This study used cell culture and molecular techniques to identify the infectious agent associated with SARS. A novel coronavirus was found in multiple samples from 18 patients but in no specimens from control subjects. In the patients there were high concentrations of viral RNA in sputum, a finding consistent with a highly infectious agent. Low concentrations of viral RNA were also detected in stool.

This report describes 10 epidemiologically linked patients in Hong Kong in whom SARS was diagnosed between late February and late March. They presented with fever, cough, malaise, dyspnea, and hypoxemia. Chest radiographs showed progressive airway disease. In the two patients who died, examination of the lungs showed diffuse alveolar damage.

In Canada, SARS was identified in 10 patients who presented with fever, malaise, and nonproductive cough. In most, there was lymphopenia and elevated levels of lactate dehydrogenase and creatine kinase. Five patients required mechanical ventilation, and three died. Laboratory studies of sputum samples found both human metapneumovirus and a novel coronavirus.

Heart failure is a costly and deadly condition that currently affects nearly 5 million Americans. The incidence approaches 10 per 1000 population among persons older than 65 years of age. This review highlights current pathophysiological concepts and discusses available therapies for a range of patients — from those at risk to those with widespread disease.

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