Fast Five Quiz: Severe Acute Respiratory Syndrome (SARS)

Michael Stuart Bronze, MD

Disclosures

May 04, 2020

The clinical course of SARS generally follows a typical pattern. Stage 1 is an influenza-like prodrome that begins 2-7 days after incubation, lasts 3-7 days, and is characterized by:

  • Fever (> 100.4°F [38.3°C])

  • Fatigue

  • Headaches

  • Chills

  • Myalgias

  • Malaise

  • Anorexia

Less common features include:

  • Sputum production

  • Sore throat

  • Coryza

  • Nausea and vomiting

  • Dizziness

  • Diarrhea

Stage 2 is the lower respiratory tract phase and is characterized by:

  • Dry cough

  • Dyspnea

  • Progressive hypoxemia (in many cases)

  • Respiratory failure that requires mechanical ventilation support (in some cases)

The symptoms of COVID-19 are similar to those seen in SARS, including fever, cough, and shortness of breath. Other symptoms, such as malaise and respiratory distress, have also been described in patients with COVID-19. Anosmia, change in taste, and diarrhea may precede the onset of respiratory symptoms in patients with COVID-19. Isolated cases of acute necrotizing encephalitis have also been described in patients with COVID-19.

According to a study of the SARS outbreak in Toronto, Canada, reactive hepatitis is a common complication of SARS-CoV infection; 24% of patients had elevated alanine aminotransferase (ALT) levels upon admission, and 69% had raised ALT levels during the subsequent course of their illness. Patients with severe hepatitis had worse clinical outcomes. Liver conditions are also a concern among patients with COVID-19. No fatalities were reported in young children and teenaged patients with SARS during its outbreak.

Read more about the presentation of SARS.

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