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

Abstract

1 Since December 2019, a newly identified coronavirus (2019 novel coronavirus, 2 2019-nCov) is causing outbreak of pneumonia in one of largest cities, Wuhan, in 3 Hubei province of China and has draw significant public health attention. The same as 4 severe acute respiratory syndrome coronavirus (SARS-CoV), 2019-nCov enters into 5 host cells via cell receptor angiotensin converting enzyme II (ACE2). In order to 6 dissect the ACE2-expressing cell composition and proportion and explore a potential 7 route of the 2019-nCov infection in digestive system infection, 4 datasets with 8 single-cell transcriptomes of lung, esophagus, gastric, ileum and colon were analyzed.9

The epidemic of 2019-novel-coronavirus (2019-nCoV) pneumonia and insights for emerging infectious diseases in the future

“…The ubiquitous expression of ACE2 in various cells, such as lung AT2 cells, esophagus upper, stratified epithelial cells, and absorptive enterocytes of ileum and colon may contribute to the multi-tissue infection of 2019-nCoV [22]. Therefore, besides respiratory and bodily contact, fecal-oral transmission is a potential route for 2019-nCoV infection [23,24].…”

Coronavirus 2019-nCoV: A brief perspective from the front line

“…Besides, the fecal-oral route of transmission is considered but unconfirmed because 2019-nCoV nucleic acids could be detected in the stool samples of pneumonia patients with abdominal symptoms. 20 Vertical transmission between mothers and infants is another possible route based on the finding that a 30 h-old newborn was confirmed with 2019-nCoV in Wuhan Children's Hospital. Some researchers also warn that the transmission through the ocular surface must not be ignored considering human conjunctival epithelium can be contaminated easily by infectious droplets and body fluids.…”

COVID-19: Gastrointestinal Manifestations and Potential Fecal–Oral Transmission

“…7 Recent bioinformatics analysis on available 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 and absorptive enterocytes from ileum and colon. 8 With the increasing gastrointestinal wall permeability to foreign pathogens once virus infected, enteric symptoms like diarrhea will occur by the invaded enterocytes malabsorption, which in theory indicated the digestive system might be vulnerable to COVID-19 infection. On the other hand, since ACE2 and TMPRSS especially TMPRSS2 are co-localized in the same host cells and the latter exerts hydrolytic effects responsible for S-protein priming and viral entry into target cells, further bioinformatics investigation renders additional evidence for enteric infectivity of COVID-19 in that the high co-expression ratio was found in absorptive enterocytes and upper epithelial cells of esophagus besides lung AT2 cells.…”