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      SARS‐CoV‐2 receptor ACE2 and TMPRSS2 are primarily expressed in bronchial transient secretory cells

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          Abstract

          The SARS‐CoV‐2 pandemic affecting the human respiratory system severely challenges public health and urgently demands for increasing our understanding of COVID‐19 pathogenesis, especially host factors facilitating virus infection and replication. SARS‐CoV‐2 was reported to enter cells via binding to ACE2, followed by its priming by TMPRSS2. Here, we investigate ACE2 and TMPRSS2 expression levels and their distribution across cell types in lung tissue (twelve donors, 39,778 cells) and in cells derived from subsegmental bronchial branches (four donors, 17,521 cells) by single nuclei and single cell RNA sequencing, respectively. While TMPRSS2 is strongly expressed in both tissues, in the subsegmental bronchial branches ACE2 is predominantly expressed in a transient secretory cell type. Interestingly, these transiently differentiating cells show an enrichment for pathways related to RHO GTPase function and viral processes suggesting increased vulnerability for SARS‐CoV‐2 infection. Our data provide a rich resource for future investigations of COVID‐19 infection and pathogenesis.

          Abstract

          A single‐cell RNA‐seq resource identifies expression of coronavirus entry‐linked host cofactors ACE2 , TMPRSS2 and FURIN primarily in bronchial cells in cells transitioning from secretory to ciliated identity.

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          Most cited references39

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          Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing

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            Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

            Summary Background A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. Methods All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. Findings By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0–58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0–13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. Interpretation The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. Funding Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.
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              Clinical Characteristics of Coronavirus Disease 2019 in China

              Abstract Background Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients. Methods We extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in mainland China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death. Results The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission. Conclusions During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. (Funded by the National Health Commission of China and others.)
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                Author and article information

                Contributors
                kreuter@uni-heidelberg.de
                christian.conrad@bihealth.de
                roland.eils@bihealth.de
                Journal
                EMBO J
                EMBO J
                10.1002/(ISSN)1460-2075
                EMBJ
                embojnl
                The EMBO Journal
                John Wiley and Sons Inc. (Hoboken )
                0261-4189
                1460-2075
                14 April 2020
                18 May 2020
                14 April 2020
                : 39
                : 10 ( doiID: 10.1002/embj.v39.10 )
                : e105114
                Affiliations
                [ 1 ] Charité ‐ Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
                [ 2 ] Center for Digital Health Berlin Institute of Health (BIH) Berlin Germany
                [ 3 ] Department of Pneumology and Respiratory Critical Care Medicine Center for interstitial and rare lung diseases Thoraxklinik, Heidelberg University Hospital Heidelberg Germany
                [ 4 ] Translational Lung Research Center Heidelberg (TLRC) Member of the German Center for Lung Research (DZL) Heidelberg Germany
                [ 5 ] Translational Research Unit Thoraxklinik, Heidelberg University Hospital Heidelberg Germany
                [ 6 ] Department of Thoracic Surgery Thoraxklinik, Heidelberg University Hospital Heidelberg Germany
                [ 7 ] Division of Redox Regulation German Cancer Research Center (DKFZ) Heidelberg Germany
                [ 8 ] Faculty of Health, Medicine and Life Sciences Department of Pharmacology and Toxicology NUTRIM School of Nutrition Translational Research and Metabolism Maastricht University Maastricht the Netherlands
                [ 9 ] Health Data Science Unit Heidelberg University Hospital and BioQuant Heidelberg Germany
                Author notes
                [*] [* ] Corresponding author. Tel: +49 6221 396 1214; E‐mail: kreuter@ 123456uni-heidelberg.de

                Corresponding author. Tel: +49 30 450 543 097; E‐mail: christian.conrad@ 123456bihealth.de

                Corresponding author. Tel: +49 30 450 543 088; E‐mail: roland.eils@ 123456bihealth.de

                [†]

                These authors contributed equally to this work

                [‡]

                These authors contributed equally to this work as senior authors

                Author information
                https://orcid.org/0000-0001-7045-6327
                https://orcid.org/0000-0003-4402-2159
                https://orcid.org/0000-0001-7036-342X
                https://orcid.org/0000-0002-0034-4036
                Article
                EMBJ20105114
                10.15252/embj.20105114
                7232010
                32246845
                d4bb507e-e63f-47cd-955d-a366bb86fd6f
                © 2020 The Authors. Published under the terms of the CC BY 4.0 license

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 27 March 2020
                : 30 March 2020
                Page count
                Figures: 9, Tables: 1, Pages: 15, Words: 11037
                Funding
                Funded by: EC|Horizon 2020 Framework Programme (H2020) , open-funder-registry 10.13039/100010661;
                Award ID: 874710
                Funded by: German Center for Lung Research (DLZ)
                Award ID: 82DZL00402
                Funded by: European Respiratory Society (STRTF ‐ 201804‐00377) ‐ fellowship CV
                Categories
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                Resource
                Custom metadata
                2.0
                18 May 2020
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.8.1 mode:remove_FC converted:18.05.2020

                Molecular biology
                covid‐19,epithelial differentiation,furin,human cell atlas,respiratory tract,chromatin, epigenetics, genomics & functional genomics,computational biology,microbiology, virology & host pathogen interaction

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