[Clinical features of 77 patients with severe acute respiratory syndrome]

To analyze the clinical features of the severe acute respiratory syndrome (SARS) and the value for caring of patients suspected of having this disease.

The data of the clinical presentations and course of disease in 77 epidemiologically linked patients (27 men and 50 women, 15 to 74 years old) in whom SARS was diagnosed after April 16, 2003 in Tianjin, China were summarized.

Exposure to ailing patients and occurrence of the disease ranged from minimal to close contact, such as between patient and health care personnel. The incubation period ranged from 1 to 11 days. All patients presented fever, and some of them complained of rigor, dry cough, dyspnea, malaise, headache, and hypoxemia. Physical examination of the chest revealed bubbling rales and dullness on percussion. Lymphopenia was observed in 80% of all patients, and some patients had mildly elevated aminotransferase levels but normal serum creatinine levels. Serial chest radiographs showed progressive inflammatory changes. One patient died of progressive respiratory failure; pathological examination of the lung showed diffuse alveolar damage. One patient died of suicide. There was no evidence of infection by Mycoplasma pneumoniae, Chlamydia pneumoniae, or Legionella pneumophila. All patients received corticosteroid and ribavirin therapy for a mean of (18.6+/-5.4) days after the onset of symptoms, and were treated with a combination of beta-lactams and macrolide early for (4.0+/-1.9)days, but with no clinical or radiologic evidences of improvement.

The combination treatment, especially including corticosteroid and ribavirn, is efficient.