Sequential symptomatic analysis in probable severe acute respiratory syndrome cases.

Area of Science:

• Infectious Diseases
• Epidemiology
• Clinical Medicine

Background:

• Previous reports on severe acute respiratory syndrome (SARS) primarily focused on symptoms, with limited discussion on their temporal sequence.
• Understanding the time course of symptom development is crucial for early diagnosis and effective management of infectious diseases.

Purpose of the Study:

• To chronologically document the sequence of symptom development in probable SARS cases.
• To compare the symptom timeline of SARS with febrile non-SARS cases for improved early recognition.

Main Methods:

• A prospective, descriptive cohort study involving patients with fever and exposure history in an academic university hospital.
• Detailed recording of individual symptom timelines, chest radiography, and laboratory tests for probable SARS and non-SARS cases.
• Exclusion of pediatric cases and SARS patients with negative PCR results from final analysis.

Main Results:

• Seventy-nine SARS and 220 non-SARS cases were analyzed. Common initial SARS symptoms included myalgia, diarrhea, cough, headache, and chills.
• Upper airway symptoms were rare in SARS but common in non-SARS cases.
• A characteristic SARS symptom sequence (fever, diarrhea, myalgia, then respiratory symptoms) was observed in 69.6% of SARS patients, compared to 3.2% of non-SARS patients.

Conclusions:

• Heightened awareness of SARS clinical presentation, including symptom timing, is vital during outbreaks.
• The chronological sequence of symptoms, alongside travel and contact history, can assist frontline physicians in early SARS screening.
• Identifying specific symptom patterns aids in differentiating SARS from other febrile illnesses, improving diagnostic accuracy.