Severe Acute Respiratory Syndrome Associated Coronavirus Is Detected in Intestinal Tissues of Fatal Cases

Shi, Xueying; Gong, Encong; Gao, Dongxia; Zhang, Bo; Zheng, Jie; Gao, Zifen; Zhong, Yan; Zou, Wan-zhong; Wu, Bingquan; Fang, Wei‐Gang; Liao, Sian; Wang, Shenglan; Xie, Zhigang; Lü, Min; Hou, Lin; Zhong, Hao; Shao, Hanjuan; Li, Ning; Liu, Congrong; Pei, Fei; Yang, Jenny; Wang, Yuping; Zhao, Han; Shi, Xia; Zhang, Qianying; You, Jing; Zhu, Xuan; Gu, Jiang

doi:10.1111/j.1572-0241.2005.40377.x

Cited by 94 publications

(101 citation statements)

References 27 publications

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“…In general, no changes have been evident on gross examination of the digestive system. In some confirmed SARS cases, mild diffused inflammation of the digestive tract, together with autolytic changes have been reported Shi et al, 2005;, whereas other authors have reported no histological abnormalities (Lang et al, 2003;Leung et al, 2003). The most prominent histopathological change, which has been reported in the digestive tract, is atrophy of the submucosal lymphoid tissues , which is described in detail in Section 2.2 of this review.…”

Section: Digestive Tractmentioning

confidence: 82%

“…Liver tissues of SARS autopsies have shown numerous hepatocyte mitoses, balloon degeneration of hepatocytes and mild to moderate lymphocytic infiltrates (Chau et al, 2004;Lang et al, 2003). Fatty degeneration and central lobular necrosis have also been reported (Ding et al, 2003;Gu et al, 2005;Lang et al, 2003;Shi et al, 2005). Apoptosis was evident in all three SARS cases reported by Chau et al (2004).…”

Section: Livermentioning

confidence: 83%

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Pathogenetic mechanisms of severe acute respiratory syndrome

et al. 2008

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Severe acute respiratory syndrome (SARS) is an acute respiratory disease with significant morbidity and mortality. While its clinical manifestations have been extensively studied, its pathogenesis is not yet fully understood. A limited number of autopsy studies have revealed that the lungs and the immune system are the organs that sustain the most severe damage. Other organs affected include the kidneys, brain, digestive tract, heart, liver, thyroid gland and urogenital tract. The primary target cells are pneumocytes and enterocytes, both cell types abundantly expressing angiotensin-converting enzyme 2 which is the main SARS-CoV receptor. Other cell types infected include the epithelial cells of renal tubules, cerebral neurons, and immune cells. The pathology of this disease results from both direct and indirect injury. Direct injury is caused by infection of the target cells by the virus. Indirect injury mainly results from immune responses, circulatory dysfunction, and hypoxia. In this review, we summarize the major pathological findings at the gross, cellular and molecular levels and discuss the various possible mechanisms that may contribute to the pathogenesis of SARS. The implications of the proposed pathogenesis for prevention, diagnosis and therapy of the disease are discussed.

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Section: Digestive Tractmentioning

confidence: 82%

Section: Livermentioning

confidence: 83%

Pathogenetic mechanisms of severe acute respiratory syndrome

et al. 2008

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“…The virus may be present in anal swabs or blood of patients when oral swabs detection negative. In SARS-CoV and MERS-CoV infected patients, intestinal infection was observed at later stages of infection [7][8][9]. However, patients infected with 2019-nCoV may harbour the virus in the intestine at the early or late stage of disease.…”

Section: Discussionmentioning

confidence: 99%

Molecular and serological investigation of 2019-nCoV infected patients: implication of multiple shedding routes

Zhang

et al. 2020

Emerging Microbes & Infections

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In December 2019, a novel coronavirus (2019-nCoV) caused an outbreak in Wuhan, China, and soon spread to other parts of the world. It was believed that 2019-nCoV was transmitted through respiratory tract and then induced pneumonia, thus molecular diagnosis based on oral swabs was used for confirmation of this disease. Likewise, patient will be released upon two times of negative detection from oral swabs. However, many coronaviruses can also be transmitted through oralfecal route by infecting intestines. Whether 2019-nCoV infected patients also carry virus in other organs like intestine need to be tested. We conducted investigation on patients in a local hospital who were infected with this virus. We found the presence of 2019-nCoV in anal swabs and blood as well, and more anal swab positives than oral swab positives in a later stage of infection, suggesting shedding and thereby transmitted through oral-fecal route. We also showed serology test can improve detection positive rate thus should be used in future epidemiology. Our report provides a cautionary warning that 2019-nCoV may be shed through multiple routes.

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“…Detection of SARS-CoV in intestinal tissue of fatal SARS cases indicated that the gastrointestinal tract is another tar-get for SARS-CoV infection [38]. Hence, a vaccine candidate should ideally induce protective response in mucosal sites.…”

Section: Mucosal Igg and Iga Response In Micementioning

confidence: 99%

Antibodies against trimeric S glycoprotein protect hamsters against SARS-CoV challenge despite their capacity to mediate FcγRII-dependent entry into B cells in vitro

Kam

Kien

Roberts

et al. 2007

Vaccine

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239

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Vaccine-induced antibodies can prevent or, in the case of feline infectious peritonitis virus, aggravate infections by coronaviruses. We investigated whether a recombinant native full-length S-protein trimer (triSpike) of severe acute respiratory syndrome coronavirus (SARS-CoV) was able to elicit a neutralizing and protective immune response in animals and analyzed the capacity of anti-S antibodies to mediate antibody-dependent enhancement (ADE) of virus entry in vitro and enhancement of replication in vivo. SARS-CoV-specific serum and mucosal immunoglobulins were readily detected in immunized animals. Serum IgG blocked binding of the S-protein to the ACE2 receptor and neutralized SARS-CoV infection in vitro. Entry into human B cell lines occurred in a FcgammaRII-dependent and ACE2-independent fashion indicating that ADE of virus entry is a novel cell entry mechanism of SARS-CoV. Vaccinated animals showed no signs of enhanced lung pathology or hepatitis and viral load was undetectable or greatly reduced in lungs following challenge with SARS-CoV. Altogether our results indicate that a recombinant trimeric S protein was able to elicit an efficacious protective immune response in vivo and warrant concern in the safety evaluation of a human vaccine against SARS-CoV.

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Severe Acute Respiratory Syndrome Associated Coronavirus Is Detected in Intestinal Tissues of Fatal Cases

Cited by 94 publications

References 27 publications

Pathogenetic mechanisms of severe acute respiratory syndrome

Pathogenetic mechanisms of severe acute respiratory syndrome

Molecular and serological investigation of 2019-nCoV infected patients: implication of multiple shedding routes

Antibodies against trimeric S glycoprotein protect hamsters against SARS-CoV challenge despite their capacity to mediate FcγRII-dependent entry into B cells in vitro

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