May 8, 2003
非典型肺炎 (Atypical Pneumonia)
嚴重急性呼吸系統綜合症 (SARS: Severe Acute Respiratory
acute respiratory syndrome ---response
to this article
of Virology: search
JVI for coronavirus
- A Major Outbreak of Severe Acute Respiratory Syndrome
in Hong Kong (source)
(April 7, 2003)
- SARS Summary
on major findings in relation to coronavirus by members of the WHO multi-centre
collaborative network on SARS aetiology and diagnosis 4/4/2003
- A Cluster of Cases of Severe Acute Respiratory Syndrome
in Hong Kong. (source)
- Summary on major findings in relation to coronavirus
by members of the WHO multi-centre collaborative network on SARS aetiology
and diagnosis 4 April 2003 (source)
detection of chlamydia-like and coronavirus-like agents in 7 fatal cases
- Survival characteristics of airborne human coronavirus
and coronavirus infection-associated hospitalizations among older adults
to the Nucleolus Is a Common Feature of Coronavirus Nucleoproteins, and the
Protein May Disrupt Host Cell Division 10/2001 (pdf)
- Coronavirus-related nosocomial viral respiratory infections in a neonatal
and paediatric intensive care unit: a prospective study. (source)
Coronavirus 229E Infects Polarized Airway Epithelia from the Apical Surface
- Multiple Sclerosis
& CoronaVirus (list of article)
- Molecular Mimicry:
CoronaVirus Infections: Importance And Diagnosis (Abstract)
- CoronaVirus Infection
& DeMyelination Development Of Lesions In Lewis Rats (Abstract)
- Sudden acute respiratory
to this article
purification, and characterization of the human coronavirus 229E 3C-like proteinase
aminopeptidase N serves as a receptor for feline, canine, porcine, and human
coronaviruses in serogroup I (pdf)
A Major Outbreak of Severe Acute Respiratory Syndrome
in Hong Kong (source)
(April 7, 2003) (Full
Text in PDF)
- Published at www.nejm.org April 7, 2003 (10.1056/NEJMoa030685)
- Nelson Lee, M.D., David Hui, M.D., Alan Wu, M.D., Paul Chan, M.D., Peter
Cameron, M.D., Gavin M. Joynt, M.D., Anil Ahuja, M.D., Man Yee Yung, B.Sc.,
C.B. Leung, M.D., K.F. To, M.D., S.F. Lui, M.D., C.C. Szeto, M.D., Sydney
Chung, M.D., and Joseph J.Y. Sung, M.D.
Background: There has been an outbreak of the severe acute respiratory syndrome
(SARS) worldwide. We report the clinical, laboratory, and radiologic features
of 138 cases of suspected SARS during a hospital outbreak in Hong Kong.
Methods: From March 11 to 25, 2003, all patients with suspected SARS after
exposure to an index patient or ward were admitted to the isolation wards of
the Prince of Wales Hospital. Their demographic, clinical, laboratory, and radiologic
characteristics were analyzed. Clinical end points included the need for intensive
care and death. Univariate and multivariate analyses were performed.
Results: There were 66 male patients and 72 female patients in this cohort,
69 of whom were health care workers. The most common symptoms included fever
(in 100 percent of the patients); chills, rigors, or both (73.2 percent); and
myalgia (60.9 percent). Cough and headache were also reported in more than 50
percent of the patients. Other common findings were lymphopenia (in 69.6 percent),
thrombocytopenia (44.8 percent), and elevated lactase dehydrogenase and creatine
kinase levels (71.0 percent and 32.1 percent, respectively). Peripheral air-space
consolidation was commonly observed on thoracic computed tomographic scanning.
A total of 32 patients (23.2 percent) were admitted to the intensive care unit;
5 patients died, all of whom had coexisting conditions.
In a multivariate analysis, the independent predictors of an adverse outcome
- advanced age (odds ratio per decade
of life, 1.80; 95 percent confidence interval, 1.16 to 2.81; P=0.009),
- a high peak lactate dehydrogenase level
(odds ratio per 100 U per liter, 2.09; 95 percent confidence interval, 1.28
to 3.42; P=0.003),
- and a high absolute neutrophil count on presentation
(odds ratio, 1.60; 95 percent confidence interval, 1.03 to 2.50; P=0.04).
Conclusions: SARS is a serious respiratory illness that led to significant
morbidity and mortality in our cohort.
A Cluster of Cases of Severe Acute Respiratory Syndrome
in Hong Kong. (source)
1/4/2003 (April 1, 2003) (Full
Text in PDF)
- N Engl J Med 2003 Apr 1; [epub ahead of print] Related Articles, Links
- Tsang KW, Ho PL, Ooi GC, Yee WK, Wang T, Chan-Yeung M, Lam WK, Seto WH,
Yam LY, Cheung TM, Wong PC, Lam B, Ip MS, Chan J, Yuen KY, Lai KN.
Background: Information on the clinical features of severe acute respiratory
syndrome (SARS) will be of value to physicians caring for patients suspected
of having this disorder.
Methods: We abstracted the clinical presentation and course of disease
in 10 epidemiologically linked Chinese patients (5 men and 5 women 38 to 72
years old) in whom SARS was diagnosed between February 22, 2003, and March 22,
2003, at our hospitals in Hong Kong, China.
- Exposure between the source patient and subsequent patients ranged from
minimal to that between patient and health care provider.
- The incubation period ranged from 2 to 11 days.
- All patients presented with fever (temperature, >38 degrees C for over
24 hours), and most presented with rigor, dry cough, dyspnea, malaise, headache,
- Physical examination of the chest revealed crackles and percussion dullness.
- Lymphopenia was observed in nine patients, and most patients had mildly
elevated aminotransferase levels but normal serum creatinine levels.
- Serial chest radiographs showed progressive air-space disease.
- Two patients died of progressive respiratory failure; histologic analysis
of their lungs showed diffuse alveolar damage.
- There was no evidence of infection by Mycoplasma pneumoniae, Chlamydia pneumoniae,
or Legionella pneumophila.
- All patients received corticosteroid and ribavirin therapy a mean (+/-SD)
of 9.6+/-5.42 days after the onset of symptoms, and eight were treated earlier
with a combination of beta-lactams and macrolide for 4+/-1.9 days, with no
clinical or radiological efficacy.
Conclusions: SARS appears to be infectious in origin. Fever followed
by rapidly progressive respiratory compromise is the key complex of signs and
symptoms from which the syndrome derives its name. The microbiologic origins
of SARS remain unclear.
Summary on major findings in relation to coronavirus
by members of the WHO multi-centre collaborative network on SARS aetiology and
diagnosis 4 April 2003 (source)
Since its inception on 17 March network members obtained the following results:
- A new coronavirus which is unlike any other known members of the genus Coronavirus
has been isolated consistently by several network laboratories from SARS patients
from several countries.
- This virus causes a cytopathogenic effect (CPE) in VERO cells and FRhk-4
cells, which can be inhibited with serum from SARS convalescent patients.
- Electron microscopic pictures from cell-culture and respiratory specimens
from SARS patients show coronavirus-like particles.
- Immunofluorescence assays (IFA) with serum from convalescent patients detect
cells infected with the virus in cell-culture.
- Reactivity with a new coronavirus could not be detected in serum from several
hundreds of non-SARS individuals in the U.S.A., Canada and Hong Kong.
- Generic coronavirus primers detect a new coronavirus RNA in cell-culture
and in specimens from SARS patients. Specific primers have been developed
in several laboratories and are currently been compared for sensitivity (
primers for SARS developed by WHO Network Laboratories ).
- Hyperimmune sera against Transmissible Gastroenteritis Virus (TGEV), Feline
Infectious Peritonitis virus (FIPV), Murine Hepatitis Virus (MHV) and 229E
human coronavirus inhibit growth of a new coronavirus in cell-culture.
- Partial sequencing of a new coronavirus in several laboratories confirms
affiliation of a new coronavirus to the genus Coronavirus as well as dissimilarities
with known members belonging to each of the three existing groups of this
- Animal inoculation experiments are ongoing.
- It is currently agreed that this coronavirus
is the major causative agent of SARS.
- Human metapneumovirus
(hMPV) has also been found in respiratory specimens and antibodies
against hMPV in serum of some SARS patients,
- as well as evidence of dual infection
with hMPV and the new coronavirus.
- The significance of hMPV in SARS remains unclear at this time and will be
reported on later.
Survival characteristics of airborne human coronavirus
229E. (Please note that the SARS virus is a new strand.) (source)
- J Gen Virol 1985 Dec;66 ( Pt 12):2743-8 Related Articles, Links
- Ijaz MK, Brunner AH, Sattar SA, Nair RC, Johnson-Lussenburg CM.
The survival of airborne human coronavirus 229E (HCV/229E) was studied under
different conditions of temperature (20 +/- 1 degree C and 6 +/- 1 degree C)
and low (30 +/- 5%), medium (50 +/- 5%) or high (80 +/- 5%) relative humidities
Temperature / RH
low (30 +/- 5%)
medium (50 +/- 5%)
high (80 +/- 5%)
20 +/- 1 degree C
26.76 +/- 6.21 h
67.33 +/- 8.24 h
6 +/- 1 degree C
86.01 +/- 5.28 h
At 20 +/- 1 degree C, aerosolized HCV/229E was found
to survive best
- at 50% RH with a half-life of 67.33 +/- 8.24 h while
- at 30% RH the virus half-life was 26.76 +/- 6.21 h.
- At 50% RH nearly 20% infectious virus was still detectable
at 6 days.
High RH at 20 +/- 1 degree C, on the other hand,
- was found to be the least favourable to the survival
of aerosolized virus and under these conditions the
virus half-life was only about 3 h;
- no virus could be detected after 24 h in aerosol.
At 6 +/- 1 degree C, in either 50% or 30% RH conditions,
- the survival of HCV/229E was significantly enhanced,
- with the decay pattern essentially similar to that seen at 20 +/- 1 degree
At low temperature and high RH (80%), however, the
survival pattern was completely reversed,
- with the HCV/229E half-life increasing to 86.01 +/- 5.28 h, nearly 30 times
that found at 20 +/- 1 degree C and high RH.
Although optimal survival at 6 degree C still occurred at 50% RH, the pronounced
stabilizing effect of low temperature on the survival of HCV/229E at high RH
indicates that the role of the environment on the survival
of viruses in air may be more complex and significant than previously thought.
PMID: 2999318 [PubMed - indexed for MEDLINE]