Viral infiltration of pancreatic islets in patients with COVID-19

Charlotte Steenblock, Stefanie Richter, Ilona Berger, Marko Barovic, Janine Schmid, Undine Schubert, Natalia Jarzebska, Anne von Mässenhausen, Andreas Linkermann, Annette Schürmann, Jessica Pablik, Thomas Dienemann, Katja Evert, Roman N. Rodionov, Natalia Y. Semenova, Vsevolod A. Zinserling, Raul R. Gainetdinov, Gustavo Baretton, Dirk Lindemann, Michele Solimena, Barbara Ludwig and Stefan R. Bornstein ()
Additional contact information
Charlotte Steenblock: University Hospital Carl Gustav Carus, Technische Universität Dresden
Stefanie Richter: Technische Universität Dresden
Ilona Berger: University Hospital Carl Gustav Carus, Technische Universität Dresden
Marko Barovic: Technische Universität Dresden
Janine Schmid: University Hospital Carl Gustav Carus, Technische Universität Dresden
Undine Schubert: University Hospital Carl Gustav Carus, Technische Universität Dresden
Natalia Jarzebska: University Hospital Carl Gustav Carus, Technische Universität Dresden
Anne von Mässenhausen: University Hospital Carl Gustav Carus, Technische Universität Dresden
Andreas Linkermann: University Hospital Carl Gustav Carus, Technische Universität Dresden
Annette Schürmann: Technische Universität Dresden
Jessica Pablik: University Hospital Carl Gustav Carus, Technische Universität Dresden
Thomas Dienemann: University of Regensburg
Katja Evert: University of Regensburg
Roman N. Rodionov: University Hospital Carl Gustav Carus, Technische Universität Dresden
Natalia Y. Semenova: S. P. Botkin Clinical Infectious Diseases Hospital
Vsevolod A. Zinserling: S. P. Botkin Clinical Infectious Diseases Hospital
Raul R. Gainetdinov: St. Petersburg State University
Gustavo Baretton: University Hospital Carl Gustav Carus, Technische Universität Dresden
Dirk Lindemann: Technische Universität Dresden
Michele Solimena: Technische Universität Dresden
Barbara Ludwig: University Hospital Carl Gustav Carus, Technische Universität Dresden
Stefan R. Bornstein: University Hospital Carl Gustav Carus, Technische Universität Dresden

Nature Communications, 2021, vol. 12, issue 1, 1-12

Abstract: Abstract Metabolic diseases are associated with an increased risk of severe COVID-19 and conversely, new-onset hyperglycemia and complications of preexisting diabetes have been observed in COVID-19 patients. Here, we performed a comprehensive analysis of pancreatic autopsy tissue from COVID-19 patients using immunofluorescence, immunohistochemistry, RNA scope and electron microscopy and detected SARS-CoV-2 viral infiltration of beta-cells in all patients. Using SARS-CoV-2 pseudoviruses, we confirmed that isolated human islet cells are permissive to infection. In eleven COVID-19 patients, we examined the expression of ACE2, TMPRSS and other receptors and factors, such as DPP4, HMBG1 and NRP1, that might facilitate virus entry. Whereas 70% of the COVID-19 patients expressed ACE2 in the vasculature, only 30% displayed ACE2-expression in beta-cells. Even in the absence of manifest new-onset diabetes, necroptotic cell death, immune cell infiltration and SARS-CoV-2 viral infection of pancreatic beta-cells may contribute to varying degrees of metabolic dysregulation in patients with COVID-19.

Date: 2021
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DOI: 10.1038/s41467-021-23886-3

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