Newly discovered coronavirus as the primary cause of severe acute respiratory syndrome.
Newly discovered coronavirus as the primary cause of severe acute respiratory syndrome.
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DOI：
10.1016/s0140-6736(03)13967-0
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发表时间：
2003-07-26
期刊：
影响因子：
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通讯作者：
Osterhaus AD
中科院分区：
文献类型：
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作者：
Kuiken T;Fouchier RA;Schutten M;Rimmelzwaan GF;van Amerongen G;van Riel D;Laman JD;de Jong T;van Doornum G;Lim W;Ling AE;Chan PK;Tam JS;Zambon MC;Gopal R;Drosten C;van der Werf S;Escriou N;Manuguerra JC;Stöhr K;Peiris JS;Osterhaus AD
严重急性呼吸综合症（SARS）的全球爆发与新发现的冠状病毒，与SARS相关的冠状病毒（SARSCOV）有关。我们进行了临床和实验研究，以评估该病毒在SARS原因中的作用。
我们测试了来自六个国家 /地区的436名SARS患者的临床和验尸样本，以感染Sarscov，人类元瘤病毒和其他呼吸道病原体。我们用SARS-COV感染了四个Cynomolgus Macaques（Macaca fascicularis），以试图复制SARS并在感染后的第6天进行尸检。
在适合SARS病例定义的436名患者中，有329名患者中有329名（75％）诊断出SARS-COV感染；在335例中有41例（12％）诊断出人元病毒，其他呼吸道病原体仅偶尔诊断。因此，SARS-COV是最有可能的SARS因果因素。感染后2天，从鼻子，嘴和咽部从鼻子，口和咽部排出了四个SARS-COV感染的猕猴。四个猕猴中有三个出现了弥漫性肺泡损伤，类似于SARS患者的肿瘤损伤，其特征是上皮坏死，血清语言渗出液，透明膜的形成，2型肺细胞增生和合成症的存在。通过病毒分离和RT-PCR在肺炎区域中检测到SARS-COV，并通过免疫组织化学和透射电子显微镜将其定位于肺泡上皮细胞和合成症。
SARS-COV感染的肺炎猕猴的复制类似于与SARS的人类相似的，以及SARS患者中SARS-COV感染的高流行率，满足证明SARS-COV是SARS的主要原因所需的标准。
2003年7月22日在线发布http://image.thelancet.com/extras/03art6318web.pdf
The worldwide outbreak of severe acute respiratory syndrome (SARS) is associated with a newly discovered coronavirus, SARS-associated coronavirus (SARSCoV). We did clinical and experimental studies to assess the role of this virus in the cause of SARS. We tested clinical and postmortem samples from 436 SARS patients in six countries for infection with SARSCoV, 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. 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. 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. Published online July 22, 2003 http://image.thelancet.com/extras/03art6318web.pdf