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A cohort autopsy study defines COVID-19 systemic pathogenesis
Severe COVID-19 disease caused by SARS-CoV-2 is frequently accompanied by dysfunction of the lungs and extrapulmonary organs. However, the organotropism of SARS-CoV-2 and the port of virus entry for systemic dissemination remain largely unknown. We profiled 26 COVID-19 autopsy cases from four cohort...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Singapore
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8208380/ https://www.ncbi.nlm.nih.gov/pubmed/34135479 http://dx.doi.org/10.1038/s41422-021-00523-8 |
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author | Yao, Xiao-Hong Luo, Tao Shi, Yu He, Zhi-Cheng Tang, Rui Zhang, Pei-Pei Cai, Jun Zhou, Xiang-Dong Jiang, Dong-Po Fei, Xiao-Chun Huang, Xue-Quan Zhao, Lei Zhang, Heng Wu, Hai-Bo Ren, Yong Liu, Zhen-Hua Zhang, Hua-Rong Chen, Cong Fu, Wen-Juan Li, Heng Xia, Xin-Yi Chen, Rong Wang, Yan Liu, Xin-Dong Yin, Chang-Lin Yan, Ze-Xuan Wang, Juan Jing, Rui Li, Tai-Sheng Li, Wei-Qin Wang, Chao-Fu Ding, Yan-Qing Mao, Qing Zhang, Ding-Yu Zhang, Shu-Yang Ping, Yi-Fang Bian, Xiu-Wu |
author_facet | Yao, Xiao-Hong Luo, Tao Shi, Yu He, Zhi-Cheng Tang, Rui Zhang, Pei-Pei Cai, Jun Zhou, Xiang-Dong Jiang, Dong-Po Fei, Xiao-Chun Huang, Xue-Quan Zhao, Lei Zhang, Heng Wu, Hai-Bo Ren, Yong Liu, Zhen-Hua Zhang, Hua-Rong Chen, Cong Fu, Wen-Juan Li, Heng Xia, Xin-Yi Chen, Rong Wang, Yan Liu, Xin-Dong Yin, Chang-Lin Yan, Ze-Xuan Wang, Juan Jing, Rui Li, Tai-Sheng Li, Wei-Qin Wang, Chao-Fu Ding, Yan-Qing Mao, Qing Zhang, Ding-Yu Zhang, Shu-Yang Ping, Yi-Fang Bian, Xiu-Wu |
author_sort | Yao, Xiao-Hong |
collection | PubMed |
description | Severe COVID-19 disease caused by SARS-CoV-2 is frequently accompanied by dysfunction of the lungs and extrapulmonary organs. However, the organotropism of SARS-CoV-2 and the port of virus entry for systemic dissemination remain largely unknown. We profiled 26 COVID-19 autopsy cases from four cohorts in Wuhan, China, and determined the systemic distribution of SARS-CoV-2. SARS-CoV-2 was detected in the lungs and multiple extrapulmonary organs of critically ill COVID-19 patients up to 67 days after symptom onset. Based on organotropism and pathological features of the patients, COVID-19 was divided into viral intrapulmonary and systemic subtypes. In patients with systemic viral distribution, SARS-CoV-2 was detected in monocytes, macrophages, and vascular endothelia at blood–air barrier, blood–testis barrier, and filtration barrier. Critically ill patients with long disease duration showed decreased pulmonary cell proliferation, reduced viral RNA, and marked fibrosis in the lungs. Permanent SARS-CoV-2 presence and tissue injuries in the lungs and extrapulmonary organs suggest direct viral invasion as a mechanism of pathogenicity in critically ill patients. SARS-CoV-2 may hijack monocytes, macrophages, and vascular endothelia at physiological barriers as the ports of entry for systemic dissemination. Our study thus delineates systemic pathological features of SARS-CoV-2 infection, which sheds light on the development of novel COVID-19 treatment. |
format | Online Article Text |
id | pubmed-8208380 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer Singapore |
record_format | MEDLINE/PubMed |
spelling | pubmed-82083802021-06-17 A cohort autopsy study defines COVID-19 systemic pathogenesis Yao, Xiao-Hong Luo, Tao Shi, Yu He, Zhi-Cheng Tang, Rui Zhang, Pei-Pei Cai, Jun Zhou, Xiang-Dong Jiang, Dong-Po Fei, Xiao-Chun Huang, Xue-Quan Zhao, Lei Zhang, Heng Wu, Hai-Bo Ren, Yong Liu, Zhen-Hua Zhang, Hua-Rong Chen, Cong Fu, Wen-Juan Li, Heng Xia, Xin-Yi Chen, Rong Wang, Yan Liu, Xin-Dong Yin, Chang-Lin Yan, Ze-Xuan Wang, Juan Jing, Rui Li, Tai-Sheng Li, Wei-Qin Wang, Chao-Fu Ding, Yan-Qing Mao, Qing Zhang, Ding-Yu Zhang, Shu-Yang Ping, Yi-Fang Bian, Xiu-Wu Cell Res Article Severe COVID-19 disease caused by SARS-CoV-2 is frequently accompanied by dysfunction of the lungs and extrapulmonary organs. However, the organotropism of SARS-CoV-2 and the port of virus entry for systemic dissemination remain largely unknown. We profiled 26 COVID-19 autopsy cases from four cohorts in Wuhan, China, and determined the systemic distribution of SARS-CoV-2. SARS-CoV-2 was detected in the lungs and multiple extrapulmonary organs of critically ill COVID-19 patients up to 67 days after symptom onset. Based on organotropism and pathological features of the patients, COVID-19 was divided into viral intrapulmonary and systemic subtypes. In patients with systemic viral distribution, SARS-CoV-2 was detected in monocytes, macrophages, and vascular endothelia at blood–air barrier, blood–testis barrier, and filtration barrier. Critically ill patients with long disease duration showed decreased pulmonary cell proliferation, reduced viral RNA, and marked fibrosis in the lungs. Permanent SARS-CoV-2 presence and tissue injuries in the lungs and extrapulmonary organs suggest direct viral invasion as a mechanism of pathogenicity in critically ill patients. SARS-CoV-2 may hijack monocytes, macrophages, and vascular endothelia at physiological barriers as the ports of entry for systemic dissemination. Our study thus delineates systemic pathological features of SARS-CoV-2 infection, which sheds light on the development of novel COVID-19 treatment. Springer Singapore 2021-06-16 2021-08 /pmc/articles/PMC8208380/ /pubmed/34135479 http://dx.doi.org/10.1038/s41422-021-00523-8 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Yao, Xiao-Hong Luo, Tao Shi, Yu He, Zhi-Cheng Tang, Rui Zhang, Pei-Pei Cai, Jun Zhou, Xiang-Dong Jiang, Dong-Po Fei, Xiao-Chun Huang, Xue-Quan Zhao, Lei Zhang, Heng Wu, Hai-Bo Ren, Yong Liu, Zhen-Hua Zhang, Hua-Rong Chen, Cong Fu, Wen-Juan Li, Heng Xia, Xin-Yi Chen, Rong Wang, Yan Liu, Xin-Dong Yin, Chang-Lin Yan, Ze-Xuan Wang, Juan Jing, Rui Li, Tai-Sheng Li, Wei-Qin Wang, Chao-Fu Ding, Yan-Qing Mao, Qing Zhang, Ding-Yu Zhang, Shu-Yang Ping, Yi-Fang Bian, Xiu-Wu A cohort autopsy study defines COVID-19 systemic pathogenesis |
title | A cohort autopsy study defines COVID-19 systemic pathogenesis |
title_full | A cohort autopsy study defines COVID-19 systemic pathogenesis |
title_fullStr | A cohort autopsy study defines COVID-19 systemic pathogenesis |
title_full_unstemmed | A cohort autopsy study defines COVID-19 systemic pathogenesis |
title_short | A cohort autopsy study defines COVID-19 systemic pathogenesis |
title_sort | cohort autopsy study defines covid-19 systemic pathogenesis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8208380/ https://www.ncbi.nlm.nih.gov/pubmed/34135479 http://dx.doi.org/10.1038/s41422-021-00523-8 |
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