Coronavirus SARS-CoV1 infection (SARS)

Essential Evidence

Last Updated on 2021-03-10 © 2021 John Wiley & Sons, Inc.

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Authors:
M. Joyce Green, MD, Assistant Professor, Penn State Health Hershey Medical Center
Pete Yunyongying, MD, FACP, Associate Professor , Carle-Illinois College of Medicine, University of Illinois
Mark H. Ebell, MD, MS, Professor, College of Public Health, University of Georgia
Mindy A. Smith, MD, MS, Clinical Professor, Department of Family Medicine, Michigan State University

Editor:
Mark H. Ebell, MD, MS, Professor, College of Public Health, University of Georgia

Overall Bottom Line

  • The most common presenting symptoms of the SARS-CoV1 in 2003 were fever, chills, myalgia, malaise, and cough. 1 Test patients for SARS-CoV1 using PCR only if no other cause of pneumonia can be found 72 hours after starting a workup and if the patient has risk factors for SARS-CoV1. Consult public health authorities prior to testing. G5C
  • Supportive care is the mainstay of treatment. Although most patients were treated with corticosteroids and antivirals, there is little evidence that these interventions improved outcomes, and they are known to have ill effects. C 2
  • The case fatality ratio in over 8000 cases reported by the WHO in 2003 was 9.6%. G18C
  • A separate chapter address infection with SARS-CoV2 and COVID-19.

Screening and Prevention

Bottom Line

  • The CDC recommended the use of airborne, droplet, and standard precautions for all personnel who come in contact with a SARS-CoV1 patient. G5C
  • Healthcare workers are at higher risk, especially those involved in procedures that may generate droplets or those that provide direct patient care. 1 Strict airborne isolation is recommended, including use of negative pressure rooms as well as N95 respirators for healthcare workers who are treating these patients. C G4
  • During the 2003 SARS-CoV1 outbreak in Taiwan, wearing surgical face masks on entering the hospital, on hospital wards and in out-patient clinics prevented nearly all cases of SARS-CoV1 among healthcare workers. 52
  • Based in part on experience with SARS-CoV1, masks and physical distancing have been broadly mandated around the world during the 2020 COVID-19/ SARS-CoV2 pandemic. A Cochrane review of 29 studies has concluded that these measures are consistently effective in slowing the spread of an epidemic. It is most effective when implemented early and in conjunction with other measures like closing schools and restricting travel. 53
  • Contacts of SARS-CoV1 exposed individuals were recommended to be placed in quarantine for 10 days and monitored daily for fever and other symptoms C G3
  • The most recent 2020 CDC recommendation for COVID-19/ SARS-CoV 2 are similar. They recommend that contacts of COVID-19 exposed individuals should quarantine for 14 days with daily monitoring for fever and other symptoms. Persons living alone should have daily virtual contact with someone who can obtain help in the event of worsening.