The digestive system is a potential route of 2019-nCov infection: a bioinformatics analysis based on single-cell transcriptomes

By Hao Zhang, Zijian Kang, Haiyi Gong, Dan Xu, Jing Wang, Zifu Li, X. Cui, Jianru Xiao, T. Meng, Wang Zhou and 2 more. bioRxiv, 2020

637 citations recorded by the source corpus.

Since December 2019, a newly identified coronavirus (2019 novel coronavirus, 2019-nCov) is causing outbreak of pneumonia in one of largest cities, Wuhan, in Hubei province of China and has draw significant public health attention. The same as severe acute respiratory syndrome coronavirus (SARS-CoV), 2019-nCov enters into host cells via cell receptor angiotensin converting enzyme II (ACE2). In order to dissect the ACE2-expressing cell composition and proportion and explore a potential route of the 2019-nCov infection in digestive system infection, 4 datasets with single-cell transcriptomes of lung, esophagus, gastric, ileum and colon were analyzed. The data showed that ACE2 was not only highly expressed in the lung AT2 cells, esophagus upper and stratified epithelial cells but also in absorptive enterocytes from ileum and colon. These results indicated along with respiratory systems, digestive system is a potential routes for 2019-nCov infection. In conclusion, this study has provided the bioinformatics evidence of the potential route for infection of 2019-nCov in digestive system along with respiratory tract and may have significant impact for our healthy policy setting regards to prevention of 2019-nCoV infection.

Subfields: Infectious Diseases, Molecular Biology

View Paper: https://www.semanticscholar.org/paper/70b4af707b1bf5eebacaadcf994335feb3d7a43a

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Citations in the corpus

Risk factors for disease severity, unimprovement, and mortality in COVID-19 patients in Wuhan, China (2020, background): “A recent study reported the presence of SARS-CoV-2 nucleic acid fragments in the stool samples of patients with abdominal symptoms and suggested that SARS-CoV-2 might also be transmitted via the fecal-oral route (15) .”
COVID‐19 patients' clinical characteristics, discharge rate, and fatality rate of meta‐analysis (2020, background): “A recent study showed that nCOV was detected in stool samples of patients with abdominal symptoms.(21) Therefore, while paying great attention to patients with the respiratory system as the primary symptom, more attention should also be paid to patients with headaches, dizziness, diarrhea, anorexia,”
Specific ACE2 Expression in Cholangiocytes May Cause Liver Damage After 2019-nCoV Infection (2020, result): “Significantly, but different from the protein analysis, ACE expression level in cholangiocytes is comparable to Alveolar Type 2 cells [13, 14], which is the major SARS and 2019-nCoV targeting cell type in lung.”
Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. (2020, neutral): “Respiratory rate, median (IQR) 20(19-21) 20(16-25) 20(19-21) .”
SARS-CoV-2 Receptor ACE2 Is an Interferon-Stimulated Gene in Human Airway Epithelial Cells and Is Detected in Specific Cell Subsets across Tissues (2020, neutral): “During the preparation of this manuscript, several papers have been posted to bioRxiv assessing patterns of ACE2+ and TMPRSS2+ cells in barrier tissues (Brann et al., 2020; Lukassen et al., 2020; Qi et al., 2020; Wu et al., 2020; Zhang et al., 2020).”
COVID-19 and Multiorgan Response (2020, positive): “This is through (1) respiratory droplets released via coughing or sneezing, (2) aerosol, typically during aerosolgenerating clinical procedures, and (3) mucosal membrane contact with fomites.18,19 Faecal-oral transmission has been speculated,20 given the detection of viral RNA in stools, reported ga”
Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: a scoping review (2020, background): “Since patients had abdominal discomfort and diarrhea symptoms, researchers analyzed four datasets with single-cell transcriptomes of digestive systems and found that ACE2 was highly expressed in absorptive enterocytes from ileum and colon [44] .”
Single cell RNA sequencing of 13 human tissues identify cell types and receptors of human coronaviruses (2020, background): “Since the outbreak, many data analysis have showed a wide distribution of ACE2 across human tissues, including lung[5], liver[6], stomach[7], ileum[7], colon[7] and kidney[8], indicating”
Favipiravir versus Arbidol for COVID-19: A Randomized Clinical Trial (2020, background): “6171) and digestive tract reactions (nausea, anti-acid, flatulence [10]) (14 [11.”
Mechanisms of SARS-CoV-2 Transmission and Pathogenesis (2020, background): “Indeed, ACE2 and TMPRSS2 are abundantly expressed within the human and many other mammalian intestinal tracts, specifically the brush border of intestinal enterocytes [23,25,26,39].”
The protein expression profile of ACE2 in human tissues (2020, neutral): “Similarly, in the recently published Human Cell Landscape (HCL) 16 , the expression levels of ACE2 were highest in cell types supporting the data from antibody-based immunohistochemistry from the HPA program, including jejunal and duodenal enterocytes, gallbladder epithelial cells, renal proximal tu”
Coronavirus disease 2019 (COVID-19): current status and future perspectives (2020, background): “A recent tudy showed that the enteric symptoms of COVID-19 pneumonia re associated with invaded ACE2-expressing enterocytes [42] , sugesting that the digestive tract is a potential route of SARS-CoV-2 nfection besides the respiratory tract.”
COVID-19: Gastrointestinal Manifestations and Potential Fecal–Oral Transmission (2020, positive): “single-cell transcriptomes data of normal human lung and gastrointestinal system was carried out to identify the ACE2-expressing cell composition and proportion, and revealed that ACE2 was not only highly expressed in the lung AT2 cells, but also in esophagus upper and stratified epithelial cells an”