Treatment
Antibiotics are ineffective, as SARS is a viral disease. Treatment of SARS so far has been largely supportive with antipyretics, supplemental oxygen and ventilation support as needed.
Suspected cases of SARS must be isolated, preferably in negative pressure rooms, with complete barrier nursing precautions taken for any necessary contact with these patients.
There was initially anecdotal support for steroids and the antiviral drug ribavirin, but no published evidence has supported this therapy.
Researchers are currently testing all known antiviral treatments for other diseases, including AIDS, hepatitis, influenza and others of the SARS-causing coronavirus.
Some of the more serious damage in SARS may be due to the body's own immune system overreacting to the virus – a cytokine storm. Research is continuing in this area.
In December 2004, Chinese researchers were reported to have produced a SARS vaccine; it has been tested on a group of 36 volunteers, 24 of whom developed antibodies against the virus.
A 2006 systematic review of all the studies done on the 2003 SARS epidemic found no evidence that antivirals, steroids or other therapies helped patients. A few suggested they caused harm.
The clinical treatment of SARS has been relatively ineffective, with most high risk patients requiring artificial ventilation. Currently, corticosteroids and ribavirin are the most common drugs used for treatment of SARS (Wu et al., 2004). In vitro studies of ribavirin have yielded little results at clinical, nontoxic concentrations. Better combinations of drugs that have yielded a more positive clinical outcome (when administered early) have included the use of Kaletra, ribavirin and corticosteroids. The administration of corticosteroids, marketed as Prednisone, during viral infections has been controversial. Lymphopenia can also be a side effect of corticosteroids, even further decreasing the immune response and allowing a spike in the viral load, yet physicians must balance the need for the anti-inflammatory treatment of corticosteroids (Murphy 2008).
Clinicians have also noticed positive results during the use of human interferon and glycyrrhizin. No compounds have yielded inhibitory results of any significance. The HIV protease inhibitors ritonavir and saquinavir did not show any inhibitory effect at nontoxic levels. Iminocyclitol 7 has been found to have an inhibitory effect on SARS-CoV in that it disrupts the envelope glycoprotein processing. Iminocyclitol 7 specifically inhibits the production of human fucosidase and in vitro trials yielded promising results in the treatment of SARS, yet one problem exists. A deficiency of fucosidase can lead to a condition known as fucosidosis in which there is a decrease in neurological function.
Currently, there is no cure or protective vaccine for SARS. The identification and development of novel vaccines and medicines to treat SARS is a priority for governments and public health agencies around the world.
Read more about this topic: Severe Acute Respiratory Syndrome
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—Hippocrates (c. 460–c. 370 B.C.)