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Am J Pathol . Molecular Profiling of COVID-19 Autopsies Uncovers Novel Disease Mechanisms

tetano

Editor, Senior Moderator
Am J Pathol


. 2021 Sep 7;S0002-9440(21)00382-5.
doi: 10.1016/j.ajpath.2021.08.009. Online ahead of print.
Molecular Profiling of COVID-19 Autopsies Uncovers Novel Disease Mechanisms


Elisabet Pujadas[SUP] 1 [/SUP], Michael Beaumont[SUP] 2 [/SUP], Hardik Shah[SUP] 2 [/SUP], Nadine Schrode[SUP] 2 [/SUP], Nancy Francoeur[SUP] 2 [/SUP], Sanjana Shroff[SUP] 2 [/SUP], Clare Bryce[SUP] 1 [/SUP], Zachary Grimes[SUP] 1 [/SUP], Jill Gregory[SUP] 3 [/SUP], Ryan Donnelly[SUP] 1 [/SUP], Mary E Fowkes[SUP] 1 [/SUP], Kristin G Beaumont[SUP] 2 [/SUP], Robert Sebra[SUP] 4 [/SUP], Carlos Cordon-Cardo[SUP] 5 [/SUP]



Affiliations
Free PMC article

Abstract

Current understanding of COVID-19 pathophysiology is limited by disease heterogeneity, complexity, and a paucity of studies assessing patient tissues with advanced molecular tools. Rapid autopsy tissues were evaluated using multi-scale RNASeq methods (bulk, single-nuclei, and spatial RNASeq next-generation sequencing) to provide unprecedented molecular resolution of COVID-19 induced damage. Comparison of infected/uninfected tissues revealed four major regulatory pathways. Effectors within these pathways could constitute novel therapeutic targets, including the complement receptor C3AR1, calcitonin receptor like receptor or decorin. Single-nuclei RNA sequencing of olfactory bulb and prefrontal cortex highlighted remarkable diversity of coronavirus receptors. ACE2 was rarely expressed, while BSG showed diffuse expression, and ANPEP was associated with vascular/mesenchymal cell types. Comparison of lung and lymph node tissues from patients with different symptomatology (one died after a month-long hospitalization with multi-organ involvement, the other after a few days of respiratory symptoms) with digital spatial profiling resulted in distinct molecular phenotypes. Evaluation of COVID-19 rapid autopsy tissues with advanced molecular techniques can identify pathways and effectors, map diverse receptors at the single-cell level, and help dissect differences driving diverging clinical courses among individual patients. Extension of this approach to larger datasets will substantially advance the understanding of the mechanisms behind COVID-19 pathophysiology.
 
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