus, Urbani, SARS-Associated Coronavirus, SARS-Related Coronavirus, Urbani SARS Associated Coronavirus, Urbani SARS-Associated Coronavirus, Coronavirus, SARS-Related, SARS Coronavirus, SARS-CoV, Coronavirus, SARS-Associated, SARS, Severe acute respiratory syndrome coronavirus, SARS coronavirus
Swedish SARS virus
Czech SARS-CoV, virus SARS
Spanish Virus del SRAS, Virus del Síndrome Respiratorio Agudo Grave, Virus SARS, Virus del SRAG, Virus de la Neumonía Asiática, Virus SRAG, coronavirus del SARS, coronavirus del SRAG, coronavirus del síndrome respiratorio agudo grave (organismo), coronavirus del síndrome respiratorio agudo grave, Coronavirus Asociado a SARS, SARS-CoV, Virus del Síndrome Respiratorio Agudo Severo
Finnish SARS-virus
Russian DYKHATEL'NYKH RASSTROISTV SINDROMA OSTROGO VIRUS, TIAZHELOGO OSTROGO RESPIRATORNOGO SINDROMA VIRUS, TORS-KV, KORONAVIRUS TORS, ТОРС-ВИРУС, ТОРС-КВ, SARS VIRUS, SARS-ASSOTSIIROVANNYI KORONAVIRUS, TORS-VIRUS, КОРОНАВИРУС ТОРС, ТЯЖЕЛОГО ОСТРОГО РЕСПИРАТОРНОГО СИНДРОМА ВИРУС, SARS ВИРУС, SARS-АССОЦИИРОВАННЫЙ КОРОНАВИРУС, ДЫХАТЕЛЬНЫХ РАССТРОЙСТВ СИНДРОМА ОСТРОГО ВИРУС
Japanese SARSウイルス, コロナウイルス-SARS, 重症急性呼吸器症候群ウイルス
Italian Sindrome acuta respiratoria grave, Coronavirus della SARS, Urbani SARS coronavirus, SARS-CoV, Coronavirus associato alla SARS, Sindrome acuta respiratoria severa, Virus della SARS
Croatian SARS VIRUS, VIRUS SARS-a
French Virus du syndrome respiratoire aigu grave, SARS-CoV, Coronavirus Urbani associé au SRAS, Coronavirus associé au SRAS, SARS virus, Coronavirus lié au SRAS, CoV-SRAS, SARS coronavirus, Coronavirus du SRAS, Virus du SRAS, Virus du syndrome respiratoire aigu sévère
Polish Wirus SARS
Portuguese CoV-SRAG, SRAG-CoV, Vírus da Síndrome Respiratória Aguda Severa, Vírus SARS, CoV-SARS, Vírus da Pneumonia Asiática, Coronavirus Associado a SARS, SARS-CoV, Vírus da SARS, Vírus da Síndrome Respiratória Aguda Grave
German SARS-Virus
Dutch SARS-CoV, SARS-geassocieerd coronavirus, SARS-virus, 'Severe Acute Respiratory Syndrome'-virus, Virus, SARS-
Derived from the NIH UMLS (Unified Medical Language System)

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