title: Multiple organ infection and the pathogenesis of SARS.
abstract: 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.
authors.affiliation: Department of Pathology, Peking University, Beijing, China 100083. jgu@privatedoctor.org
authors.forename: Jiang
authors.initials: J
authors.lastname: Gu
authors.forename: Encong
authors.initials: E
authors.lastname: Gong
authors.forename: Bo
authors.initials: B
authors.lastname: Zhang
authors.forename: Jie
authors.initials: J
authors.lastname: Zheng
authors.forename: Zifen
authors.initials: Z
authors.lastname: Gao
authors.forename: Yanfeng
authors.initials: Y
authors.lastname: Zhong
authors.forename: Wanzhong
authors.initials: W
authors.lastname: Zou
authors.forename: Jun
authors.initials: J
authors.lastname: Zhan
authors.forename: Shenglan
authors.initials: S
authors.lastname: Wang
authors.forename: Zhigang
authors.initials: Z
authors.lastname: Xie
authors.forename: Hui
authors.initials: H
authors.lastname: Zhuang
authors.forename: Bingquan
authors.initials: B
authors.lastname: Wu
authors.forename: Haohao
authors.initials: H
authors.lastname: Zhong
authors.forename: Hongquan
authors.initials: H
authors.lastname: Shao
authors.forename: Weigang
authors.initials: W
authors.lastname: Fang
authors.forename: Dongshia
authors.initials: D
authors.lastname: Gao
authors.forename: Fei
authors.initials: F
authors.lastname: Pei
authors.forename: Xingwang
authors.initials: X
authors.lastname: Li
authors.forename: Zhongpin
authors.initials: Z
authors.lastname: He
authors.forename: Danzhen
authors.initials: D
authors.lastname: Xu
authors.forename: Xeying
authors.initials: X
authors.lastname: Shi
authors.forename: Virginia M
authors.initials: VM
authors.lastname: Anderson
authors.forename: Anthony S-Y
authors.initials: AS
authors.lastname: Leong
mesh_terms: 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