Multiple organ infection and the pathogenesis of SARS.
After >8,000 infections and >700 deaths worldwide, the pathogenesis of the new infectious disease, severe acute respiratory syndrome (SARS), remains poorly understood. We investigated 18 autopsies of patients who had suspected SARS; 8 cases were confirmed as SARS. We evaluated white blood cells from 22 confirmed SARS patients at various stages of the disease. T lymphocyte counts in 65 confirmed and 35 misdiagnosed SARS cases also were analyzed retrospectively. SARS viral particles and genomic sequence were detected in a large number of circulating lymphocytes, monocytes, and lymphoid tissues, as well as in the epithelial cells of the respiratory tract, the mucosa of the intestine, the epithelium of the renal distal tubules, the neurons of the brain, and macrophages in different organs. SARS virus seemed to be capable of infecting multiple cell types in several organs; immune cells and pulmonary epithelium were identified as the main sites of injury. A comprehensive theory of pathogenesis is proposed for SARS with immune and lung damage as key features.
Gu
Jiang
J
Department of Pathology, Peking University, Beijing, China 100083. jgu@privatedoctor.org
Gong
Encong
E
Zhang
Bo
B
Zheng
Jie
J
Gao
Zifen
Z
Zhong
Yanfeng
Y
Zou
Wanzhong
W
Zhan
Jun
J
Wang
Shenglan
S
Xie
Zhigang
Z
Zhuang
Hui
H
Wu
Bingquan
B
Zhong
Haohao
H
Shao
Hongquan
H
Fang
Weigang
W
Gao
Dongshia
D
Pei
Fei
F
Li
Xingwang
X
He
Zhongpin
Z
Xu
Danzhen
D
Shi
Xeying
X
Anderson
Virginia M
VM
Leong
Anthony S-Y
AS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy; D001921:Brain / Q000473:pathology / Q000821:virology; D005260:Female; D006801:Humans; D007422:Intestines / Q000473:pathology / Q000821:virology; D007686:Kidney Tubules, Distal / Q000473:pathology / Q000821:virology; D007962:Leukocytes / Q000473:pathology / Q000821:virology; D008168:Lung; D008221:Lymphoid Tissue / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D012137:Respiratory System / Q000473:pathology / Q000821:virology; D012189:Retrospective Studies; D045473:Severe acute respiratory syndrome-related coronavirus; D045169:Severe Acute Respiratory Syndrome / Q000401:mortality / Q000473:pathology* / Q000821:virology