A significant percentage of confirmed severe acute respiratory syndrome (SARS) patients experienced gastrointestinal symptoms, and the viral sequence was detectable in the stool of most patients.
At present, the knowledge of the pathology of the digestive system in SARS patients is limited.
Because a resurgence of the SARS epidemic is constantly possible, there is an urgent need to understand the involvement of the digestive system in this new disease.
Professor Gu and colleagues from Bejing in China performed seven SARS autopsies.
The investigators examined samples of alimentary tract and digestive glands using routine pathology, electron microscopy (EM), in situ hybridization (ISH), immunohistochemistry, and real-time polymerase chain reaction (PCR).
|SARS-coronavirus (CoV)-like particles were detected in the mucosal epithelial cells under EM and mild focal inflammation in the alimentary tract|
|American Journal of Gastroenterology|
The researchers noted that atrophy of the mucosal lymphoid tissue was the main histological finding.
A few mucosal epithelial cells and lymphocytes in the intestine were positively stained for coronavirus with ISH.
The researchers found SARS-coronavirus (CoV)-like particles in the mucosal epithelial cells under EM and mild focal inflammation was detected in the alimentary tract.
The research team noted that 1 patient who experienced severe diarrhea had pseudomembranous enteritis of the ileum.
The research team observed fatty degeneration and central lobular necrosis in the liver.
The researchers, however found no evidence of direct viral infection in the esophagus, the stomach, the salivary gland, the liver, or the pancreas.
Professor Gu concluded, "In addition to the lungs, the gastrointestinal tract is another target of SARS-CoV infection, as the intestinal epithelial cells and mucosal lymphoid tissue are infected."
"The findings provide possible explanations for the gastrointestinal symptoms and the presence of virus in the stool of SARS patients."