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

Trop Med Int Health. 2004 Aug;9(8):923-7. doi: 10.1111/j.1365-3156.2004.01281.x.


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.

MeSH terms

  • Adult
  • Antiviral Agents / therapeutic use*
  • Female
  • Hospital Mortality
  • Humans
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Retrospective Studies
  • Ribavirin / therapeutic use*
  • Severe Acute Respiratory Syndrome / drug therapy*
  • Treatment Outcome


  • Antiviral Agents
  • Ribavirin