Severe immune response kills SARS victims

NewScientist.com news service ^ | May 3, 2003 | Robert Walgate

[Sloth]

Good news for AIDS patients, I guess. :-P

[Thud]

ping

[aristeides]

This would be consistent with what Laurie Garrett was saying about receptors.

[aristeides]

Thanks for the ping.

[Dog Gone]

If I catch this, I want them to treat me with enough steroids to turn me into Arnold Schwarzenegger.

[Iris7]

You are talking about anabolic, they are talking about corticosteriods, in particular cortisol. Different stuff.

[aristeides]

Prospective study of the clinical progression and viral load of SARS associated coronavirus pneumonia in a community outbreak

JSM Peiris, CM Chu, VCC Cheng, KS Chan, IFN Hung, LLM Poon, KI Law, BSF Tang, TYW Hon, CS Chan, KH Chan, JSC Ng, BJ Zheng, WL Ng, RWM Lai, Y Guan, KY Yuen and members of the HKU / UCH SARS Study Group

This paper has been accepted by The Lancet and will be published next week. We are grateful to The Lancet for the permission to publish the summary of this paper in advance.

Summary

Background:

A community outbreak of severe acute respiratory distress syndrome (SARS) with epidemiological linkage was reported. The temporal progression of the clinical, radiological, and virological changes was investigated.

Methods:

A prospective study of the clinical, haematological, radiological, and microbiological findings of 75 patients managed with a standardized treatment protocol of the Hospital Authority, Hong Kong Special Administrative Region using ribavirin and corticosteroid was performed over a 3 week period. The pattern of clinical disease, viral load, the risk factors for a poor clinical outcome and the usefulness of virological diagnostic methods was presented and analyzed.

Findings:

The fever and pneumonia initially responded to treatment. However, patients developed recurrent fever (85.3%) on day 8.9 ± 3.1 (range 4 to 18), watery diarrhoea (73.3%) on day 7.5 ± 2.3 (range 3 to 15), radiological deterioration (80%) on day 7.4 ± 2.2 (range 3 to 13) and respiratory deterioration (45.3%) on day 8.6 ± 3 days (range 5 to 19). In 45.3% of patients, marked improvement of initial pulmonary lesions was closely associated with appearance of new radiological lesions at other sites. Twenty percent progressed to acute respiratory distress syndrome (ARDS) during the third week. Quantitative RT-PCR of nasopharyngeal aspirates in 14 patients (4 had ARDS and 10 without ARDS) consistently demonstrated a peak viral load at day 10 and a decrease to admission level at day 15. Age and chronic HBV infection are independent significant risk factors for progression to ARDS on multivariate analysis. Faecal excretion of coronavirus was present and continued through the period of follow-up. Seroconversion and RT-PCR of nasopharyngeal aspirates and stool are useful for confirmation of SARS.

Interpretation:

The consistent clinical progression, shifting radiological infiltrates and an inverted V viral load profile suggested that deterioration during the second week is not related to uncontrolled viral replication but may rather be related to immunopathological damage. Age and HBV status are risk factors for progression to ARDS.

http://www.who.int/csr/sars/prospectivestudy/en/index.html

[CathyRyan]

Thank you, good find. :)

The topic of sars seems to be slowing. I wonder if people are getting burnt out on it?

[Betty Jo]

Lots and lots of SARS articles in todays,May 2,Wall Street Journal.

The whole SARS mess gets bigger and bigger.

No accurate testing.

No good accurate diagnostic definition.

No good tratment.

No vaccine.

Continual new cases.

Continual new deaths.

Continual loss to the worlds economies.

Clearly the biggest story in the world.

Cant wait to hear Presidential candidates on this.

[Dog Gone]

Well, darn.

[CathyRyan]

It maybe the biggest story in the world but is looks like it is starting to run out of steam on FR.

[Nov3]

I want them to treat me with enough Growth Hormone to make my immune system think I am six years old and a ton of cortisteroids (unfortunately catabolic!) and maybe some singulair for the hell of it!

[wiseone]

Severe immune response kills SARS victims?? Are you saying his own bodies immune system killed him?

I assume your an MD, can you simplify ,and summorize for us peons?

[riri]

Unfortunately, I don't think we are fortunate enough to just "burn out" on this story. We are stuck with it.

DC, maybe you can anser this..I have a nagging question. Why is this virus so durable? Are other corona viruses this durable and capable of living for such long periods of time?

Admitted tin foil time, but is the durability something that could have been "added"? Could someone have taken the durability of a, say, smallpox virus and somehow given it to a virus such as this?

[aristeides]

I'm not an M.D. (I'm a lawyer,) so I don't trust myself to summarize these articles accurately. But my understanding of them is the same as yours.

[aristeides]

The coronavirus that causes feline infectious peritonitis (FIP) can survive on surfaces for weeks.

[riri]

Yikes. I wonder how long this virus truly can survive outside a host?!

I bought the big industrial sized Purell today. When the cashier went to put it on the bag, I said "Thanks, can I have that, I am going to carry it in my purse" She looked at me like, "Okaaaay"

[blam]

"It maybe the biggest story in the world but is looks like it is starting to run out of steam on FR."

Nah. Most of us just can't think of any thing else to say, at least I can't.

[CathyRyan]

I can not either. Guess that is why I just cut and paste.