4.6 Article

Multisystemic Cellular Tropism of SARS-CoV-2 in Autopsies of COVID-19 Patients

期刊

CELLS
卷 10, 期 8, 页码 -

出版社

MDPI
DOI: 10.3390/cells10081900

关键词

formalin-fixed paraffin-embedded (FFPE) tissue; post-mortem; histology; SARS-CoV-2; ACE2; TMPRSS2

资金

  1. Federal Ministry of Health [ZMVI1-2520COR201]
  2. Federal Ministry of Education and Research within the framework of the network of university medicine [01KX2021, STOP-FSGS-01GM1901A]
  3. German Research Foundation (DFG) [SFB/TRR219, 322900939, BO3755/13-1, 454024652, DJ100/1-1432698239]
  4. European Research Council (ERC) under the European Union's Horizon 2020 research and innovation program [101001791]
  5. RWTH START-program [125/17, 109/20]
  6. European Research Council (ERC)
  7. European Consolidator Grant [771883]

向作者/读者索取更多资源

The SARS-CoV-2 virus has been shown to have a multiorgan tropism, primarily infecting epithelial cells across various organs, and co-localizing with ACE2 and TMPRSS2. However, apart from the respiratory tract, there were no specific histomorphologic alterations attributed to SARS-CoV-2 infection in other organs.
Multiorgan tropism of SARS-CoV-2 has previously been shown for several major organs. We have comprehensively analyzed 25 different formalin-fixed paraffin-embedded (FFPE) tissues/organs from autopsies of fatal COVID-19 cases (n = 8), using histopathological assessment, detection of SARS-CoV-2 RNA using polymerase chain reaction and RNA in situ hybridization, viral protein using immunohistochemistry, and virus particles using transmission electron microscopy. SARS-CoV-2 RNA was mainly localized in epithelial cells across all organs. Next to lung, trachea, kidney, heart, or liver, viral RNA was also found in tonsils, salivary glands, oropharynx, thyroid, adrenal gland, testicles, prostate, ovaries, small bowel, lymph nodes, skin and skeletal muscle. Viral RNA was predominantly found in cells expressing ACE2, TMPRSS2, or both. The SARS-CoV-2 replicating RNA was also detected in these organs. Immunohistochemistry and electron microscopy were not suitable for reliable and specific SARS-CoV-2 detection in autopsies. These findings were validated using in situ hybridization on external COVID-19 autopsy samples (n = 9). Apart from the lung, correlation of viral detection and histopathological assessment did not reveal any specific alterations that could be attributed to SARS-CoV-2. In summary, SARS-CoV-2 and its replication could be observed across all organ systems, which co-localizes with ACE2 and TMPRSS2 mainly in epithelial but also in mesenchymal and endothelial cells. Apart from the respiratory tract, no specific (histo-)morphologic alterations could be assigned to the SARS-CoV-2 infection.

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