| Objective To describe epidemiological and clinical characteristics of patients with a diagnosed of probable severe acute respiratory syndrome(SARS); to identify the variables associated with SARS-CoV infection and poor outcome; to provide scientific basis for clinical treatments and prevention and contol measures against SARS.Methods Epidemiological and clinical data of the SARS patients were collected by means of consulting case history combining the field investigation and interview. Distribution of the studied population in place, time and persons were analyzed, as well as clinical features. ELISA for anti-SARS-CoV IgG antibody was performed in 122 convalescent-phase serum samples and some healthy population ones. Clinical end points included the need for intensive care unit, death, and other complications. We compared factors associated with SARS-CoV infection and poor outcome by Pearson x1 test for categorical variables and Student's t test for continuous ones. Significant variables identified on univariate analyses were further analyzed by bionary Logistic regression and multiple Cox regressions to identify independent risk factors associated with SARS-CoV infection and poor outcome repictively. We took p<0.05 to be significant and used SPSS (version 10.0) for all analyses.Result There were a total of 168 SARS patients. 127 cases were found in every urban districts of Guangzhou, and the rest was from non-Guangzhou. Number of cases increased in February 2003 and reached its peak with 74 patients. Most of cases were between 20 and 50 with 92 males versus 76 females. As of occupation distribution, the number of businessmen, employees, health care workers, unemplyees and retiree was more than 20 respectively. 56 belonged to cluster cases and 66 had history of contact SARS patients. 144(85.71%)had fever at onset with 17 cough. Clinial features most commonly found during the course of illness were self-reported fever(168), cough(129) in which 111 had nonproductive cough, fatigue(89), headache(75), chill(74), shortenss of breath(64), and inappetence(60). 114 had documented 39.0 C temperature at least with a average 39.2 C one. Common laboratory features included intial normal white bloodcount(65.87%) and below it(16.17%), intial normal lymphocytes (71.17%), normal lymphocytes percent (55.83%) and lung involvement on admission by chest X-ray(97.59%). The positive rate of SARS-CoV IgG antibody of probable SARS was higer than that of close contacts, children and undergraduate in a medical university(P<0.001).Of the total 122, 77 serum samples were positive by ELISA for anti-SARS-CoV IgG antibody, with 45 negative. There were statistical significance in sex, history of contact with SARS patient, expose to hospital 2 weeks before onset, interval between admission and discharge, 7-day-duration fever, chronic hepatitis B infection and presence of any coexisting disease(P<0.05)between patients who had SARS-CoV infection and those did not. there were no significance in other demographic, epidemiologic, cilical ,and coexisting conditions characters between two groups(P>0.05). By binary Logistic regression, contact history was independently associated with SARS-CoV infection(P<0.001).26 (15.48%, 26/168) patients developed poor outcome with 11 death, at a mean of 16.73 days after onset of symptoms. On univariate analysis, the risk factors associated with adverse outcome were age, the highest temperature, duration of fever, initial white blood cell count, initial lymphocyte, initial lymphocytes percent, presence of diabetes mellirus, and coexisting more 2 chronic diseases (P<0.05). The 6-month poor events incidence was 16.67%. By Cox regression, duration of fever, the highest temperature and presence of diabetes mellitus at prsentation were independent predictors for develop into poor outcome (P<0.05). Age older than 60 years, presence of diabetes mellitus, and coexisting more than 2 chronic disease were associated with death (P<0.05).Conclusion The epidemiological and clinical features in the st...
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