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Review article

SARS: clinical presentation, transmission, pathogenesis and treatment options

Paul K. S. Chan, Julian W. Tang, David S. C. Hui
Clinical Science Jan 17, 2006, 110 (2) 193-204; DOI: 10.1042/CS20050188
Paul K. S. Chan
Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of ChinaCentre for Emerging Infectious Diseases, School of Public Health, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
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  • For correspondence: paulkschan@cuhk.edu.hk
Julian W. Tang
Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
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David S. C. Hui
Centre for Emerging Infectious Diseases, School of Public Health, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of ChinaDepartment of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
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Abstract

SARS (severe acute respiratory syndrome) appeared as the first emerging infectious disease of this century. It is fortunate that the culprit virus can be grown without much difficulty from a commonly used cell line, allowing an unlimited supply of isolates for further molecular studies and leading to the development of sensitive diagnostic assays. How the virus has successfully jumped the species barrier is still a mystery. The superspreading events that occurred within hospital, hotel and high-density housing estate opens a new chapter in the mechanisms and routes of virus transmission. The old practice of quarantine proved to be still useful in controlling the global outbreak. Despite all the available sophisticated tests, alertness with early recognition by healthcare workers and prompt isolation of suspected cases is still the most important step for containing the spread of the infection. Although the rapidly evolving outbreak did not allow the conducting of systematic clinical trails to evaluate treatment options, the accumulated experience on managing SARS patients will improve the clinical outcome should SARS return. Although SARS led to more than 700 deaths worldwide, the lessons learnt have prepared healthcare systems worldwide to face future emerging and re-emerging infections.

  • coronavirus
  • inflammation
  • respiratory infection
  • severe acute respiratory syndrome (SARS)
  • viral transmission

Abbreviations: ACE-II, angiotensin-converting enzyme 2; ALT, alanine aminotransferase; ARDS, acute respiratory distress syndrome; FIPV, feline infectious peritonitis virus; huMab, human monoclonal antibody; IFN, interferon; IL, interleukin; IP-10, IFN-γ-inducible protein-10; IVIg, intravenous γ-globulin; LDH, lactate dehydrogenase; LPV/r, 400 mg of lopinavir/100 mg of ritonavir; MCP-1, monocyte chemoattractant protein-1; MHV, mouse hepatitis virus; NO, nitric oxide; NPPV, non-invasive positive pressure ventilation; R0, reproductive number; S protein, spike glycoprotein; SARS, severe acute respiratory syndrome; SARS-CoV, SARS-associated coronavirus; TGEV, transmissible gastroenteritis virus; TNF-α, tumour necrosis factor-α; WHO, World Health Organization

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February 2006

Volume: 110 Issue: 2

Clinical Science: 110 (2)
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SARS: clinical presentation, transmission, pathogenesis and treatment options
Paul K. S. Chan, Julian W. Tang, David S. C. Hui
Clinical Science Feb 2006, 110 (2) 193-204; DOI: 10.1042/CS20050188
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SARS: clinical presentation, transmission, pathogenesis and treatment options
Paul K. S. Chan, Julian W. Tang, David S. C. Hui
Clinical Science Feb 2006, 110 (2) 193-204; DOI: 10.1042/CS20050188

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  • Article
    • Abstract
    • INTRODUCTION
    • THE VIRUS
    • CLINICAL FEATURES
    • TRANSMISSION
    • PATHOGENESIS
    • TREATMENT
    • OUTCOMES
    • SUMMARY AND CONCLUSIONS
    • Acknowledgments
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Keywords

coronavirus
inflammation
respiratory infection
severe acute respiratory syndrome (SARS)
viral transmission

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