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Times Cited - 08/22/2010 03:17:40 pm 0800 - iso-8859-1 - OpenWebMail

  1. 1. Last data updates: 12 November 2010 Peiris, J.S.M., Lai, S.T., Poon, L.L.M., Guan, Y., Yam, L.Y.C., Lim, W., Nicholls, J., Yee, W.K.S., Yan, W.W., Cheung, M.T., Cheng, V.C.C., Chan, K.H., Tsang, D.N.C., Yung, R.W.H., Ng, T.K. and Yuen, K.Y. (2003), Coronavirus as a possible cause of severe acute respiratory syndrome. Lancet, 361 (9366), 1319-1325. Document type: Article Language: English Cited references:15 Times cited: 1055 Times self cited: 149 Abstract: Background An outbreak of severe acute respiratory syndrome (SARS) has been reported in Hong Kong. We investigated the viral cause and clinical presentation among 50 patients. Methods We analysed case notes and microbiological findings for 50 patients with SARS, representing more than five separate epidemiologically linked transmission clusters. We defined the clinical presentation and risk factors associated with severe disease and investigated the causal agents by chest radiography and laboratory testing of nasopharyngeal aspirates and sera samples. We compared the laboratory findings with those submitted for microbiological investigation of other diseases from patients whose identity was masked. Findings Patients, age ranged from 23 to 74 years. Fever, chills, myalgia, and cough were the most frequent complaints. When compared with chest radiographic changes, respiratory symptoms and auscultatory findings were disproportionally mild. Patients who were household contacts of other infected people and had older age, lymphopenia, and liver dysfunction were associated with severe disease. A virus belonging to the family Coronaviridae was isolated from two patients. By use of serological and reverse-transcriptase PCR specific for this virus, 45 of 50 patients with SARS, but no controls, had evidence of infection with this virus. Interpretation A coronavirus was isolated from patients with SARS that might be the primary agent associated with this disease. Serological and molecular tests specific for the virus permitted a definitive laboratory diagnosis to be made and allowed further investigation to define whether other cofactors play a part in disease progression. KeyWords Plus: Human-Disease; Virus; Infections; Diagnosis Reprint Address: Peiris, JSM (reprint author), Univ Hong Kong, Queen Mary Hosp, Dept Microbiol, Pokfulam Rd, Hong Kong, Hong Kong Peoples R China Addresses: 1. Univ Hong Kong, Queen Mary Hosp, Dept Pathol & Microbiol, Hong Kong, Hong Kong Peoples R China 2. Princess Margaret Hosp, Dept Med Intens Care & Pathol, Hong Kong, Hong Kong Peoples R China 3. Dept Hlth, Govt Virus Unit, Hong Kong, Hong Kong Peoples R China 4. Pamela Youde Nethersole Eastern Hosp, Dept Pathol & Med, Hong Kong, Hong Kong Peoples R China 5. Kwong Wah Hosp, Dept Med, Hong Kong, Hong Kong Peoples R China 6. Queen Elizabeth Hosp, Dept Pathol, Kowloon, Hong Kong Peoples R China 1. Anderson, L.J. and Tong, S.X. (2010), Update on SARS research and other possibly zoonotic coronaviruses. International Journal of Antimicrobial Agents, 36, S21-S25. 2. Zhao, K., Yang, B.Y., Xu, Y.Q. and Wu, C.Y. (2010), CD8(+) T cell response in HLA-A*0201 transgenic mice is elicited by epitopes from SARS-CoV S protein. Vaccine, 28 (41), 6666-6674. 3. Kostoff, R.N. (2010), The highly cited SARS research literature. Critical Reviews in Microbiology, 36 (4), 299-317. 4. Renukaradhya, G.J., Alekseev, K., Jung, K., Fang, Y. and Saif, L.J. (2010), Porcine reproductive and respiratory syndrome virus-induced immunosuppression exacerbates the inflammatory response to porcine respiratory coronavirus in pigs. Viral Immunology, 23 (5), 457-466. 5. Chuck, C.P., Chong, L.T., Chen, C., Chow, H.F., Wan, D.C.C. and Wong, K.B. (2010), Profiling of substrate specificity of SARS-CoV 3CL(pro). Plos One, 5 (10.
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