Treatments used for SARS no benefit to victims

Sep 13 2006

Researchers have found, following a systematic review of all studies done on the 2003 SARS epidemic, that none of the treatments used to treat patients appear to have worked.

It seems that there is no evidence that the antivirals, steroids or other therapies used benefited patients and some possibly harmed them.

The researchers say their work illustrates just how difficult it is to deal with newly emerging viruses.

Severe Acute Respiratory Syndrome (SARS) is thought to have first appeared in China in 2002 and spread around the world in 2003, mainly by airline travel and then within hospitals.

It eventually infected more than 8,000 people and killed 774 before it was brought under control.

The infection was caused by a virus previously unseen in people, the SARS coronavirus which affects some animals and it may have spread to people from exotic live animals sold for food.

The virus made people cough and wheeze violently and doctors in desperation tried a variety of treatments.

There are very few drugs which effectively treat viruses, so most of the known antivirals, including drugs that treat AIDS, hepatitis and influenza, were tried.

Following the outbreak, the World Health Organization established an International SARS Treatment Study Group, which recommended a review of SARS treatments, with a particular focus on certain antiviral drugs (ribavirin, lopinavir, and ritonavir), steroids, and proteins called immunoglobulins, which occur naturally in human blood.

Lauren Stockman of the U.S. Centers for Disease Control and Prevention and colleagues in the United States and Britain unearthed more than 70 studies and also looked at experiments done in the laboratory and on more general acute respiratory distress syndrome.

The team of researchers found that most studies on the use of steroids to reduce inflammation were inconclusive and four different treatments possibly caused harm.

It appears some SARS survivors have been permanently disabled by the illness, the treatment or both.

The fact that there was no accepted treatment for SARS and no easy test for the virus, made the study difficult and doctors and nurses at the time were busy fighting to save patients' lives, not dithering about which treatment was the best.

The researchers say it is not possible to determine from these studies, whether any of the treatments used against SARS are effective.

The group recommends if there is another outbreak of SARS or another new virus, a coordinated effort is needed from the outset to assess which treatment works best.