Coronavirus as a possible cause of severe acute respiratory syndrome.
Coronavirus as a possible cause of severe acute respiratory syndrome.
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DOI：
10.1016/s0140-6736(03)13077-2
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发表时间：
2003-04-19
期刊：
影响因子：
--
通讯作者：
SARS study group
中科院分区：
文献类型：
--
作者：
Peiris JS;Lai ST;Poon LL;Guan Y;Yam LY;Lim W;Nicholls J;Yee WK;Yan WW;Cheung MT;Cheng VC;Chan KH;Tsang DN;Yung RW;Ng TK;Yuen KY;SARS study group
在香港已经报道了严重的急性呼吸综合症（SARS）的爆发。我们研究了50名患者的病毒原因和临床表现。
我们分析了50例SARS患者的病例注释和微生物学发现，代表了5个以上单独的流行病学连接的传输簇。我们定义了与严重疾病相关的临床表现和危险因素，并通过胸部射线照相和鼻咽抽吸物和血清样品的实验室测试研究了因果因素。我们将实验室发现与提交的研究结果进行了比较，从而对掩盖身份的患者的其他疾病进行了微生物学研究。
患者的年龄为23至74岁。发烧，发冷，肌痛和咳嗽是最常见的抱怨。与胸部射线照相变化相比，呼吸道症状和听诊的发现非常轻度。是其他受感染者的家庭接触的患者，年龄较大，淋巴细胞减少和肝功能障碍与严重疾病有关。从两名患者中分离出属于冠状病科的病毒。通过使用针对该病毒的血清学和逆转录酶PCR，在50例SARS患者中有45例（但没有对照）有这种病毒感染的证据。
从可能是与该疾病相关的主要药物的患者中分离出冠状病毒。针对该病毒的血清学和分子测试允许进行确定的实验室诊断，并允许进一步研究以定义其他辅助因子是否在疾病进展中起作用。
An outbreak of severe acute respiratory syndrome (SARS) has been reported in Hong Kong. We investigated the viral cause and clinical presentation among 50 patients. We analysed case notes and microbiological findings for 50 patients with SARS, representing more than five separate epidemiologically linked transmission clusters. We defined the clinical presentation and risk factors associated with severe disease and investigated the causal agents by chest radiography and laboratory testing of nasopharyngeal aspirates and sera samples. We compared the laboratory findings with those submitted for microbiological investigation of other diseases from patients whose identity was masked. Patients' age ranged from 23 to 74 years. Fever, chills, myalgia, and cough were the most frequent complaints. When compared with chest radiographic changes, respiratory symptoms and auscultatory findings were disproportionally mild. Patients who were household contacts of other infected people and had older age, lymphopenia, and liver dysfunction were associated with severe disease. A virus belonging to the family Coronaviridae was isolated from two patients. By use of serological and reverse-transcriptase PCR specific for this virus, 45 of 50 patients with SARS, but no controls, had evidence of infection with this virus. A coronavirus was isolated from patients with SARS that might be the primary agent associated with this disease. Serological and molecular tests specific for the virus permitted a definitive laboratory diagnosis to be made and allowed further investigation to define whether other cofactors play a part in disease progression.
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作者：
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