Poor prognostic factors
Prognostic factors associated with a poor outcome (intensive care unit admission or death) include advanced age and the presence of comorbidities such as diabetes mellitus, hepatitis B infection, and heart disease.
An increased LDH level, elevated CRP, and high neutrophil count on presentation as well as low counts of CD4 and CD8 lymphocytes are also associated with an independent increased risk of death.
Morbidity and mortality
Clinical deterioration requiring intubation and mechanical ventilation occurs at a median of 8 days after the onset of symptoms. Death is most often attributed to sepsis, ARDS, and multiple organ failure.
The case-fatality rate during the 2003 SARS outbreak was 9.6% and ranged between 0% and 40%. The mortality rate in patients over 65 years of age exceeds 50%.
A residual decrease in lung function and persistent radiologic abnormalities, as well as prolonged psychological sequelae and muscle weakness, are frequently observed in the survivors of SARS, although these tend to improve over time.
Children (<12 years of age)
Children have a milder and shorter clinical course resembling that of the common cold. Prognosis is thus more favorable than in adults, and no death has been reported in young children infected by SARS coronavirus.
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