[The clinical characteristics and outcome of 45 early stage patients with SARS]

To investigate the clinical characteristics and therapeutic effect in the early stage of patients with Severe Acute Respiratory Syndrome (SARS).

A total of 45 clinical diagnosed SARS patients were enrolled in the study.

43 (95.6%) of all 45 patients had exposure to SARS patients and the average incubation time was (7.3 +/- 4.7) days (range 2 to 20 days). The clinical features including fatigue (60%), dry cough (68.9%), dyspnea (53.3%), joint pain (26.7%) and diarrhea (26.7%). The laboratory test show that 33% patients with leukopenia and thrombocytopenia, 53.3% with elevated serum aminotransferase and 26.6% with increased creatinine kinase levels. The occurrence of abnormal chest radiographs was (4.2 +/- 2.9) days from the onset, and CT scanning was better than X-ray in the early diagnosis. The average time for the progression and improvement of the chest radiographs were (9.3 +/- 4.1) and (14.5 +/- 5.0) days, respectively. The administration of corticosteroids was started (4.8 +/- 3.5) days from the onset and the maximal dosage using of steroids was (8.4 +/- 3.9) days. There was a significant difference in the dosage of steroid between severe and mild patients [(610.6 +/- 212.4) mg/day vs (268.1 +/- 202.5) mg/day, P < 0.001)]. The IgG antibody was detected in 22 out of 34 (64.7%) patients and the average time for the occurrence of antibody was (18.2 +/- 6.4) days (range 9-27 days).

Exposure to the SARS patients happened in most patients. The most common clinical features were fever and fatigue. The most common laboratory abnormalities were leukopenia and thrombocytopenia. Serum antibody was not detected until on the 9th day of the course of illness; CT is a more sensitive method for detection of the abnormal chest radiographs than regular X-ray test. The early usage of cortiscosteroids was an efficient method for the treatment, and the dosage of steroids should be individualized.