PubMed Journals: BMJ

  Source:		PMID: 12816821
  Download:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC162124/pdf/3261358.pdf

    		BMJ. 2003 Jun 21;326(7403):1358-62.
			Haematological manifestations in patients
			with severe acute respiratory syndrome:
			retrospective analysis.

			Wong RS(1), Wu A, To KF, Lee N, Lam CW,
			Wong CK, Chan PK, Ng MH, Yu LM, Hui DS,
			Tam JS, Cheng G, Sung JJ.

			Author Information
			(1) Department of Medicine and Therapeutics,
			Chinese University of Hong Kong, Prince
			of Wales Hospital, Shatin, New Territories,
			Hong Kong Special Administrative Region,

			Comment in BMJ. 2003 Sep 13;327(7415):620.
			BMJ. 2003 Dec 13;327(7428):1405.

			OBJECTIVES: To evaluate the haematological
			findings of patients with
			severe acute respiratory syndrome (SARS).
			DESIGN: Analysis of the demographic, clinical, and
			laboratory characteristics of patients with SARS.
			SETTING: Prince of Wales Hospital, Hong Kong.
			Subjects All patients with a diagnosis of SARS between
			11 March and 29 March 2003 who had no pre-existing
			haematological disorders. MAIN OUTCOME MEASURES:
			Clinical end points included the need for
			intensive care and death. Univariate and
			multivariate analyses were performed to
			examine factors associated with adverse
			outcome. RESULTS: 64 male and 93 female
			patients were included in this study. The
			most common findings included lymphopenia
			in 153 (98%) of the 157 patients, neutrophilia
			in 129 (82%), thrombocytopenia in 87 patients
			(55%), followed by thrombocytosis in 77
			(49%), and isolated prolonged activated
			partial thromboplastin time in 96 patients
			(63%). The haemoglobin count dropped by
			more than 20 g/l from baseline in 95 (61%)
			patients. Four patients (2.5%) developed
			disseminated intravascular coagulation.
			Lymphopenia was shown in haemato-lymphoid
			organs at postmortem examination. Multivariate
			analysis showed that advanced age and a
			high concentration of lactate dehydrogenase
			at presentation were independent predictors
			of an adverse outcome. Subsets of peripheral
			blood lymphocytes were analysed in 31 patients.
			The counts of CD4 positive and CD8 positive
			T cells fell early in the course of illness.
			Low counts of CD4 and CD8 cells at presentation
			were associated with adverse outcomes. CONCLUSIONS:
			Abnormal haematological variables were common
			among patients with SARS. Lymphopenia and
			the depletion of T lymphocyte subsets may
			be associated with disease activity.

			DOI: 10.1136/bmj.326.7403.1358 PMCID: PMC162124
			PMID: 12816821 [Indexed for MEDLINE]

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