A cohort autopsy study defines COVID-19 systemic pathogenesis

• 作者: Xiao-Hong Yao Tao Luo Yu Shi Zhi-Cheng He Rui Tang Pei-Pei Zhang Jun Cai Xiang-Dong Zhou Dong-Po Jiang Xiao-Chun Fei Xue-Quan Huang Lei Zhao Heng Zhang Hai-Bo Wu Yong Ren Zhen-Hua Liu Hua-Rong Zhang Cong Chen Wen-Juan Fu Heng Li Xin-Yi Xia Rong Chen Yan Wang Xin-Dong Liu Chang-Lin Yin Ze-Xuan Yan Juan Wang Rui Jing Tai-Sheng Li Wei-Qin Li Chao-Fu Wang Yan-Qing Ding Qing Mao Ding-Yu Zhang Shu-Yang Zhang Yi-Fang Ping Xiu-Wu Bian
• 来源期刊: 细胞研究（英文版）
• 年，卷（期）: 2021,（8）
• 所属期刊栏目: ARTICLES
• 页码范围: 836-846
• 页数: 11页
• 语种: 英文

摘要

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.