The clinical pathology of severe acute respiratory syndrome (SARS): a report from China

By Yanqing Ding, Hui-jun Wang, Hong Shen, Zhuguo Li, Jian Geng, Hui-xia Han, Jun-jie Cai, Xin Li, Wei Kang, Desheng Weng and 4 more. Journal of Pathology, 2003

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In order to investigate the clinical pathology of severe acute respiratory syndrome (SARS), the autopsies of three patients who died from SARS in Nan Fang Hospital Guangdong, China were studied retrospectively. Routine haematoxylin and eosin (H&E) staining was used to study all of the tissues from the three cases. The lung tissue specimens were studied further with Macchiavello staining, viral inclusion body staining, reticulin staining, PAS staining, immunohistochemistry, ultrathin sectioning and staining, light microscopy, and transmission electron microscopy. The first symptom was hyperpyrexia in all three cases, followed by progressive dyspnoea and lung field shadowing. The pulmonary lesions included bilateral extensive consolidation, localized haemorrhage and necrosis, desquamative pulmonary alveolitis and bronchitis, proliferation and desquamation of alveolar epithelial cells, exudation of protein and monocytes, lymphocytes and plasma cells in alveoli, hyaline membrane formation, and viral inclusion bodies in alveolar epithelial cells. There was also massive necrosis of splenic lymphoid tissue and localized necrosis in lymph nodes. Systemic vasculitis included oedema, localized fibrinoid necrosis, and infiltration of monocytes, lymphocytes, and plasma cells into vessel walls in the heart, lung, liver, kidney, adrenal gland, and the stroma of striated muscles. Thrombosis was present in small veins. Systemic toxic changes included degeneration and necrosis of the parenchyma cells in the lung, liver, kidney, heart, and adrenal gland. Electron microscopy demonstrated clusters of viral particles, consistent with coronavirus, in lung tissue. SARS is a systemic disease that injures many organs. The lungs, immune organs, and systemic small vessels are the main targets of virus attack, so that extensive consolidation of the lung, diffuse alveolar damage with hyaline membrane formation, respiratory distress, and decreased immune function are the main causes of death. Copyright © 2003 John Wiley & Sons, Ltd.

Subfields: Epidemiology, Infectious Diseases

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Citations in the corpus

Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis (2004, background): “The main targets of SARS-CoV are the lungs, immune organs, and systemic small vessels, resulting in systemic vasculitis, decreased immune function, and respiratory distress caused by extensive pulmonary consolidation and diffuse alveolar damage with hyaline membrane formation [5]: the latter causes ”
Coronavirus Disease 2019: Coronaviruses and Blood Safety (2020, neutral): “MERS-CoV, which was isolated in 2012, is similar to SARS-CoV — both can infect the lower respiratory tract and usually cause a severe respiratory syndromeinhumans[14]witha casefatality rate of 35.5% and 10%, respectively[15].”
Severe Acute Respiratory Syndrome Coronavirus as an Agent of Emerging and Reemerging Infection (2007, background): “and plasma cells were noted in one report (87).”
Binding of SARS coronavirus to its receptor damages islets and causes acute diabetes (2009, background): “b Multivariate baseline predictors of death including old age (C60 years), elevated ALT (C80 IU/l), elevated LDH (C250 IU/l) and hyperglycemia (FPG C7.0 mmol/l) among the SARS patients, presented by hazard ratio and 95% CI The multi-system nature of SARS infection has been demonstrated in several au”
Coagulation disorders in coronavirus infected patients: COVID-19, SARS-CoV-1, MERS-CoV and lessons from the past (2020, background): “Additionally, thrombi have been identified in pulmonary, bronchial, and small lung veins of postmortem SARS-CoV-1 infected lung autopsies, suggesting a prothrombotic effect of the SARS-CoV-1 virus, mainly affecting the pulmonary vasculature [19,21,25].”
Coronavirus Pathogenesis and the Emerging Pathogen Severe Acute Respiratory Syndrome Coronavirus (2005, background): “However, SARS patients may also exhibit gastrointestinal symptoms (313) and splenic atrophy and lymphadenopathy (79).”
COVID-19: what has been learned and to be learned about the novel coronavirus disease (2020, result): “On February 18, 2020, the first pathological analysis of COVID-19 demonstrated the desquamation of pneumocytes, hyaline membrane formation, and interstitial lymphocyte infiltration, and multinucleated syncytial cells in the lungs of a patient who died of the disease, consistent with the pathology of”