Where does SARS-CoV-2 go to in man?^†.

Area of Science:

• Pathology
• Virology
• Cell Biology

Background:

• The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19 by targeting the angiotensin-converting enzyme 2 (ACE2) receptor.
• The respiratory tract is a primary site of infection, but the full range of susceptible cells across human organs remains under investigation.

Purpose of the Study:

• To comprehensively identify human cells and tissues susceptible to SARS-CoV-2 infection.
• To investigate the distribution of the ACE2 receptor and viral presence in various organs beyond the respiratory system.

Main Methods:

• Analysis of autopsy-derived human tissues.
• Detection of SARS-CoV-2 RNA and ACE2 expression in diverse cell types.

Main Results:

• SARS-CoV-2, associated with ACE2, was detected in endothelial cells, renal and biliary epithelium, megakaryocytes, hepatocytes, and gut myenteric plexus cells.
• The virus was notably absent in heart myofibres and brain neurones.
• Infection susceptibility was confirmed across the respiratory epithelium from the nose to the alveoli.

Conclusions:

• This study confirms and expands the known cellular tropism of SARS-CoV-2 in humans.
• The widespread presence of ACE2 and viral RNA in endothelial cells and other organs highlights potential mechanisms for systemic COVID-19 pathology.
• Findings support further research into the pathogenesis of COVID-19 in various organ systems.