Severe Acute Respiratory Syndrome Among Children

Objective. To study the epidemiologic, clinical, laboratory, and radiologic features, prognostic indicators, and short-term to medium-term outcomes for children with severe acute respiratory syndrome (SARS) and to validate the performance characteristics of a clin- ical case definition, calculated with respect to SARS- associated coronavirus (SARS-CoV) seroconversion. Methods. Children 12 years was associ- ated with methylprednisolone therapy for severe illness. After exclusion of the only infant, an age of >12 years was associated with oxygen requirements. Sore throat, high neutrophil count at presentation, and peak neutro- philia were independent factors predicting severe illness. The clinical case definition demonstrated good sensitiv- ity, specificity, and positive and negative predictive val- ues (97.8%, 92.7%, 88%, and 98.7%, respectively) for di- agnostic accuracy. Conclusions. Children are susceptible to SARS-CoV infection. Teenagers resemble adults with respect to dis- ease progression and may develop severe illness. The short-term to medium-term outcomes are good. Sore throat and initial and peak neutrophilia seem to be predictors of severe illness. Our clinical case definition performed well in the epidemic. Pediatrics 2004; 113:e535-e543. URL: http://www.pediatrics.org/cgi/ content/full/113/6/e535; severe acute respiratory syn- drome, SARS, children.