Clinical course and management of SARS

May 28, 2003

An article on the clinical course and management of SARS is being released online today by the Canadian Medical Association Journal. This early release takes place approximately a month before the paper's appearance in the print version of CMAJ.

The article, by Drs. Monica Avendano and Peter Derkach and nurse practitioner Susan Swan, is the first to detail the course the disease took in 14 front-line health care workers, all of whom were treated in the SARS unit of the West Park Healthcare Centre in Toronto. It is of clinical interest to physicians because it is the first study to present individual (not aggregate) patient data, and it emphasizes treatment regimens and information on the patients' clinical status 1 and 3 weeks after being discharged from the centre's SARS unit. It also provides a wealth of clinical information, including x-rays showing the disease's impact on patients' lungs. One of the key findings is that severe hemolytic anemia may either be a feature of SARS or a complication of treatment, possibly associated with the use of ribavirin.

The article also points out that:

1. It is difficult to decide on the appropriate time to discharge SARS patients.
2. SARS appears to have lingering after effects once the acute phase of the disease ends.
3. Psychosocial aspects of this illness "should not be underestimated." Because of that last point, the online version of the article will contain verbatim summaries of the disease's impact on some of the 14 health workers who participated in this study.

Canadian Medical Association Journal

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