Pulmonology Book

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Severe Acute Respiratory Syndrome

Aka: Severe Acute Respiratory Syndrome, SARS
  1. Epidemiology
    1. Asia has been epicenter of SARS outbreaks
  2. Pathophysiology
    1. Coronavirus spread by respiratory droplet transmission
  3. Symptoms
    1. Fever (temperature over 100.4 F or 38 C)
    2. Chills
    3. Myalgias
    4. Non-productive Cough
    5. Headache
    6. Dizziness
  4. 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
  5. 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
  6. 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
  7. 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
  8. Prevention
    1. Respiratory protection
      1. N95 or equivalent mask
    2. SARS vaccine
      1. WHO trials of vaccine due to start winter of 2004
  9. 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
  10. Prognosis: Predictors of worse prognosis
    1. Advanced age
    2. Lactate Dehydrogenase (LDH) increased
    3. Neutrophilia
  11. References
    1. Lee (2003) N Engl J Med 348:1986-94
    2. Varia (2003) CMAJ 169(4):285-92

SARS coronavirus (C1175743)

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
English SARS coronavirus (organism), Severe acute respiratory syndrome (SARS) coronavirus, Severe acute respiratory syndrome (SARS) coronavirus (organism), SARS virus, Severe acute respiratory syndrome coronavirus (organism), SARS ASSOC CORONAVIRUS, SARS RELAT CORONAVIRUS, URBANI SARS ASSOC CORONAVIRUS, sars-cov, virus SARS, coronavirus 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 SRAG, 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 de la Neumonía Asiática, Virus del Síndrome Respiratorio Agudo Grave, Virus del Síndrome Respiratorio Agudo Severo, Virus SARS, Virus de la Neumonia Asiatica, Virus del Sindrome Respiratorio Agudo Grave, Virus del Sindrome 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, Coronavirus du SRAS, SRAS-CoV, Virus du SRAS, Virus du syndrome respiratoire aigu sévère
Polish Wirus SARS
German SARS-Virus
Dutch SARS-CoV, SARS-geassocieerd coronavirus, SARS-virus, 'Severe Acute Respiratory Syndrome'-virus, Virus, SARS-
Portuguese Coronavirus Associado a SARS, CoV-SARS, CoV-SRAG, SARS-CoV, SRAG-CoV, Vírus da Pneumonia Asiática, Vírus da SARS, Vírus da Síndrome Respiratória Aguda Grave, Vírus da Síndrome Respiratória Aguda Severa, Vírus SARS
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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