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Article: Distinct disease severity between children and older adults with COVID-19: Impacts of ACE2 expression, distribution, and lung progenitor cells

TitleDistinct disease severity between children and older adults with COVID-19: Impacts of ACE2 expression, distribution, and lung progenitor cells
Authors
KeywordsCOVID-19
disease severity
patients’ ages
ACE2 expression and distribution
lung progenitor cells
Issue Date2021
PublisherOxford University Press. The Journal's web site is located at http://www.oxfordjournals.org/our_journals/cid/
Citation
Clinical Infectious Diseases, 2021, v. 2021-01-02, p. article no. ciaa1911 How to Cite?
AbstractBackground: 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.
Persistent Identifierhttp://hdl.handle.net/10722/296367
ISSN
2023 Impact Factor: 8.2
2023 SCImago Journal Rankings: 3.308
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorZhang, Z-
dc.contributor.authorGuo, L-
dc.contributor.authorHuang, L-
dc.contributor.authorZhang, C-
dc.contributor.authorLuo, R-
dc.contributor.authorZeng, L-
dc.contributor.authorLiang, H-
dc.contributor.authorLi, Q-
dc.contributor.authorLu, X-
dc.contributor.authorWang, X-
dc.contributor.authorMa, CY-
dc.contributor.authorShao, J-
dc.contributor.authorLuo, W-
dc.contributor.authorLi, L-
dc.contributor.authorLiu, L-
dc.contributor.authorLi, Z-
dc.contributor.authorZhou, X-
dc.contributor.authorZhang, X-
dc.contributor.authorLiu, J-
dc.contributor.authorYang, J-
dc.contributor.authorKwan, KY-
dc.contributor.authorLiu, W-
dc.contributor.authorXu, Y-
dc.contributor.authorJiang, H-
dc.contributor.authorLiu, H-
dc.contributor.authorDu, H-
dc.contributor.authorWu, Y-
dc.contributor.authorYu, G-
dc.contributor.authorChen, J-
dc.contributor.authorWu, J-
dc.contributor.authorZhang, J-
dc.contributor.authorLiao, C-
dc.contributor.authorChen, HJ-
dc.contributor.authorChen, Z-
dc.contributor.authorTse, HF-
dc.contributor.authorXia, H-
dc.contributor.authorLian, Q-
dc.date.accessioned2021-02-22T04:54:18Z-
dc.date.available2021-02-22T04:54:18Z-
dc.date.issued2021-
dc.identifier.citationClinical Infectious Diseases, 2021, v. 2021-01-02, p. article no. ciaa1911-
dc.identifier.issn1058-4838-
dc.identifier.urihttp://hdl.handle.net/10722/296367-
dc.description.abstractBackground: 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.-
dc.languageeng-
dc.publisherOxford University Press. The Journal's web site is located at http://www.oxfordjournals.org/our_journals/cid/-
dc.relation.ispartofClinical Infectious Diseases-
dc.rightsPost-print: This is a pre-copy-editing, author-produced PDF of an article accepted for publication in [insert journal title] following peer review. The definitive publisher-authenticated version [insert complete citation information here] is available online at: xxxxxxx [insert URL that the author will receive upon publication here]. -
dc.subjectCOVID-19-
dc.subjectdisease severity-
dc.subjectpatients’ ages-
dc.subjectACE2 expression and distribution-
dc.subjectlung progenitor cells-
dc.titleDistinct disease severity between children and older adults with COVID-19: Impacts of ACE2 expression, distribution, and lung progenitor cells-
dc.typeArticle-
dc.identifier.emailZhang, Z: zhucex1a@hku.hk-
dc.identifier.emailLuo, R: rbluo@cs.hku.hk-
dc.identifier.emailMa, CY: mcy920@hku.hk-
dc.identifier.emailLiu, L: liuli71@hkucc.hku.hk-
dc.identifier.emailKwan, KY: hallieky@hku.hk-
dc.identifier.emailChen, Z: zchenai@hku.hk-
dc.identifier.emailTse, HF: hftse@hkucc.hku.hk-
dc.identifier.emailLian, Q: qzlian@hkucc.hku.hk-
dc.identifier.authorityLuo, R=rp02360-
dc.identifier.authorityLiu, L=rp00268-
dc.identifier.authorityChen, Z=rp00243-
dc.identifier.authorityTse, HF=rp00428-
dc.identifier.authorityLian, Q=rp00267-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1093/cid/ciaa1911-
dc.identifier.pmid33388749-
dc.identifier.pmcidPMC7799282-
dc.identifier.scopuseid_2-s2.0-85120304872-
dc.identifier.hkuros321289-
dc.identifier.volume2021-01-02-
dc.identifier.spagearticle no. ciaa1911-
dc.identifier.epagearticle no. ciaa1911-
dc.identifier.isiWOS:000735309500088-
dc.publisher.placeUnited States-

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