Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.
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Wall Street Journal - May 12, 2003
Karen Richardson, Staff Reporter of The Wall Street Journal
"You get more side effects if you give steroids early, so we're now adjusting our treatment to give steroids only at the second phase," said E.K. Yeoh, Hong Kong's secretary of health, welfare and food.
Dr. Yeoh has been among the staunchest supporters of Hong Kong's drug protocol despite the lack of endorsement by the World Health Organization and the U.S. Centers for Disease Control and Prevention. Canada, which has also been grappling with a SARS outbreak, recently stopped giving most patients ribavirin, saying it wasn't effective and had serious side effects.
Dr. Yeoh noted that the body's immune system reacts aggressively to the SARS virus, and can cause permanent damage to lung tissue. He said that despite the use of corticosteroids to calm the immune system at this stage, about 10% of recovered patients show signs of lung-tissue damage.
"There may be long-term consequences on their respiratory systems," he said, though he declined to attribute the problem to the treatment protocol.
The WHO estimates that about 15% of people who contract the disease die, but a study in the Lancet estimates that about 20% of the people hospitalized with the disease in Hong Kong are dying from it, and that more than half of those more than 60 years old die.
Meanwhile, David Ho, a U.S. scientist who pioneered successful HIV-AIDS treatments, said he and colleagues in Hong Kong had made progress in laboratory tests using synthetic peptides to tackle the coronavirus that causes SARS. Peptides are groups of amino acids that have been used to slow AIDS in a drug called Fuzeon.
The lab results are a first step in identifying the best drug treatments for the disease, Dr. Ho said, but "we're not saying this is the drug to treat [SARS] patients tomorrow or next month."
Hong Kong health authorities are using other treatments related to HIV-AIDS drugs in conjunction with or in place of ribavirin, such as Kaletra, a protease inhibitor. They are increasing their use of a serum made from the blood plasma of recovered patients that contains antibodies that fight SARS.
Two mainland Chinese doctors invited by the Hong Kong government have also been treating SARS patients using traditional Chinese medicine when requested by patients and their families and have been working with Hong Kong clinicians to develop a new drug treatment.
Write to Karen Richardson at karen.richardson@wsj.com
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