Pulmonology Book

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Severe Acute Respiratory SyndromeAka: SARS

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  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
    2. Varia (2003) CMAJ 169(4):285

SARS coronavirus (C1175743)

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.
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.
ConceptsVirus (T005)
MSHD045473
EnglishSARS, SARS ASSOC CORONAVIRUS, SARS Associated Coronavirus, SARS coronavirus, SARS RELAT CORONAVIRUS, SARS Related Coronavirus, SARS Virus, SARS-Associated Coronavirus, SARS-CoV, SARS-Related Coronavirus, Severe acute respiratory syndrome coronavirus, Severe Acute Respiratory Syndrome Virus, URBANI SARS ASSOC CORONAVIRUS, Urbani SARS Associated Coronavirus, Urbani SARS-Associated Coronavirus
Spanishcoronavirus del SARS, coronavirus del sindrome respiratorio agudo grave, coronavirus del SRAG
Parent ConceptsCoronaviridae (C0010076), Genus: Coronavirus (C0206419), Coronavirus Group 2 (C1074746), Human coronavirus (C0206422)
SourcesCSP, LNC, MSH, MTH, NCBI, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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