SARS-CoV-2 Infects Human Engineered Heart Tissues and Models COVID-19 Myocarditis
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Abstract
Epidemiological studies of the COVID-19 pandemic have revealed evidence of cardiac involvement and documented that myocardial injury and myocarditis are predictors of poor outcomes. Nonetheless, little is understood regarding SARS-CoV-2 tropism within the heart and whether cardiac complications result directly from myocardial infection. Here, we develop a human engineered heart tissue model and demonstrate that SARS-CoV-2 selectively infects cardiomyocytes. Viral infection is dependent on expression of angiotensin-I converting enzyme 2 (ACE2) and endosomal cysteine proteases, suggesting an endosomal mechanism of cell entry. After infection with SARS-CoV-2, engineered tissues display typical features of myocarditis, including cardiomyocyte cell death, impaired cardiac contractility, and innate immune cell activation. Consistent with these findings, autopsy tissue obtained from individuals with COVID-19 myocarditis demonstrated cardiomyocyte infection, cell death, and macrophage-predominate immune cell infiltrate. These findings establish human cardiomyocyte tropism for SARS-CoV-2 and provide an experimental platform for interrogating and mitigating cardiac complications of COVID-19.
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Wassenaar, J. W., Clark, D. E., Dixon, D., George‐Durrett, K., Parikh, A., Li, D. ‘., Baker, M., Gupta, D. K., Hughes, S. G., Soslow, J. H., et al. (2022) · Radiology Cardiothoracic Imaging · doi:10.1148/ryct.210310 · Cited by 7 · see citing works
Long-Term Effects of COVID-19 on the Cardiopulmonary System in Adults and Children
Rischard, F. P., Altman, N. L., Szmuszkovicz, J. R., Sciurba, F. C., Rosenzweig, E. B., Lee, S., Krishnan, S., Truong, N., Wood, J. C., & Finn, A. V. (2024) · CHEST Journal · doi:10.1016/j.chest.2023.12.030 · Cited by 7 · see citing works
- Authors
- Bailey, A. L., Dmytrenko, O., Greenberg, L., Bredemeyer, A. L., Ma, P., Liu, J., Penna, V., Winkler, E. S., Sviben, S., Brooks, E., Nair, A. P., Heck, K. A., Rali, A. S., Simpson, L., Saririan, M., Hobohm, D., Stump, W. T., Fitzpatrick, J. A., Xie, X., Zhang, X., Shi, P.-Y., Hinson, J. T., Gi, W.-T., Schmidt, C., Leuschner, F., Lin, C.-Y., Diamond, M. S., Greenberg, M. J., & Lavine, K. J.
- Affiliations
- Washington University in St. Louis (US)
- University of Wisconsin–Madison (US)
- Baylor College of Medicine (US)
- Vanderbilt University (US)
- Creighton University (US)
- The University of Texas Medical Branch at Galveston (US)
- The Jackson Laboratory for Genomic Medicine (US)
- Heidelberg University (DE)
- Corresponding author
- Lavine, Kory J.
- ORCID
- Bailey, Adam L.
- Dmytrenko, Oleksandr
- Greenberg, Lina
- Bredemeyer, Andrea L.
- Ma, Pan
- Liu, Jing
- Penna, Vinay
- Winkler, Emma S.
- Sviben, Sanja
- Brooks, Erin
- Nair, Ajith P.
- Rali, Aniket S.
- Simpson, Leo
- Saririan, Mehrdad
- Fitzpatrick, James A.
- Xie, Xuping
- Zhang, Xianwen
- Shi, Pei-Yong
- Hinson, J. Travis
- Gi, Weng-Tein
- Schmidt, Constanze
- Leuschner, Florian
- Lin, Chieh-Yu
- Diamond, Michael S.
- Greenberg, Michael J.
- Lavine, Kory J.
- Venue
- JACC: Basic to Translational Science
- Publisher
- Elsevier BV
- Published
- 2021-04
- Volume
- 6
- Issue
- 4
- Pages
- 331-345
- ISSN
- 2452-302X (ISSN-L)
- PMC
- PMC7909907
- OpenAlex
- W3134776434
- Cited by
- 193
- References
- 80
- Citations by year
- 2026: 8 · 2025: 13 · 2024: 37 · 2023: 50 · 2022: 42 · 2021: 43
- FWCI
- 29.50
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- JACC Basic to Translational Science (publishedVersion, cc-by-nc-nd)
- bioRxiv (Cold Spring Harbor Laboratory) (acceptedVersion)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Digital Commons@Becker (Washington University School of Medicine) (submittedVersion, cc-by-nc-nd)
- PubMed Central (submittedVersion)
- Digital Commons-TMC (Texas Medical Center) (submittedVersion)
- The Mouseion at the JAXlibrary (Jackson Laboratory) (submittedVersion)
- Funders
- Foundation for Barnes-Jewish Hospital
- Center for Cellular Imaging, Washington University
- National Institutes of Health (75N93019C00062, R01 AI127828, R01 HL138466, R01 HL139714, R01 HL141086)
- St. Louis Children's Hospital (CDI-CORE-2015-505, CDI-CORE-2019-813)
- Defense Advanced Research Projects Agency (HR001117S0019)
- Burroughs Wellcome Fund (1014782)
- March of Dimes Foundation (FY18-BOC-430198)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Viral Infections and Immunology Research
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Keywords
- SARS-CoV-2, COVID-19 myocarditis, engineered heart tissue, cardiac complications of COVID-19, sarcomere disassembly, cytokine production, cardiomyocyte contractile dysfunction, cell death, viral pathogenesis, myocardial pathology
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