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Newly discovered coronavirus as the primary cause of severe acute respiratory syndrome.

Abstract : BACKGROUND: The worldwide outbreak of severe acute respiratory syndrome (SARS) is associated with a newly discovered coronavirus, SARS-associated coronavirus (SARS-CoV). We did clinical and experimental studies to assess the role of this virus in the cause of SARS. METHODS: We tested clinical and postmortem samples from 436 SARS patients in six countries for infection with SARS-CoV, 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. FINDINGS: 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. INTERPRETATION: 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.
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https://hal-pasteur.archives-ouvertes.fr/pasteur-00167032
Contributor : Christiane Goisnard <>
Submitted on : Tuesday, August 14, 2007 - 10:52:37 AM
Last modification on : Friday, March 27, 2020 - 3:47:18 AM

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Thijs Kuiken, Ron a M Fouchier, Martin Schutten, Guus F Rimmelzwaan, Geert van Amerongen, et al.. Newly discovered coronavirus as the primary cause of severe acute respiratory syndrome.. The Lancet, Elsevier, 2003, 362 (9380), pp.263-70. ⟨10.1016/S0140-6736(03)13967-0⟩. ⟨pasteur-00167032⟩

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