Fatal Severe Acute Respiratory Syndrome Is Associated with Multiorgan Involvement by Coronavirus

Farcas, Gabriella A.; Poutanen, Susan M.; Mazzulli, Tony; Willey, Barbara M.; Butany, Jagdish; Asa, Sylvia L.; Faure, Peter; Akhavan, Poolak; Low, Donald E.; Kain, Kevin C.

Severe acute respiratory syndrome (SARS) is characterized by pulmonary compromise; however, patients often have evidence of other organ dysfunction that may reflect extrapulmonary dissemination of SARS coronavirus (SARS-CoV). We report on the distribution and viral load of SARS-CoV in multiple organ samples from patients who died of SARS during the Toronto outbreak. SARS-CoV was detected in lung (100%), bowel (73%), liver (41%), and kidney (38%) in 19 patients who died of SARS, with the highest viral loads observed in lung (1.0 × 10(10) copies/g) and bowel (2.7 × 10(9) copies/g). Fatal SARS was associated with multiorgan viral dissemination in a distribution that has implications for disease manifestation, viral shedding, and transmission.