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ACE2, TMPRSS2 distribution and extrapulmonary organ injury in patients with COVID-19 - 28/10/20

Doi : 10.1016/j.biopha.2020.110678 
Mengzhen Dong a, b, c, Jie Zhang a, b, c, Xuefeng Ma a, b, c, Jie Tan a, b, c, Lizhen Chen a, b, c, Shousheng Liu a, b, c, Yongning Xin a, b, c, , Likun Zhuang a, b, c,
a Department of Infectious Diseases, Qingdao Municipal Hospital, Qingdao University, Qingdao, China 
b Institute of Hepatology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China 
c Digestive Disease Key Laboratory of Qingdao, Qingdao, China 

Corresponding authors at: Department of Infectious Disease and Institute of Hepatology, Qingdao Municipal Hospital, Qingdao University, Digestive Disease Key Laboratory of Qingdao, Qingdao, 266071, China.Department of Infectious Disease and Institute of HepatologyQingdao Municipal HospitalQingdao UniversityDigestive Disease Key Laboratory of QingdaoQingdao266071China

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Highlights

Expressions of ACE2 and TMPRSS2 were observed in the extrapulmonary organs.
Direct infections of SARS-CoV-2 in extrapulmonary organs were observed in patients with COVID-19.
Clinical manifestation and management for extrapulmonary organ injuries in COVID-19 should be noticed.
There might be a relationship between the infection of extrapulmonary organs and positive SARS-CoV-2 test in recovered patients.

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Abstract

At the end of 2019, the coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in China. Currently, it is breaking out globally and posing a serious threat to public health. The typically clinical characteristics of COVID-19 patients were fever and respiratory symptoms, and a proportion of patients were accompanied by extrapulmonary symptoms including cardiac injury, kidney injury, liver injury, digestive tract injury, and neurological symptoms. Angiotensin converting enzyme 2 (ACE2) has been proven to be a major receptor for SARS-CoV-2 and could mediate virus entry into cells. And transmembrane protease serine 2 (TMPRSS2) could cleave the spike (S) protein of SARS-CoV-2, which facilitates the fusion of SARS-CoV-2 and cellular membranes. The mRNA expressions of both ACE2 and TMPRSS2 were observed in the heart, digestive tract, liver, kidney, brain and other organs. SARS-CoV-2 may have a capacity to infect extrapulmonary organs due to the expressions of ACE2 and TMPRSS2 in the cells and tissues of these organs. It seems that there is a potential involvement of ACE2 and TMPRSS2 expressions in the virus infection of extrapulmonary organs and the manifestation of symptoms related to these organs in patients with COVID-19. Here, we revealed the expressions of ACE2 and TMPRSS2 in extrapulmonary organs, and we also summarized the clinical manifestation and the management of extrapulmonary complications in patients with COVID-19.

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Abbreviations : ACE2, AKI, ALI, ALP, ALS, ALT, AMI, ARDS, AST, AT2, BUN, CCLE, CNS, COVID-19, GEO, GGT, GI, GTEx, ICU, MCS, NP, PCI, SARS-CoV-2, Scr, ScRNA-Seq, STEMI, TBIL, TEM, TMPRSS2, V-V, WHO

Keywords : SARS-CoV-2, COVID-19, ACE2, TMPRSS2, Extrapulmonary organs, Clinical management


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© 2020  The Authors. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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Vol 131

Artículo 110678- novembre 2020 Regresar al número
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