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CORD-19:80fd81c46001bbd1c5efb56169239a872b271e88 JSONTXT 7 Projects

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Id Subject Object Predicate Lexical cue
T1 0-81 Sentence denotes Features discriminating SARS from other severe viral respiratory tract infections
T2 83-91 Sentence denotes Abstract
T3 92-323 Sentence denotes This study investigated the discriminatory features of severe acute respiratory syndrome (SARS) and severe non-SARS community-acquired viral respiratory infection (requiring hospitalization) in an emergency department in Hong Kong.
T4 324-632 Sentence denotes In a case-control study, clinical, laboratory and radiological data from 322 patients with laboratory-confirmed SARS from the 2003 SARS outbreak were compared with the data of 253 non-SARS adult patients with confirmed viral respiratory tract infection from 2004 in order to identify discriminatory features.
T5 633-795 Sentence denotes Among the non-SARS patients, 235 (93%) were diagnosed as having influenza infections (primarily H3N2 subtype) and 77 (30%) had radiological evidence of pneumonia.
T6 796-1048 Sentence denotes In the early phase of the illness and after adjusting for baseline characteristics, SARS patients were less likely to have lower respiratory symptoms (e.g. sputum production, shortness of breath, chest pain) and more likely to have myalgia (p < 0.001).
T7 1049-1204 Sentence denotes SARS patients had lower mean leukocyte and neutrophil counts (p<0.0001) and more commonly had "ground-glass" radiological changes with no pleural effusion.
T8 1205-1357 Sentence denotes Despite having a younger average age, SARS patients had a more aggressive respiratory course requiring admission to the ICU and a higher mortality rate.
T9 1358-1481 Sentence denotes The area under the receiver operator characteristic curve for predicting SARS when all variables were considered was 0.983.
T10 1482-1587 Sentence denotes Using a cutoff score of >99, the sensitivity was 89.1% (95%CI 82.0-94.0) and the specificity was 98.0% ).
T11 1588-1738 Sentence denotes The area under the receiver operator characteristic curve for predicting SARS when all variables except radiological change were considered was 0.933.
T12 1739-1860 Sentence denotes Using a cutoff score of >8, the sensitivity was 80.7% (95% CI 72.4-87.3) and the specificity was 94.5% (95%CI 90.9-96.9).
T13 1861-1981 Sentence denotes Certain clinical manifestations and laboratory changes may help to distinguish SARS from other influenza-like illnesses.
T14 1982-2086 Sentence denotes Scoring systems may help identify patients who should receive more specific tests for influenza or SARS.
T15 2087-2267 Sentence denotes Severe acute respiratory syndrome (SARS) is a novel, infectious, respiratory disease caused by a SARS-coronavirus (SARS-CoV) [1-3] that manifested in a global outbreak in 2003 [4].
T16 2268-2345 Sentence denotes Over 99% of SARS cases are characterized by Eur J Clin Microbiol Infect Dis (
T17 2347-2481 Sentence denotes pneumonia [5] , and in the 2003 SARS outbreak an estimated 1,755 patients in Hong Kong were affected with an overall mortality of 17%.
T18 2482-2651 Sentence denotes SARS re-emerges sporadically, as evidenced by the high prevalence of antibodies against SARS-CoV in animal traders in Guangdong [6] , and thus poses a continuing threat.
T19 2652-2831 Sentence denotes During the 2003 outbreak, the diagnostic accuracy of clinicians in Hong Kong was high, facilitated by the absence of any coinciding influenza or other respiratory infections [4] .
T20 2832-2934 Sentence denotes However, the clinical, radiological and laboratory features of SARS are nonspecific [7] [8] [9] [10] .
T21 2935-3119 Sentence denotes Therefore, if a coexisting outbreak of acquired pneumonia had occurred in the SARS-CoVnegative community, the diagnosis would have been hampered, with potentially catastrophic results.
T22 3120-3378 Sentence denotes The non-specific nature of many of the symptoms associated with SARS makes the development of sensitive diagnostic tests challenging, particularly if a SARS reemergence were to be concurrent with an epidemic of another respiratory disease, such as influenza.
T23 3379-3759 Sentence denotes Although initial case definitions were insensitive for diagnosing SARS early in the course of the illness [11] , and prediction guidelines have subsequently been developed to help diagnose and stratify SARS [12, 13] , these guidelines have never been tested during a co-existent outbreak of influenza, bacterial infection or any other common cause of community-acquired pneumonia.
T24 3760-3903 Sentence denotes Worldwide, influenza is estimated to be responsible for 4.1-4.5 million excess illnesses annually in individuals aged 20 years and older [14] .
T25 3904-3950 Sentence denotes The symptoms of this disease are debilitating.
T26 3951-4238 Sentence denotes Influenza-related complications, such as lower respiratory illnesses (e.g. bronchitis, pneumonia) and other systemic complications (e.g. cardiovascular, cerebrovascular diseases) commonly result in approximately 150,000 hospitalizations and 20,000 deaths annually in the USA alone [14] .
T27 4239-4526 Sentence denotes The aim of this study was to compare early clinical, radiological and laboratory results collected during the SARS outbreak of 2003 with those collected during non-SARS outbreaks of viral respiratory illnesses in 2004 for patients presenting from the same community to the same hospital.
T28 4527-4794 Sentence denotes If early discriminating features are recognized, they may facilitate the diagnosis of SARS and hence the timely control of SARS transmission, since the overall detection rate for SARS-CoV RNA by PCR assays is currently only 60% in the first week of illness [15, 16] .
T29 4795-5039 Sentence denotes It has been postulated that improvement of diagnostic guidelines specific to SARS would be much more costeffective than testing with PCR assays; establishing an alternative diagnosis by influenza testing is another costeffective strategy [17] .
T30 5040-5200 Sentence denotes The World Health Organization has continued to call for the improvement of diagnostic guidelines for distinguishing SARS from other respiratory illnesses [18] .
T31 5201-5312 Sentence denotes This case-control study was conducted at the emergency department of the Prince of Wales Hospital in Hong Kong.
T32 5313-5464 Sentence denotes The SARS crisis in 2003 was so rapid and severe it was not possible to pursue normal channels of approval and consent for the duration of the outbreak.
T33 5465-5615 Sentence denotes Nevertheless, all patients were given a questionnaire to answer and were informed that the data would be used for surveillance, analysis and research.
T34 5616-5880 Sentence denotes The chief executives and associated institutional review boards of the Hospital Authority of Hong Kong and of the Prince of Wales Hospital later approved the collection of clinical data and the use of blood tests for surveillance, analysis, research and reporting.
T35 5881-5986 Sentence denotes Many of the SARS patients included in this study have been described in previous reports [4, 7, 11, 12] .
T36 5987-6214 Sentence denotes Approval was obtained from the institutional review boards for the second phase of the study, which involved the prospective collection of data from patients with severe viral respiratory illnesses admitted to hospital in 2004.
T37 6215-6393 Sentence denotes The records of 322 patients with laboratory-confirmed SARS who were admitted to Prince of Wales Hospital during the SARS outbreak of 2003 between February and June were reviewed.
T38 6394-6723 Sentence denotes For comparison, data was collected prospectively from 253 consecutive non-SARS patients with febrile respiratory illness and likely lower respiratory tract involvement; these patients were diagnosed with other viral etiologies and were admitted to hospital through the emergency department between 1 January and 31 December 2004.
T39 6724-6886 Sentence denotes The Prince of Wales Hospital is a 1,400-bed teaching hospital and tertiary referral centre for the New Territories of the Hong Kong Special Administrative Region.
T40 6887-6949 Sentence denotes It serves a mainly urban catchment area of 1.5 million people.
T41 6950-7035 Sentence denotes The emergency department sees 160,000 new patients per annum, and admits 24% of them.
T42 7036-7168 Sentence denotes Approximately 50 patients are admitted to internal medicine wards each day, and 20% of these admissions are due to infective causes.
T43 7169-7630 Sentence denotes Patients were included in the study if they met the following criteria: (a) adult patients aged ≥18 years; (b) presented to the emergency department and required hospitalization; (c) had a febrile respiratory illness, as defined by the presence of lower respiratory symptoms (cough, sputum production, shortness of breath), with or without radiological features of pneumonia (haziness or definite pneumonia) [19] ; and (d) had positive virological confirmation.
T44 7631-7691 Sentence denotes Patients without established viral etiologies were excluded.
T45 7692-7754 Sentence denotes Patients were seen by an emergency specialist and a physician.
T46 7755-7915 Sentence denotes Patients completed a health questionnaire that documented contact history, as well as upper and lower respiratory tract, gastrointestinal and systemic symptoms.
T47 7916-8091 Sentence denotes Pulse rate, systolic and diastolic blood pressure, respiratory rate, tympanic temperature and oxygen saturation at room air were also recorded as observations at presentation.
T48 8092-8308 Sentence denotes All patients received frontal plain chest radiographs, which were initially evaluated by a specialist emergency physician with reference to clinical details, and then by a radiologist blinded to clinical information.
T49 8309-8442 Sentence denotes A clear contact history was established if a person had close physical contact with another person known to have a similar infection.
T50 8443-8578 Sentence denotes The laboratory confirmation of SARS-CoV was performed as described previously [20, 21] according to World Health Organization criteria.
T51 8579-8994 Sentence denotes Briefly, SARS was confirmed if any one of three criteria were met: (a) a fourfold rise in SARS-CoV antibody titer between acute-(taken within 7 days after the onset of fever) and convalescent-(taken at least 3 weeks after the onset of fever) phase serum; (b) detection of antibody to SARS-CoV in specimens during acute illness; or (c) detection of antibody to SARS-CoV in specimens obtained from convalescent serum.
T52 8995-9150 Sentence denotes Serologically negative cases were defined as those in which antibody to SARS-CoV was absent in convalescent serum taken ≥28 days after symptom onset [22] .
T53 9151-9294 Sentence denotes For other respiratory viruses, a combination of viral antigen detection by the immunofluorescence test, virus isolation and serology were used.
T54 9295-9488 Sentence denotes Nasopharyngeal aspirates were collected for rapid viral antigen detection by immunofluorescence for influenza A and B, and respiratory syncytial virus using commercial assays (Dako Diagnostic).
T55 9489-9611 Sentence denotes These aspirates were collected either in the emergency department or within the first few hours after admission to a ward.
T56 9612-9669 Sentence denotes Results were generally available on the same working day.
T57 9670-9926 Sentence denotes Virus isolation was performed using rhesus monkey kidney (LLC-MK2), human laryngeal carcinoma (HEp-2), Mardin Darby Canine Kidney (MDCK), human embryonic lung fibroblast, Buffalo green monkey kidney (BGM), and African green monkey kidney (Vero) monolayers.
T58 9927-9985 Sentence denotes Cell monolayers were examined daily for cytopathic effect.
T59 9986-10221 Sentence denotes After 14 days of incubation, the growth of influenza A and B, parainfluenza types 1, 2, and 3, respiratory syncytial virus (RSV) and adenovirus were examined using commercial monoclonal antibodies with the immunofluorescence technique.
T60 10222-10304 Sentence denotes In addition, the hemadsorption test was performed for LLC-MK2 and MDCK monolayers.
T61 10305-10511 Sentence denotes Paired sera were subjected to antibody detection by complement fixation tests covering influenza A and B, respiratory syncytial virus, parainfluenza viruses 1, 2 and 3, adenovirus and Mycoplasma pneumoniae.
T62 10512-10628 Sentence denotes Sputum specimens were also sent for Gram stain and bacterial culture, Ziehl-Neelsen stain and mycobacterial culture.
T63 10629-10667 Sentence denotes Peripheral blood was sent for culture.
T64 10668-10799 Sentence denotes Urine was sent for rapid antigen testing for Pneumococcus spp and Legionella pneumophila serogroup 1 whenever clinically indicated.
T65 10800-11025 Sentence denotes Imaging technique Due to the high infectivity of the disease and the volume of patients seen during the SARS outbreak, only frontal radiographs were performed for most patients, and these were used for analysis in this study.
T66 11026-11108 Sentence denotes As a precaution, all inpatient chest radiographs were performed with mobile units.
T67 11109-11194 Sentence denotes Film handling was minimized and, for this project only, digital images were reviewed.
T68 11195-11271 Sentence denotes Chest radiographs were performed following an established standard protocol.
T69 11272-11427 Sentence denotes Frontal chest radiographs were obtained, in the postero-anterior projection for patients who could stand, or anteroposterior views for those who could not.
T70 11428-11496 Sentence denotes A similar approach was used for the non-SARS patients in this study.
T71 11497-11644 Sentence denotes All radiological examinations were performed using radiological equipment (Mobilett Plus; Siemens, Erlangen, Germany) and a standardized technique:
T72 11645-11853 Sentence denotes 75 kV, 4 mAs, and a 180-cm film-focus distance for the posteroanterior views and 70 kV, 4 mAs, and a 100-cm film-focus distance for the anteroposterior views; a broad tube focus was used to obtain both views.
T73 11854-12050 Sentence denotes Radiograph evaluation The images were assessed using a picture archiving and communication system, or PACS, viewer workstation with a 2,048×2,048-pixel monitor (Magicview, version VA22E; Siemens).
T74 12051-12149 Sentence denotes The images were reviewed by radiologists working in pairs and the interpretation was by consensus.
T75 12150-12238 Sentence denotes Classification/scoring system Each lung was divided into upper, middle, and lower zones.
T76 12239-12379 Sentence denotes Each of the three zones encompassed one-third of the craniocaudal distance of the lung on a frontal radiograph and was evaluated separately.
T77 12380-12690 Sentence denotes The radiologists assessed and recorded the presence, appearance (airspace opacity, reticular opacity, mass, nodule, pleural effusion, and/or lymphadenopathy), and distribution (upper, middle, or lower lung zone involvement and unilateral or bilateral involvement) of changes observed on the frontal radiograph.
T78 12691-12899 Sentence denotes Demographic, clinical, laboratory and radiological features were analyzed using the unpaired Student's t test for continuous variables and the chi-square test or Fisher's exact test for categorical variables.
T79 12900-13036 Sentence denotes Data were analyzed using Statview® for Windows version 7.1 statistical analysis software (Abacus Concepts, SAS Institute, Cary NC, USA).
T80 13037-13124 Sentence denotes Data is presented in terms of means and standard deviations unless otherwise specified.
T81 13125-13218 Sentence denotes All analyses were two tailed and a p-value of <0.05 was considered statistically significant.
T82 13219-13333 Sentence denotes In the first instance, there were too many variables to construct a single multivariate logistic regression model.
T83 13334-13539 Sentence denotes Therefore, adjusted odds ratios were calculated by constructing four separate logistic regression models with different sets of variablesclinical, observations at presentation, laboratory and radiological.
T84 13540-13601 Sentence denotes Age and sex were initially entered into each of these models.
T85 13602-13807 Sentence denotes For each model, variables that failed to meet the significance levels of the likelihood ratio test (p>0.05) were removed by backward stepwise elimination until all insignificant variables had been removed.
T86 13808-13951 Sentence denotes The remaining significant variables from each of the four initial models were then entered into a final multivariate logistic regression model.
T87 13952-14028 Sentence denotes Insignificant variables were again removed by backward stepwise elimination.
T88 14029-14121 Sentence denotes Scores were assigned to each of the remaining variables based on their logistic odds ratios.
T89 14122-14239 Sentence denotes Receiver operator characteristic (ROC) curves for sensitivity and specificity were constructed based on these scores.
T90 14240-14378 Sentence denotes During the 2003 SARS outbreak, 322 of 1,530 (21%) patients screened at Prince of Wales Hospital were confirmed to have SARS-CoV infection.
T91 14379-14670 Sentence denotes During 2004, 1,461 patients were admitted from the emergency department to a medical ward with a provisional diagnosis of febrile respiratory illness with or without pneumonia; among them, 253 (17%) had SARS-CoV-negative respiratory tract infection confirmed to be of other viral etiologies.
T92 14671-14759 Sentence denotes 19 (8%) patients, and respiratory syncytial virus for 12 (5%) patients admitted in 2004.
T93 14760-14898 Sentence denotes Among the cases in which subtyping data was available, 61 of 253 (24%) infections were due to subtypes H3N2, and 10 (4%) were due to H1N1.
T94 14899-15057 Sentence denotes Table 1 shows the clinical features and observations at presentation of the 575 patients who presented within a mean time from symptom onset of 4 days (SD 3).
T95 15058-15272 Sentence denotes The following features were more common in non-SARS than SARS cases in univariate analysis: cough, runny nose, sputum production, chest pain, shortness of breath, vomiting, and impaired general condition (elderly).
T96 15273-15374 Sentence denotes Chills, malaise, myalgia, rigors, diarrhea and headache were more common in SARS than non-SARS cases.
T97 15375-15574 Sentence denotes Patients from the non-SARS group had a higher mean systolic blood pressure, respiratory rate and initial temperature reading and lower mean oxygen saturation on room air than those in the SARS group.
T98 15575-15887 Sentence denotes Although most patients were admitted to the ward based on the emergency physicians' impression that they had a febrile respiratory illness with possible lower respiratory tract involvement, only 77 (30%) patients in 2004, and 305 (95%) SARS cases in 2003 had definite pneumonia visible on radiographs (Table 2) .
T99 15888-16090 Sentence denotes Most (98%) of the patients with SARS pneumonia had ground-glass opacification on chest radiograph; in comparison, the non-SARS pneumonia patients demonstrated ground-glass opacification in 17% of cases.
T100 16091-16215 Sentence denotes Pleural effusion was not a feature of SARS viral infection, but it was present in 14 (7%) cases of non-SARS viral infection.
T101 16216-16373 Sentence denotes Patients were more likely to be admitted quickly at the first emergency department presentation during 2004 than during the SARS outbreak of 2003 (Table 3) .
T102 16374-16499 Sentence denotes SARS patients were more likely to require admission to the ICU than patients with non-SARS viral respiratory tract infection.
T103 16500-16625 Sentence denotes Six patients presenting early in the course of illness when no diagnostic tests were available were not admitted to the ward.
T104 16626-16676 Sentence denotes Subsequent testing identified these as SARS cases.
T105 16677-16858 Sentence denotes The overall mortality of our SARS patients (10%) was greater than that of patients with non-SARS viral infection (3%) and was similar to the global mortality of 9.6% for SARS [23] .
T106 16859-17176 Sentence denotes The mean ages of survivors and patients who died after non-SARS viral infection were 68 (SD 19) and 61 (SD 32) years, respectively, (difference -7, p=0.31), whereas the mean ages of survivors and patients who died after SARS viral infection were 38 (SD 15) and 73 (SD 13) years, respectively, (difference 35, p<0.01).
T107 17177-17314 Sentence denotes After adjustments were made for age and sex, the odds ratio for death in patients with SARS versus non-SARS viral infection was Table 4 .
T108 17315-17440 Sentence denotes For patients over 50 years of age the mortality rates after SARS infection were much higher than those for non-SARS patients.
T109 17441-17557 Sentence denotes Initially, four separate models were constructedclinical, observations at presentation, laboratory and radiological.
T110 17558-17801 Sentence denotes After adjusting for age and sex, the clinical features most discriminatory were myalgia, sputum production, runny nose, chest pain and shortness of breath, each of which should be considered as an independent discriminating factor ( Table 5 ).
T111 17802-18021 Sentence denotes The most discriminatory observations and laboratory findings were respiratory rate, temperature, total leukocyte count, neutrophil count and lymphocyte count, all of which should be considered as discriminating factors.
T112 18022-18124 Sentence denotes The presence of a ground-glass appearance on chest radiograph was the strongest discriminating factor.
T113 18125-18267 Sentence denotes Variables from Table 5 were combined into a final model and insignificant variables were removed by backward stepwise elimination ( Table 6 ).
T114 18268-18504 Sentence denotes The significant variables that remained in favor of SARS infection were age ≤60 years, myalgia, respiratory rate ≤20 breaths per minute, temperature ≤38°C, leukocyte count ≤7.0 × 10 9 /l, and ground-glass appearance on chest radiograph.
T115 18505-18580 Sentence denotes The single significant factor against SARS infection was sputum production.
T116 18581-18656 Sentence denotes Each of these variables was scored according to its odds ratio ( Table 6 ).
T117 18657-18751 Sentence denotes The area under the ROC curve for predicting SARS when all variables were considered was 0.983.
T118 18752-18883 Sentence denotes Using a cutoff score of >99, the sensitivity was 89.1% (95%CI 82.0-94.0) and the specificity was 98.0% (95%CI 95.4-99.3) (Fig. 1) .
T119 18884-19005 Sentence denotes The area under the ROC curve for predicting SARS when all variables except radiographic change were considered was 0.933.
T120 19006-19136 Sentence denotes Using a cutoff score of >8, the sensitivity was 80.7% (95%CI 72.4-87.3) and the specificity was 94.5% (95%CI 90.9-96.9) (Fig. 2 ).
T121 19137-19349 Sentence denotes This study shows that the early clinical and laboratory presentation of patients with SARS differed significantly from that of patients with other common causes of viral respiratory tract infection and pneumonia.
T122 19350-19534 Sentence denotes Although fever was common in cases of both SARS and non-SARS viral pneumonia, other systemic symptoms such as chills, malaise, and rigors were less common in non-SARS viral infections.
T123 19535-19607 Sentence denotes Upper and lower respiratory symptoms were more common in non-SARS cases.
T124 19608-19848 Sentence denotes Patients with non- SARS viral infections had higher systolic blood pressures and respiratory rates, and lower oxygen saturation readings than patients with SARS, which may reflect older age and premorbid status rather than pneumonia itself.
T125 19849-19995 Sentence denotes The clinical diagnosis of pneumonia was supported by significant radiological changes more commonly in patients with SARS than non-SARS infection.
T126 19996-20176 Sentence denotes Total leukocyte and neutrophil counts were higher in non-SARS viral pneumonia, but mean lymphocyte counts, although depressed, did not help discriminate among different etiologies.
T127 20177-20348 Sentence denotes A recent study indicated that the absolute neutrophil count is discriminative between patients with SARS and those with other causes of community-acquired pneumonia [10] .
T128 20349-20412 Sentence denotes In contrast, our study included only non-SARS viral etiologies.
T129 20413-20539 Sentence denotes The routine total leukocyte and neutrophil counts may potentially be of use in excluding SARS and should be evaluated further.
T130 20540-20591 Sentence denotes SARS can be confused with influenza [1-5, 24, 25] .
T131 20592-20792 Sentence denotes In fact, during work-up for any patient considered to be at high risk for SARS epidemiologically, the Centers for Disease Control and Prevention recommends routine testing for influenza A and B [22] .
T132 20793-20909 Sentence denotes This is the first study to compare the clinical, laboratory and radiological features of SARS to those of influenza.
T133 20910-21095 Sentence denotes It demonstrated that certain features are more commonly seen among SARS patients; if these are seen, SARS-CoV testing is probably indicated in the correct epidemiological setting [22] .
T134 21096-21436 Sentence denotes On the other hand, specific SARS-CoV testing for all cases of acute febrile respiratory illness is not cost-effective and can cause social disruption due to the false-positive and false-negative results these tests can produce; this is especially true in the absence of worldwide transmission, since the prevalence of SARS is extremely low.
T135 21437-21546 Sentence denotes Establishing an alternative diagnosis is a reasonable strategy and is likely to be more cost-effective [16] .
T136 21547-21625 Sentence denotes This is especially important under the current threat of another pandemic flu.
T137 21626-21742 Sentence denotes Although it is possible for a patient to have coincident SARS and influenza infections, the combination is unlikely.
T138 21743-21873 Sentence denotes Nevertheless, during coincident SARS and influenza outbreaks, we cannot rule out the possibility that a patient may contract both.
T139 21874-22147 Sentence denotes Since patients in both groups of our study attended the emergency department within the first few days of illness, it is likely that the clinical and laboratory differences are not simply a result of measurements being taken at different times during the course of illness.
T140 22148-22204 Sentence denotes Nevertheless, the present study had several limitations.
T141 22205-22388 Sentence denotes First, it was conducted at a single centre, so the applicability of our findings may vary depending upon the relative prevalence of the etiological agent during any particular period.
T142 22389-22527 Sentence denotes Second, we compared patients with known SARS or non-SARS viral infection, while this status is not typically known in presenting patients.
T143 22528-22757 Sentence denotes Third, viral illness follows temporal patterns, so single data measurements obtained during the epidemic may not allow for temporal variation; however, our study did focus on a similarly early period in the course of the illness.
T144 22758-22875 Sentence denotes Fourth, the radiological assessment of SARS cases in 2003 was not as thorough as that conducted for patients in 2004.
T145 22876-23003 Sentence denotes During the SARS outbreak, the high infectivity of the disease and the large number of patients limited some of the assessments.
T146 23004-23117 Sentence denotes Only frontal radiographs were performed for most patients, and many radiographs were performed with mobile units.
T147 23118-23199 Sentence denotes In some cases, film handling was minimized and only digital images were reviewed.
T148 23200-23306 Sentence denotes Nevertheless, chest radiographs and assessments were performed following an established standard protocol.
T149 23307-23390 Sentence denotes Our non-SARS group may not be representative since they were hospitalized patients.
T150 23391-23460 Sentence denotes Non-hospitalized influenza cases may resemble SARS even more closely.
T151 23461-23633 Sentence denotes The results of this study indicate SARS appears to have a more severe intermediate course than non-viral pneumonia and it accounts more frequently for admission to the ICU.
T152 23634-23762 Sentence denotes The overall mortality was, nonetheless, the same for both groups, despite the higher mean age of patients in the non-SARS group.
T153 23763-24035 Sentence denotes Although there are clinical, laboratory and radiological differences between SARS and commonly occurring non-SARS viral respiratory infections, specific influenza testing is still important since these conditions can mimic each other clinically, despite their differences.
T154 24036-24112 Sentence denotes This is especially important given the threat of another influenza pandemic.