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Newly discovered coronavirus as the primary cause of severe acute respiratory syndrome.
- Source :
-
Lancet (London, England) [Lancet] 2003 Jul 26; Vol. 362 (9380), pp. 263-70. - Publication Year :
- 2003
-
Abstract
- Background: The worldwide outbreak of severe acute respiratory syndrome (SARS) is associated with a newly discovered coronavirus, SARS-associated coronavirus (SARS-CoV). We did clinical and experimental studies to assess the role of this virus in the cause of SARS.<br />Methods: We tested clinical and postmortem samples from 436 SARS patients in six countries for infection with SARS-CoV, human metapneumovirus, and other respiratory pathogens. We infected four cynomolgus macaques (Macaca fascicularis) with SARS-CoV in an attempt to replicate SARS and did necropsies on day 6 after infection.<br />Findings: SARS-CoV infection was diagnosed in 329 (75%) of 436 patients fitting the case definition of SARS; human metapneumovirus was diagnosed in 41 (12%) of 335, and other respiratory pathogens were diagnosed only sporadically. SARS-CoV was, therefore, the most likely causal agent of SARS. The four SARS-CoV-infected macaques excreted SARS-CoV from nose, mouth, and pharynx from 2 days after infection. Three of four macaques developed diffuse alveolar damage, similar to that in SARS patients, and characterised by epithelial necrosis, serosanguineous exudate, formation of hyaline membranes, type 2 pneumocyte hyperplasia, and the presence of syncytia. SARS-CoV was detected in pneumonic areas by virus isolation and RT-PCR, and was localised to alveolar epithelial cells and syncytia by immunohistochemistry and transmission electron microscopy.<br />Interpretation: Replication in SARS-CoV-infected macaques of pneumonia similar to that in human beings with SARS, combined with the high prevalence of SARS-CoV infection in SARS patients, fulfill the criteria required to prove that SARS-CoV is the primary cause of SARS.
- Subjects :
- Animals
China epidemiology
Communicable Diseases, Emerging epidemiology
Communicable Diseases, Emerging virology
Disease Models, Animal
Disease Outbreaks
Global Health
Humans
Macaca fascicularis
Pulmonary Alveoli pathology
Pulmonary Alveoli virology
Severe acute respiratory syndrome-related coronavirus pathogenicity
Severe Acute Respiratory Syndrome epidemiology
Severe Acute Respiratory Syndrome pathology
Severe acute respiratory syndrome-related coronavirus isolation & purification
Severe Acute Respiratory Syndrome virology
Subjects
Details
- Language :
- English
- ISSN :
- 1474-547X
- Volume :
- 362
- Issue :
- 9380
- Database :
- MEDLINE
- Journal :
- Lancet (London, England)
- Publication Type :
- Academic Journal
- Accession number :
- 12892955
- Full Text :
- https://doi.org/10.1016/S0140-6736(03)13967-0