SARS in Hong Kong

To the Editor: Lee et al. (May 15 issue)1 describe the clinical and laboratory features of 138 cases of suspected severe acute respiratory syndrome (SARS) in Hong Kong. It is striking that 44.8 percent of the patients had thrombocytopenia, 45.0 percent had elevated levels of D-dimers, and 42.8 percent had a prolonged activated partial-thromboplastin time. This combination suggests the presence of a form of disseminated intravascular coagulation2 or pulmonary-induced coagulation and fibrin polymerization with consumption of platelets and clotting factors. Elevated D-dimer levels have also been reported in patients with acute lung injury and in patients with the acute respiratory . . .