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Single-cell meta-analysis of SARS-CoV-2 entry genes across tissues and demographics

Lookup NU author(s): Dr Rachel Queen, Professor Majlinda LakoORCiD, Zerti Zerti


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Angiotensin-converting enzyme 2 (ACE2) and accessory proteases (TMPRSS2 and CTSL) are needed for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cellular entry, and their expression may shed light on viral tropism and impact across the body. We assessed the cell-type-specific expression of ACE2, TMPRSS2 and CTSL across 107 single-cell RNA-sequencing studies from different tissues. ACE2, TMPRSS2 and CTSL are coexpressed in specific subsets of respiratory epithelial cells in the nasal passages, airways and alveoli, and in cells from other organs associated with coronavirus disease 2019 (COVID-19) transmission or pathology. We performed a meta-analysis of 31 lung single-cell RNA-sequencing studies with 1,320,896 cells from 377 nasal, airway and lung parenchyma samples from 228 individuals. This revealed cell-type-specific associations of age, sex and smoking with expression levels of ACE2, TMPRSS2 and CTSL. Expression of entry factors increased with age and in males, including in airway secretory cells and alveolar type 2 cells. Expression programs shared by ACE2+TMPRSS2+ cells in nasal, lung and gut tissues included genes that may mediate viral entry, key immune functions and epithelial-macrophage cross-talk, such as genes involved in the interleukin-6, interleukin-1, tumor necrosis factor and complement pathways. Cell-type-specific expression patterns may contribute to the pathogenesis of COVID-19, and our work highlights putative molecular pathways for therapeutic intervention.

Publication metadata

Author(s): Muus C, Queen R, Lako M, Zerti D, HCA Lung Biological Network

Publication type: Article

Publication status: Published

Journal: Nature Medicine

Year: 2021

Volume: 27

Pages: 546-559

Print publication date: 27/03/2021

Online publication date: 02/03/2021

Acceptance date: 02/03/2021

ISSN (electronic): 1546-170X

Publisher: Nature


DOI: 10.1038/s41591-020-01227-z


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