Fatal severe acute respiratory syndrome is associated with multiorgan involvement by coronavirus

Abstract

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 × 1010 copies/g) and bowel (2.7 × 109 copies/g). Fatal SARS was associated with muitiorgan viral dissemination in a distribution that has implications for disease manifestation, viral shedding, and transmission.