PubMed Journals: BMJ
Source: PMID: 12816821
⇦ ⇨ BMJ. 2003 Jun 21;326(7403):1358-62.
Haematological manifestations in patients
with severe acute respiratory syndrome:
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.
(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]