Distinct Disease Severity Between Children and Older Adults With Coronavirus Disease 2019 (COVID-19): Impacts of ACE2 Expression, Distribution, and Lung Progenitor Cells

Zhang, Zhao1,2; Guo, Liyan1; Huang, Li1,3; Zhang, Che4; Luo, Ruibang5; Zeng, Liang6; Liang, Huiying7; Li, Qiuhui5; Lu, Xiaoxia8; Wang, Xianfeng9; Ma, Chui Yan2; Shao, Jianbo9; Luo, Weiren10; Li, Le11; Liu, Li12,13; Li, Ziyue1; Zhou, Xiaoya1; Zhang, Xiaoxian1; Liu, Jie1; Yang, Jinjuan1; Kwan, Ka Yi12,13; Liu, Wei11; Xu, Yi14; Jiang, Hua15; Liu, Hongsheng16; Du, Hui8; Wu, Yanheng17; Yu, Guangyin18; Chen, Junhui19; Wu, Jieying1; Zhang, Jinqiu1; Liao, Can1; Chen, Huanhuan Joyce20; Chen, Zhiwei12,13; Tse, Hung-fat2,21,22,23; Xia, Huimin7; Lian, Qizhou1,7,22

2021-12-06

10.1093/cid/ciaa1911

CLINICAL INFECTIOUS DISEASES   影响因子和分区

1058-4838

1537-6591

["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.","Compared to children, ACE2 positive cells in older adults are generally reduced and mainly distributed in lower pulmonary tract. Lung progenitor cells are also decreased. These risks may impact disease severity and recovery from pneumonia in older patients with COVID-19."]

COVID-19 disease severity patients' ages ACE2 expression and distribution lung progenitor cells

SCI

英语

其他

National Natural Science Grant of China[31571407] ; Hong Kong Health and Medical Research Fund (HMRF)[06172956] ; Start-up Grant for Stem Cell and Regenerative Medicine (Guangzhou Women and Children's Medical Centre)[5001-4001010]

Immunology ; Infectious Diseases ; Microbiology

Immunology ; Infectious Diseases ; Microbiology

WOS:000755559200121

OXFORD UNIV PRESS INC

IMMUNOLOGY

Web of Science

1.Guangzhou Med Univ, Prenatal Diagnost Ctr & Cord Blood Bank, Guangzhou Women & Childrens Med Ctr, Guangzhou, Peoples R China
2.Univ Hong Kong, Li Ka Shing Fac Med, Dept Med, Cardiol Div, Hong Kong, Peoples R China
3.Hubei Univ Med, Inst Drug Clin Trial, Taihe Hosp, Shiyan, Hubei, Peoples R China
4.Hubei Univ Med, Dept Pediat, Taihe Hosp, Shiyan, Hubei, Peoples R China
5.Univ Hong Kong, Dept Comp Sci, Hong Kong, Peoples R China
6.Guangzhou Med Univ, Guangzhou Women & Childrens Med Ctr, Dept Pathol, Guangzhou, Peoples R China
7.Guangzhou Med Univ, Guangdong Prov Childrens Med Res Ctr, Guangzhou Women & Childrens Med Ctr, Guangzhou, Peoples R China
8.Huazhong Univ Sci & Technol, Wuhan Childrens Hosp, Tongji Med Coll, Dept Resp Med, Wuhan, Hubei, Peoples R China
9.Southern Univ Sci & Technol, Peoples Hosp Shenzhen 3, Dept Pediat, Affiliated Hosp 2, Shenzhen, Peoples R China
10.Southern Univ Sci & Technol, Peoples Hosp Shenzhen 3, Dept Pathol, Affiliated Hosp 2, Shenzhen, Peoples R China
11.Guangzhou Med Univ, Guangzhou Women & Childrens Med Ctr, Dept Surg, Guangzhou, Peoples R China
12.Univ Hong Kong, AIDS Inst, Hong Kong, Peoples R China
13.Univ Hong Kong, Li Ka Shing Fac Med, Dept Microbiol, Hong Kong, Peoples R China
14.Guangzhou Med Univ, Guangzhou Women & Childrens Med Ctr, Dept Emergency Med, Guangzhou, Peoples R China
15.Guangzhou Med Univ, Guangzhou Women & Childrens Med Ctr, Dept Hematol & Oncol, Guangzhou, Peoples R China
16.Guangzhou Med Univ, Guangzhou Women & Childrens Med Ctr, Dept Radiol, Guangzhou, Peoples R China
17.Univ Queensland, Australian Inst Bioengn & Nanotechnol AIBN, Brisbane, Qld, Australia
18.Peking Univ, Dept Pathol, Shenzhen Hosp, Shenzhen, Peoples R China
19.Peking Univ, Intervent & Cell Therapy Ctr, Shenzhen Hosp, Shenzhen, Peoples R China
20.Univ Chicago, Pritzker Sch Mol Engn, Ben May Dept Canc Res, Chicago, IL USA
21.Univ Hong Kong, Dept Med, Div Cardiol, Shenzhen Hosp, Shenzhen, Peoples R China
22.Univ Hong Kong, Shenzhen Inst Res & Innovat, Shenzhen, Peoples R China
23.Univ Hong Kong, Hong Kong Guangdong Joint Lab Stem Cell & Regener, Hong Kong, Peoples R China

Zhang, Zhao,Guo, Liyan,Huang, Li,et al. Distinct Disease Severity Between Children and Older Adults With Coronavirus Disease 2019 (COVID-19): Impacts of ACE2 Expression, Distribution, and Lung Progenitor Cells[J]. CLINICAL INFECTIOUS DISEASES,2021,73(11).

Zhang, Zhao.,Guo, Liyan.,Huang, Li.,Zhang, Che.,Luo, Ruibang.,...&Lian, Qizhou.(2021).Distinct Disease Severity Between Children and Older Adults With Coronavirus Disease 2019 (COVID-19): Impacts of ACE2 Expression, Distribution, and Lung Progenitor Cells.CLINICAL INFECTIOUS DISEASES,73(11).

Zhang, Zhao,et al."Distinct Disease Severity Between Children and Older Adults With Coronavirus Disease 2019 (COVID-19): Impacts of ACE2 Expression, Distribution, and Lung Progenitor Cells".CLINICAL INFECTIOUS DISEASES 73.11(2021).