Multiple organ infection and the pathogenesis of SARS

Gu, Jiang; Gong, Encong; Zhang, Bo; Zheng, Jie; Gao, Zifen; Zhong, Yanfeng; Zou, Wanzhong; Zhan, Jun; Wang, Shenglan; Xie, Zhigang; Zhuang, Hui; Wu, Bingquan; Zhong, Haohao; Shao, Hongquan; Fang, Weigang; Gao, Dongshia; Pei, Fei; Li, Xingwang; He, Zhongpin; Xu, Danzhen; Shi, Xeying; Anderson, Virginia M.; Leong, Anthony S.-Y.

The pathologic changes in the digestive tract, and the direct viral infection of mucosal epithelial cells and lymphoid tissue in the mucosa and the submucosa of small and large intestines, provide an explanation for the presence of the virus in the stool of patients who have SARS. Approximately 29% to 39.2% of patients who have SARS have diarrhea and other digestive tract symptoms, and these symptoms occurred ‫5.7-5.3ف‬ d after the onset of fever (15, 16) . This period likely is required for the virus to infect the immune cells that circulate to attack and damage the gut. The continued The data indicate that the lymphocytes were decreased from the onset of the disease in patients who had SARS but not in patients who did not have SARS (confirmed SARS, n ϭ 15; misdiagnosed cases, n ϭ 15). D, E, and F show the cell counts of CD3, CD4, and CD8, respectively, in patients who had confirmed or misdiagnosed SARS at various time points after the onset of symptoms and who were treated with glucocorticoids (confirmed SARS, n ϭ 50; misdiagnosed cases, n ϭ 20). The lymphocytes were decreased in both groups. However, the differences in the two groups with regard to the extent of lymphocyte reduction remained the same. The results from the retrospective investigation suggest that lymphopenia is a characteristic feature of SARS, and implicates an early and consistent destruction of lymphocytes.