- Jeff...
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- The below story is suggesting that the steroids used
in treatment of SARS are the cause of the brain and nerve damage. It is
my contention, as has been published on your site, that SARS cornavirus,
itself, is the cause of the brain and nerve damage. SARS coronavirus uses
CD13 pathway to attack cells and will, therefore, attack glial cells and
myelin-bearing cells of the nervous system.
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- Bob Lee
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- Sars Patients 'Suffer Brain Damage' From Steroid Cocktail
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- By Adam Luck in Hong Kong
- The Telegraph - UK
- 6-1-3
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- Psychiatrists believe that up to 50 per cent of surviving
Sars patients may have early signs of possibly irreversible brain and nerve
damage after steroids were used experimentally to combat the potentially
fatal virus.
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- Recovering <http://www.dailytelegraph.co.uk/global/main.jhtml?xml=/global/2003/05/07/nsars.xml>Sars
patients in Hong Kong have suffered from hallucinations, manic behaviour,
rapid mood swings and memory loss after being treated with large doses
of steroids.
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- Many are doctors and nurses who have found their concentration
and short-term memory impaired since returning to work. Sars specialists
say that it is too early to tell whether the problems are permanent.
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- Ernie Lo, an intern at Queen Elizabeth Hospital, was
one of the first doctors infected with Sars. Although he was discharged
in April, the after-effects of the virus linger on.
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- "I thought that it was because I had not used my
brain for so long after being stuck in hospital as a patient that I had
lost my concentration," said Dr Lo. "But after I got back to
work, I still could not concentrate as easily as before.
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- "Although this has now improved, it is not as good
as in the past. It would appear that this is due to the medication or the
illness itself, and this may cause central nervous system impairment."
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- The disturbing evidence has emerged as health authorities
in Hong Kong begin to assess the hidden physical and mental costs of the
Sars outbreak.
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- Until now, concern about the cocktail treatment, which
combines Ribavirin - a viral suppressant - with steroids, has focused on
the steroids' potential physical side-effects. These can include damage
to the heart, liver and blood, and deformities in unborn children. Specialists
now believe that the pioneering treatment also has neuro-psychiatric effects.
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- "Cortico-steroids are known for creating side-effects
and neuro-psychiatric complications," said Dr Ronald Chen, a psychiatrist
from Queen Mary Hospital. "These vary from a sense of euphoria to
irritability, irrelevant speech and paranoia.
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- "But my concern is not only these mood disorders.
I am more concerned with impaired memory and cognitive functions, because,
from my experience, more than 50 per cent of patients are likely to have
various degrees of memory loss."
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- Dr Chen says that the symptoms suggest that the steroids
have damaged the patients' hippocampus, the part of the brain responsible
for memory.
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- He said that many healthcare workers infected by Sars,
who make up one of the largest groups of patients, were reluctant to see
him formally. So far, he has seen only five out of 50 patients treated
by the hospital.
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- "I know [about the side-effects] from my personal
contacts who have complained about memory loss. I guess, however, that
we are under-referred. If it is low-grade euphoria or depression, they
may not be considered for referral to us, and many healthcare workers hate
to see a psychiatrist."
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- Asthmatics who are treated in hospital with the steroid
in question, Prednisolone, would normally take 30mg daily over 10 days.
Doctors treating Sars victims prescribe 200mg a day for up to three weeks.
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- Leung Chi-ming, a consultant psychiatrist at Sha Tin
Hospital, who has screened more than 100 recovering Sars patients, agreed
that about 50 per cent of patients were experiencing neurological problems.
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- "The dose given is huge and if you go through medical
literature, this treatment-induced disorder relates to disorder,"
he said. "There is no question that this is neurological damage and
it relates to the use of steroids. The question is whether it is reversible.
We have so little experience of this kind of huge dose that we do not know."
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- Doctors admit that the cocktail of steroids and Ribavirin
is used as a last resort and that little is known about how the treatment
combats Sars. They say, however, that it is a gamble worth taking. Dr Kenneth
Tsang, a Sars authority, said: "Make no mistake, there is no choice.
This treatment saves lives and we have no alternative."
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