Skip to main content

Main menu

  • Home
  • COVID-19
    • Articles & podcasts
    • Blog posts
    • Collection
    • News
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • Classified ads
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
    • Career Ad Discount
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN

User menu

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN
CMAJ

Advanced Search

  • Home
  • COVID-19
    • Articles & podcasts
    • Blog posts
    • Collection
    • News
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • Classified ads
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
    • Career Ad Discount
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Pinterest
  • Follow CMAJ on Youtube
  • Follow CMAJ on Instagram
Research article

Initial viral load and the outcomes of SARS

Chung-Ming Chu, Leo L.M. Poon, Vincent C.C. Cheng, Kin-Sang Chan, Ivan F.N. Hung, Maureen M.L. Wong, Kwok-Hung Chan, Wah-Shing Leung, Bone S.F. Tang, Veronica L. Chan, Woon-Leung Ng, Tiong-Chee Sim, Ping-Wing Ng, Kin-Ip Law, Doris M.W. Tse, Joseph S.M. Peiris and Kwok-Yung Yuen
CMAJ November 23, 2004 171 (11) 1349-1352; DOI: https://doi.org/10.1503/cmaj.1040398
Chung-Ming Chu
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Leo L.M. Poon
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Vincent C.C. Cheng
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Kin-Sang Chan
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Ivan F.N. Hung
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Maureen M.L. Wong
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Kwok-Hung Chan
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Wah-Shing Leung
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Bone S.F. Tang
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Veronica L. Chan
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Woon-Leung Ng
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Tiong-Chee Sim
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Ping-Wing Ng
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Kin-Ip Law
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Doris M.W. Tse
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Joseph S.M. Peiris
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Kwok-Yung Yuen
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Tables
  • Responses
  • Metrics
  • PDF
Loading
  • © 2004 Canadian Medical Association or its licensors

Abstract

Background: Severe acute respiratory syndrome (SARS) is caused by a novel coronavirus. It may progress to respiratory failure, and a significant proportion of patients die. Preliminary data suggest that a high viral load of the SARS coronavirus is associated with adverse outcomes in the intensive care unit, but the relation of viral load to survival is unclear.

Methods: We prospectively studied an inception cohort of 133 patients with virologically confirmed SARS who were admitted to 2 general acute care hospitals in Hong Kong from Mar. 24 to May 4, 2003. The patients were followed until death or for a minimum of 90 days. We used Cox proportional hazard modelling to analyze potential predictors of survival recorded at the time of presentation, including viral load from nasopharyngeal specimens (measured by quantitative reverse transcriptase polymerase chain reaction [PCR] of the SARS-associated coronavirus).

Results: Thirty-two patients (24.1%) met the criteria for acute respiratory distress syndrome, and 24 patients (18.0%) died. The following baseline factors were independently associated with worse survival: older age (61–80 years) (adjusted hazard ratio [HR] 5.24, 95% confidence interval [CI] 2.03–13.53), presence of an active comorbid condition (adjusted HR 3.36, 95% CI 1.44–7.82) and higher initial viral load of SARS coronavirus, according to quantitative PCR of nasopharyngeal specimens (adjusted HR 1.21 per log10 increase in number of RNA copies per millilitre, 95% CI 1.06–1.39).

Interpretation: We found preliminary evidence that higher initial viral load is independently associated with worse prognosis in SARS. Mortality data for patients with SARS should be interpreted in light of age, comorbidity and viral load. These considerations will be important in future studies of SARS.

View Full Text
PreviousNext
Back to top

In this issue

Canadian Medical Association Journal: 171 (11)
CMAJ
Vol. 171, Issue 11
23 Nov 2004
  • Table of Contents
  • Index by author

Article tools

Respond to this article
Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Initial viral load and the outcomes of SARS
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Initial viral load and the outcomes of SARS
Chung-Ming Chu, Leo L.M. Poon, Vincent C.C. Cheng, Kin-Sang Chan, Ivan F.N. Hung, Maureen M.L. Wong, Kwok-Hung Chan, Wah-Shing Leung, Bone S.F. Tang, Veronica L. Chan, Woon-Leung Ng, Tiong-Chee Sim, Ping-Wing Ng, Kin-Ip Law, Doris M.W. Tse, Joseph S.M. Peiris, Kwok-Yung Yuen
CMAJ Nov 2004, 171 (11) 1349-1352; DOI: 10.1503/cmaj.1040398

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
Initial viral load and the outcomes of SARS
Chung-Ming Chu, Leo L.M. Poon, Vincent C.C. Cheng, Kin-Sang Chan, Ivan F.N. Hung, Maureen M.L. Wong, Kwok-Hung Chan, Wah-Shing Leung, Bone S.F. Tang, Veronica L. Chan, Woon-Leung Ng, Tiong-Chee Sim, Ping-Wing Ng, Kin-Ip Law, Doris M.W. Tse, Joseph S.M. Peiris, Kwok-Yung Yuen
CMAJ Nov 2004, 171 (11) 1349-1352; DOI: 10.1503/cmaj.1040398
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Abstract
    • Methods
    • Results
    • Interpretation
    • Footnotes
    • References
  • Figures & Tables
  • Responses
  • Metrics
  • PDF

Related Articles

  • Highlights of this issue
  • SARS outbreak in the Greater Toronto Area: the emergency department experience
  • The impact of SARS on a tertiary care pediatric emergency department
  • PubMed
  • Google Scholar

Cited By...

  • Can age-distribution be an indicator of the goodness of COVID-19 testing?
  • Using HoloLens2™ to reduce staff exposure to aerosol generating procedures during a global pandemic
  • A deeper look at COVID-19 CFR: health care impact and roots of discrepancy
  • The first three months of the COVID-19 epidemic: Epidemiological evidence for two separate strains of SARS-CoV-2 viruses spreading and implications for prevention strategies
  • Effect of hot zone infection outbreaks on the dynamics of SARS-CoV-2 spread in the community at large
  • Declining Trend in the Initial SARS-CoV-2 Viral Load During the Pandemic: Preliminary Observations from Detroit, Michigan
  • Heterogeneity in transmissibility and shedding SARS-CoV-2 via droplets and aerosols
  • Role of high-dose exposure in transmission hot zones as a driver of SARS-CoV2 dynamics
  • Common genetic variation in humans impacts in vitro susceptibility to SARS-CoV-2 infection
  • Early Description of Coronavirus 2019 Disease in Kidney Transplant Recipients in New York
  • Reducing risks from coronavirus transmission in the home--the role of viral load
  • COVID-19: community CPAP and NIV should be stopped unless medically necessary to support life
  • Severe Acute Respiratory Syndrome-Associated Coronavirus Infection in Toronto Children: A Second Look
  • T Cell Responses to Whole SARS Coronavirus in Humans
  • Severe Acute Respiratory Syndrome Coronavirus as an Agent of Emerging and Reemerging Infection
  • A Severe Acute Respiratory Syndrome Coronavirus That Lacks the E Gene Is Attenuated In Vitro and In Vivo
  • Serum Proteomic Fingerprints of Adult Patients with Severe Acute Respiratory Syndrome
  • SARS: clinical presentation, transmission, pathogenesis and treatment options
  • Severe Acute Respiratory Syndrome Coronavirus Group-Specific Open Reading Frames Encode Nonessential Functions for Replication in Cell Cultures and Mice
  • Evaluation of Real-Time Reverse Transcriptase PCR and Real-Time Loop-Mediated Amplification Assays for Severe Acute Respiratory Syndrome Coronavirus Detection
  • Google Scholar

More in this TOC Section

  • Falsely elevated point-of-care lactate measurement after ingestion of ethylene glycol
  • Severe necrotizing pancreatitis following combined hepatitis A and B vaccination
  • Can hockey playoffs harm your hearing?
Show more Research article

Similar Articles

Collections

  • Topics
    • Respiratory medicine

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Alerts
  • RSS
  • Early releases

Information for

  • Advertisers
  • Authors
  • Reviewers
  • CMA Members
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact
  • Copyright and Permissions

Copyright 2021, Joule Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

Powered by HighWire