Mazzulli Tony, Farcas Gabriella A, Poutanen Susan M, Willey Barbara M, Low Donald E, Butany Jagdish, Asa Sylvia L, Kain Kevin C
Toronto Medical Labaratories/Mount Sinai Hospital Department of Microbiology, Toronto, Ontario, Canada.
Emerg Infect Dis. 2004 Jan;10(1):20-4. doi: 10.3201/eid1001.030404.
Efforts to contain severe acute respiratory syndrome (SARS) have been limited by the lack of a standardized, sensitive, and specific test for SARS-associated coronavirus (CoV). We used a standardized reverse transcription-polymerase chain reaction assay to detect SARS-CoV in lung samples obtained from well-characterized patients who died of SARS and from those who died of other reasons. SARS-CoV was detected in all 22 postmortem lung tissues (to 10(9) viral copies/g) from 11 patients with probable SARS but was not detected in any of the 23 lung control samples (sample analysis was blinded). The sensitivity and specificity (95% confidence interval) were 100% (84.6% to 100%) and 100% (85.1% to 100%), respectively. Viral loads were significantly associated with a shorter course of illness but not with the use of ribavirin or steroids. CoV was consistently identified in the lungs of all patients who died of SARS but not in control patients, supporting a primary role for CoV in deaths.
由于缺乏针对严重急性呼吸综合征冠状病毒（SARS-CoV）的标准化、灵敏且特异的检测方法，控制严重急性呼吸综合征（SARS）的努力受到了限制。我们使用标准化的逆转录-聚合酶链反应检测法，对从确诊死于SARS的患者以及死于其他原因的患者获取的肺样本进行SARS-CoV检测。在11例可能患有SARS的患者的所有22份尸检肺组织中（每克组织含10^9个病毒拷贝）均检测到SARS-CoV，但在23份肺对照样本中均未检测到（样本分析采用盲法）。敏感性和特异性（95%置信区间）分别为100%（84.6%至100%）和100%（85.1%至100%）。病毒载量与病程较短显著相关，但与利巴韦林或类固醇的使用无关。在所有死于SARS的患者的肺中均持续检测到冠状病毒，但在对照患者中未检测到，这支持了冠状病毒在死亡中起主要作用的观点。
