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Characterization of SARS-CoV-2 and host entry factors distribution in a COVID-19 autopsy series

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  • Characterization of SARS-CoV-2 and host entry factors distribution in a COVID-19 autopsy series

    Published: 23 August 2021



    Xiao-Ming Wang, Rahul Mannan, Lanbo Xiao, Eman Abdulfatah, Yuanyuan Qiao, Carol Farver, Jeffrey L. Myers, Sylvia Zelenka-Wang, Lisa McMurry, Fengyun Su, Rui Wang, Liron Pantanowitz, Jeffrey Jentzen, Allecia Wilson, Yuping Zhang, Xuhong Cao, Arul M. Chinnaiyan & Rohit Mehra


    Abstract

    Background
    SARS-CoV-2 is a highly contagious virus that causes the disease COVID-19. We have recently reported that androgens regulate the expression of SARS-CoV-2 host entry factors ACE2 and TMPRSS2, and androgen receptor (AR) in lung epithelial cells. We also demonstrated that the transcriptional repression of the AR enhanceosome inhibited SARS-CoV-2 infection in vitro.

    Methods
    To better understand the various sites of SARS-CoV-2 infection, and presence of host entry factors, we extensively characterized the tissue distribution and localization of SARS-CoV-2 virus, viral replication, and host entry factors in various anatomical sites sampled via autopsy. We applied RNA in-situ-hybridization (RNA-ISH), immunohistochemistry (IHC) and quantitative reverse transcription polymerase chain reaction (qRT-PCR) approaches. We also assessed histopathological changes in SARS-CoV-2 infected tissues.

    Results
    We detect SARS-CoV-2 virus and viral replication in pulmonary tissues by RNA-ISH and IHC and a variety of non-pulmonary tissues including kidney, heart, liver, spleen, thyroid, lymph node, prostate, uterus, and colon by qRT-PCR. We observe heterogeneity in viral load and viral cytopathic effects among various organ systems, between individuals and within the same patient. In a patient with a history of kidney transplant and under immunosuppressant therapy, we observe an unusually high viral load in lung tissue by RNA-ISH, IHC and qRT-PCR. SARS-CoV-2 virus is also detected in this patent’s kidney, liver and uterus. We find ACE2, TMPRSS2 and AR expression to overlap with the infection sites.

    Conclusions
    This study portrays the impact of dispersed SARS-CoV-2 infection in diverse organ systems, thereby facilitating avenues for systematic therapeutic approaches.



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