Temporal relationship of viral load, ribavirin, interleukin (IL)-6, IL-8, and clinical progression in patients with severe acute respiratory syndrome

Clin Infect Dis. 2004 Oct 1;39(7):1071-5. doi: 10.1086/423808. Epub 2004 Sep 1.


Although viral replication and overwhelming immune responses are believed to contribute to the progression of severe acute respiratory syndrome (SARS), little is known about the temporal relationship between viral load, ribavirin, proinflammatory cytokines, and clinical progression. We report that ribavirin was not effective in reducing the SARS coronavirus load in 3 of 8 probable cases studied and that elevated levels of interleukin (IL)-6 and IL-8 subsequent to the peak viral load were found in 8 and 6 cases, respectively. The nadir lymphocyte count during lymphopenia, the peak level of lactate dehydrogenase, and the peak density of pulmonary infiltrates lag further behind the peak viral load by a median of 4, 5, and 3.5 days, respectively. These findings provide important information for therapeutic strategies to treat SARS.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antiviral Agents / therapeutic use
  • Female
  • Humans
  • Interleukin-6 / blood*
  • Interleukin-8 / blood*
  • Male
  • Middle Aged
  • Ribavirin / therapeutic use*
  • Severe Acute Respiratory Syndrome / drug therapy*
  • Severe acute respiratory syndrome-related coronavirus
  • Time Factors
  • Viral Load*


  • Antiviral Agents
  • Interleukin-6
  • Interleukin-8
  • Ribavirin