Distinct Disease Severity Between Children and Older Adults With Coronavirus Disease 2019 (COVID-19): Impacts of ACE2 Expression, Distribution, and Lung Progenitor Cells
| Autor: | Liang Zeng, Li Huang, Jinjian Yang, Huiying Liang, Huimin Xia, Ziyue Li, Liyan Guo, Hui Du, Che Zhang, Chui Yan Ma, Ruibang Luo, Xiaoxia Lu, Jie Liu, Xianfeng Wang, Xiaoxian Zhang, Zhiwei Chen, Weiren Luo, Xiaoya Zhou, Hua Jiang, J. Chen, Wei Liu, Zhao Zhang, Jinqiu Zhang, Jieying Wu, Yanheng Wu, Qizhou Lian, Li Liu, Huanhuan Joyce Chen, Le Li, Qiuhui Li, Yi Xu, Hongsheng Liu, Guangyin Yu, Ka Yi Kwan, Hung-Fat Tse, Can Liao, Jianbo Shao |
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| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Microbiology (medical) medicine.medical_specialty Lung business.industry medicine.disease Gastroenterology 03 medical and health sciences Pneumonia 030104 developmental biology 0302 clinical medicine Infectious Diseases medicine.anatomical_structure Internal medicine Cohort medicine Distribution (pharmacology) 030212 general & internal medicine Progenitor cell Airway business Receptor Ex vivo |
| Zdroj: | Clinical Infectious Diseases. 73:e4154-e4165 |
| ISSN: | 1537-6591 1058-4838 |
| DOI: | 10.1093/cid/ciaa1911 |
| Popis: | Background Children and older adults with coronavirus disease 2019 (COVID-19) display a distinct spectrum of disease severity yet the risk factors aren’t well understood. We sought to examine the expression pattern of angiotensin-converting enzyme 2 (ACE2), the cell-entry receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the role of lung progenitor cells in children and older patients. Methods We retrospectively analyzed clinical features in a cohort of 299 patients with COVID-19. The expression and distribution of ACE2 and lung progenitor cells were systematically examined using a combination of public single-cell RNA-seq data sets, lung biopsies, and ex vivo infection of lung tissues with SARS-CoV-2 pseudovirus in children and older adults. We also followed up patients who had recovered from COVID-19. Results Compared with children, older patients (>50 years.) were more likely to develop into serious pneumonia with reduced lymphocytes and aberrant inflammatory response (P = .001). The expression level of ACE2 and lung progenitor cell markers were generally decreased in older patients. Notably, ACE2 positive cells were mainly distributed in the alveolar region, including SFTPC positive cells, but rarely in airway regions in the older adults (P < .01). The follow-up of discharged patients revealed a prolonged recovery from pneumonia in the older (P < .025). Conclusions Compared to children, ACE2 positive cells are generally decreased in older adults and mainly presented in the lower pulmonary tract. The lung progenitor cells are also decreased. These risk factors may impact disease severity and recovery from pneumonia caused by SARS-Cov-2 infection in older patients. |
| Databáze: | OpenAIRE |
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