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Free Content Investigational use of ribavirin in the treatment of severe acute respiratory syndrome, Singapore, 2003

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Summary Objective 

Ribavirin is a broad spectrum nucleoside analogue efficacious in the treatment of several viral infections. In the recent severe acute respiratory syndrome (SARS) outbreak, ribavirin was used in various countries against this novel coronavirus. We conducted a retrospective analysis to assess the efficacy of ribavirin in the treatment of SARS in Singapore. Methods 

A total of 229 cases were analysed. Ninety-seven (42.4%) patients received ribavirin at a mean of 6.4 days of illness. Clinical and laboratory parameters taken at the start of ribavirin treatment were compared with day 5, 6 or 7 parameters of those patients not on treatment. The two groups were compared using Fisher's exact test and Student's t-test. Multivariate analysis was performed using Cox regression model with death as the outcome of interest. Results 

The treatment group had younger women with more symptoms of myalgia (P < 0.001). The crude death rate was 12.9% in the control and 10.3% (P = 0.679) in the treatment group. After correction for age, male sex, lactate dehydrogenase levels and steroid use, the hazard ratio was 1.03 (95% CI: 0.44–2.41, P = 0.939). Conclusion 

In this retrospective, uncontrolled cohort analysis, use of ribavirin did not appear to confer any benefit for patients with SARS.
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Keywords: Singapore; mortality; ribavirin; severe acute respiratory syndrome

Document Type: Research Article

Affiliations: 1:  Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore 2:  Department of Clinical Epidemiology, Tan Tock Seng Hospital, Singapore

Publication date: 2004-08-01

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