Multiorgan and Renal Tropism of SARS-CoV-2
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Multiorgan and Renal Tropism of SARS-CoV-2 In this autopsy series, the authors found that SARS-CoV-2 has an organotropism beyond the respiratory tract, including the kidneys, heart, liver, and brai...
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Coronavirus RNA has been found in brain tissue of deceased patients, raising the possibility of a direct brain injury mechanism.
“The finding of coronavirus RNA in brain tissue of deceased patients raised the possibility of a direct brain injury mechanism [153].”
From Cognitive decline following acute viral infections: literature review and projections for post-COVID-19 (2022) · cites this paper as [153]
A study detected SARS-CoV-2 in 8 of 21 postmortem brain tissues based on reverse transcriptase polymerase chain reaction.
“a study detected SARS-CoV-2 in 8 of 21 postmortem brain tissues, based on reverse transcriptase polymerase chain reaction [25].”
From Hyperactivation of P2X7 receptors as a culprit of COVID-19 neuropathology (2021) · cites this paper as [25]
Autopsies from human patients have found that brain contains the lowest levels of CoV-2 across organs sampled.
“In addition, human CSF samples have failed thus far to reveal CoV-2 RNA (73, 77), and autopsies from human patients have found that the brain contains the lowest levels of CoV-2 across organs sampled (78).”
From Non-neuronal expression of SARS-CoV-2 entry genes in the olfactory system suggests mechanisms underlying COVID-19-associated anosmia (2020) · cites this paper as [78]
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“This concern is particularly relevant for patients infected by SARS-CoV-2 which has shown renal tropism and been described as a frequent cause of kidney injury [87].”
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“A recent study provided evidence for extrapulmonary replication of SARS-CoV-2 in liver, colon, heart, kidney and blood in some patients [17].”
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“This may be a result of the broad organ tropism of SARS-CoV-2 (46) and resultant damage induced by both the virus and the immune response to it, which is especially true in the lung.”
BackgroundAKI in Hospitalized Patients with and without COVID-19: A Comparison Study
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Chronic kidney disease is a key risk factor for severe COVID-19: a call to action by the ERA-EDTA
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“These data also indicate that SARS-CoV-2 has multiorgan tropism that includes glomerular and, as was later shown, tubular cells [28, 29].”
ResultSARS-CoV-2 infects human pancreatic β cells and elicits β cell impairment
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Neurological Involvement in COVID-19 and Potential Mechanisms: A Review
Aghagoli, G., Gallo Marin, B., Katchur, N. J., Chaves-Sell, F., Asaad, W. F., & Murphy, S. A. (2021) · Neurocritical Care · doi:10.1007/s12028-020-01049-4 · Cited by 357 · see citing works
“This report has been followed by a second, identifying and quantifying SARS-CoV-2 virus in brain tissue samples from 8 of 22 patients (36%) who died from COVID-19 infection [12], more firmly establishing COVID-19’s neurotropic potential.”
MethodLessons learned 1 year after SARS-CoV-2 emergence leading to COVID-19 pandemic
To, K. K., Sridhar, S., Chiu, K. H., Hung, D. L. L., Li, X., Hung, I. F., Tam, A. R., Chung, T. W., Chan, J. F., Zhang, J., et al. (2021) · Emerging Microbes & Infections · doi:10.1080/22221751.2021.1898291 · Cited by 350 · see citing works
“Multiple microscopic ischaemic infarct with or without antigen expression at endothelium [174-179]”
BackgroundCOVID-19, immunothrombosis and venous thromboembolism: biological mechanisms
Loo, J., Spittle, D. A., & Newnham, M. (2021) · Thorax · doi:10.1136/thoraxjnl-2020-216243 · Cited by 337 · see citing works
COVID-19 and the Chemical Senses: Supporting Players Take Center Stage
Cooper, K. W., Brann, D. H., Farruggia, M. C., Bhutani, S., Pellegrino, R., Tsukahara, T., Weinreb, C., Joseph, P. V., Larson, E. D., Parma, V., et al. (2020) · Neuron · doi:10.1016/j.neuron.2020.06.032 · Cited by 335 · see citing works
Molecular mechanism of interaction between SARS-CoV-2 and host cells and interventional therapy
Zhang, Q., Xiang, R., Huo, S., Zhou, Y., Jiang, S., Wang, Q., & Yu, F. (2021) · Signal Transduction and Targeted Therapy · doi:10.1038/s41392-021-00653-w · Cited by 341 · see citing works
Schultheiß, C., Paschold, L., Simnica, D., Mohme, M., Willscher, E., von Wenserski, L., Scholz, R., Wieters, I., Dahlke, C., Tolosa, E., et al. (2020) · Immunity · doi:10.1016/j.immuni.2020.06.024 · Cited by 334 · see citing works
Schwabenland, M., Salié, H., Tanevski, J., Killmer, S., Lago, M. S., Schlaak, A. E., Mayer, L., Matschke, J., Püschel, K., Fitzek, A., et al. (2021) · Immunity · doi:10.1016/j.immuni.2021.06.002 · Cited by 323 · see citing works
Self-citationRoles of flavonoids against coronavirus infection
Russo, M., Moccia, S., Spagnuolo, C., Tedesco, I., & Russo, G. L. (2020) · Chemico-Biological Interactions · doi:10.1016/j.cbi.2020.109211 · Cited by 326 · see citing works
“Here, SARS-CoV-2 can target different tissues at multiple levels, starting from the cells of nose and throat down to the lung, invading, perhaps, through vasal endothelium, kidneys and nervous system where it can cause severe illness and death [4,5].”
BackgroundTissue-Specific Immunopathology in Fatal COVID-19
Dorward, D. A., Russell, C. D., Um, I. H., Elshani, M., Armstrong, S. D., Penrice-Randal, R., Millar, T., Lerpiniere, C. E. B., Tagliavini, G., Hartley, C. S., et al. (2020) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.202008-3265oc · Cited by 316 · see citing works
“Although COVID-19 is principally thought of as a pulmonary disease, increasing evidence shows that SARS-CoV-2 also has extrapulmonary tissue tropism (16) and that dysfunction of multiple organs occurs in COVID-19 (17).”
BackgroundWalsh, C., Tafforeau, P., Wagner, W. L., Jafree, D. J., Bellier, A., Werlein, C., Kühnel, M., Boller, E., Walker‐Samuel, S., Robertus, J. L., et al. (2021) · Nature Methods · doi:10.1038/s41592-021-01317-x · Cited by 313 · see citing works
SARS-CoV-2 infects human neural progenitor cells and brain organoids
Zhang, B., Chu, H., Han, S., Shuai, H., Deng, J. M., Hu, Y., Gong, H., Lee, A. C.-Y., Zou, Z., Yau, T. C. C., et al. (2020) · Cell Research · doi:10.1038/s41422-020-0390-x · Cited by 319 · see citing works
Lessons for COVID-19 immunity from other coronavirus infections
Sariol, A., & Perlman, S. (2020) · Immunity · doi:10.1016/j.immuni.2020.07.005 · Cited by 317 · see citing works
Human iPSC-Derived Cardiomyocytes Are Susceptible to SARS-CoV-2 Infection
Sharma, A., Garcia, G., Wang, Y., Plummer, J., Morizono, K., Arumugaswami, V., & Svendsen, C. N. (2020) · Cell Reports Medicine · doi:10.1016/j.xcrm.2020.100052 · Cited by 318 · see citing works
“(legend continued on next page) 2 Cell Reports Medicine 1, 100052, July 21, 2020 infection and resulting fulminant myocarditis.11–13 A recent multiorgan autopsy study of COVID-19 patients detected SARSCoV-2 viral RNA in the heart via PCR.14 However, the gold standard for confirming SARS-CoV-2 localization in CMs is en…”
InfluentialAutoinflammatory and autoimmune conditions at the crossroad of COVID-19
Rodríguez, Y., Novelli, L., Rojas, M., Santis, M. D., Acosta‐Ampudia, Y., Monsalve, D. M., Ramı́rez-Santana, C., Costanzo, A., Ridgway, W. M., Ansari, A. A., et al. (2020) · Journal of Autoimmunity · doi:10.1016/j.jaut.2020.102506 · Cited by 312 · see citing works
Postmortem Kidney Pathology Findings in Patients with COVID-19
Santoriello, D., Khairallah, P., Bomback, A. S., Xu, K. H., Kudose, S., Batal, I., Barasch, J. M., Radhakrishnan, J., D’Agati, V. D., & Markowitz, G. S. (2020) · Journal of the American Society of Nephrology · doi:10.1681/asn.2020050744 · Cited by 314 · see citing works
SARS-CoV-2 renal tropism associates with acute kidney injury
Braun, F., Lütgehetmann, M., Pfefferle, S., Wong, M. N., Carsten, A., Lindenmeyer, M. T., Nörz, D. S., Heinrich, F., Meißner, K., Wichmann, D., et al. (2020) · The Lancet · doi:10.1016/s0140-6736(20)31759-1 · Cited by 308 · see citing works
Self-citationCytokine Storm—Definition, Causes, and Implications
Jarczak, D., & Nierhaus, A. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms231911740 · Cited by 317 · see citing works
Calabrese, F., Pezzuto, F., Fortarezza, F., Hofman, P. M., Kern, I., Panizo, Á., von der Thüsen, J. H., Timofeev, S., Gorkiewicz, G., & Lunardi, F. (2020) · Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin · doi:10.1007/s00428-020-02886-6 · Cited by 304 · see citing works
“A few authors have quantified viral load in several types of tissues, finding lower levels of SARS-CoV-2 in the kidneys, liver, heart, and brain [74], thus supporting secondary rather than primary involvement.”
BackgroundPatients with COVID-19: in the dark-NETs of neutrophils
Ackermann, M., Anders, H., Bilyy, R. O., Bowlin, G. L., Daniel, C., LORENZO, R. D., Egeblad, M., Henneck, T., Hidalgo, A., Hoffmann, M. H., et al. (2021) · Cell Death and Differentiation · doi:10.1038/s41418-021-00805-z · Cited by 307 · see citing works
Neuroinvasion and Encephalitis Following Intranasal Inoculation of SARS-CoV-2 in K18-hACE2 Mice
Kumari, P., Rothan, H. A., Natekar, J. P., Stone, S., Pathak, H., Strate, P. G., Arora, K., Brinton, M. A., & Kumar, M. (2021) · Viruses · doi:10.3390/v13010132 · Cited by 296 · see citing works
“Several human autopsy reports have documented the presence of SARS-CoV-2 RNA in brain tissues [16,17].”
BackgroundZhang, L., Zhou, L., Bao, L., Liu, J., Zhu, H., Lv, Q., Liu, R., Chen, W., Tong, W., Wei, Q., et al. (2021) · Signal Transduction and Targeted Therapy · doi:10.1038/s41392-021-00719-9 · Cited by 296 · see citing works
“Huber and colleagues detected SARS-CoV-2 RNA in multiple organs, including post-mortem brain tissue of patients with COVID19.”
BackgroundA systematic review of neurological symptoms and complications of COVID-19
Chen, X., Laurent, S. A., Onur, O. A., Kleineberg, N. N., Fink, G. R., Schweitzer, F., & Warnke, C. (2020) · Journal of Neurology · doi:10.1007/s00415-020-10067-3 · Cited by 297 · see citing works
A Prospective Study of Neurologic Disorders in Hospitalized Patients With COVID-19 in New York City
Frontera, J. A., Sabadia, S. B., Lalchan, R., Fang, T., Flusty, B., Vernetti, P. M., Snyder, T. E., Berger, S. L., Yang, D., Granger, A., et al. (2020) · Neurology · doi:10.1212/wnl.0000000000010979 · Cited by 285 · see citing works
“Acute renal failure 167/606 (28) 479/3,885 (12) <0.”
Critical Determinants of Cytokine Storm and Type I Interferon Response in COVID-19 Pathogenesis
Ramasamy, S., & Subbian, S. (2021) · Clinical Microbiology Reviews · doi:10.1128/cmr.00299-20 · Cited by 291 · see citing works
“spleen, intestine, brain, and blood (54, 55).”
AKI and Collapsing Glomerulopathy Associated with COVID-19 and APOL 1 High-Risk Genotype
Wu, H., Larsen, C. P., Hernandez-Arroyo, C. F., Mohamed, M. M. B., Caza, T. N., Sharshir, M. A., Chughtai, A., Xie, L., Gimenez, J. M., Sandow, T. A., et al. (2020) · Journal of the American Society of Nephrology · doi:10.1681/asn.2020050558 · Cited by 283 · see citing works
Trougakos, I. P., Stamatelopoulos, K. S., Terpos, E., Tsitsilonis, O., Aivalioti, E., Paraskevis, D. N., Kastritis, E., Pavlakis, G. N., & Dimopoulos, M. A. (2021) · Journal of Biomedical Science · doi:10.1186/s12929-020-00703-5 · Cited by 284 · see citing works
“heart, liver, brain, and kidneys further supporting the broad organotropism of the virus [31, 32].”
BackgroundSARS-CoV-2 infects the human kidney and drives fibrosis in kidney organoids
Jansen, J., Reimer, K. C., Nagai, J. S., Varghese, F. S., Overheul, G. J., de Beer, M., Roverts, R., Daviran, D., Fermin, L. A. S., Willemsen, B., et al. (2022) · Cell Stem Cell · doi:10.1016/j.stem.2021.12.010 · Cited by 259 · see citing works
Self-citationSARS-CoV-2 infects and induces cytotoxic effects in human cardiomyocytes
Bojkova, D., Wagner, J. U. G., Shumliakivska, M., Aslan, G. S., Saleem, U., Hansen, A., Luxán, G., Günther, S., Pham, M. D., Krishnan, J., et al. (2020) · Cardiovascular Research · doi:10.1093/cvr/cvaa267 · Cited by 257 · see citing works
ACE2/ADAM17/TMPRSS2 Interplay May Be the Main Risk Factor for COVID-19
Zipeto, D., Palmeira, J. D. F., Argañaraz, G. A., & Argañaraz, E. R. (2020) · Frontiers in Immunology · doi:10.3389/fimmu.2020.576745 · Cited by 263 · see citing works
“ACE2, TMPRSS2, and cathepsin L are highly expressed and active in the kidney (89, 90).”
BackgroundHigh-Flow Nasal Cannula in Critically III Patients with Severe COVID-19
Demoule, A., Vieillard‐Baron, A., Darmon, M., Beurton, A., Géri, G., Voiriot, G., Dupont, T., Zafrani, L., Girodias, L., Labbé, V., et al. (2020) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.202005-2007le · Cited by 253 · see citing works
“Moreover, the proportion of pulmonary embolism and acute kidney and myocardial injury are reported in much higher proportions than in typical acute respiratory distress syndrome (9).”
BackgroundWenzel, J., Lampe, J., Müller‐Fielitz, H., Schuster, R., Zille, M., Müller, K., Krohn, M., Körbelin, J., Zhang, L., Özorhan, Ü., et al. (2021) · Nature Neuroscience · doi:10.1038/s41593-021-00926-1 · Cited by 252 · see citing works
“6, 7).”
Self-citationA Single-Cell RNA Expression Map of Human Coronavirus Entry Factors
Singh, M., Bansal, V., & Feschotte, C. (2020) · Cell Reports · doi:10.1016/j.celrep.2020.108175 · Cited by 239 · see citing works
Gaziano, L., Giambartolomei, C., Pereira, A. C., Gaulton, A., Posner, D. C., Swanson, S. A., Ho, Y.-L. A., Iyengar, S. K., Kosik, N., Vujković, M., et al. (2021) · Nature Medicine · doi:10.1038/s41591-021-01310-z · Cited by 236 · see citing works
Unraveling the Mystery Surrounding Post-Acute Sequelae of COVID-19
Ramakrishnan, R. K., Kashour, T., Hamid, Q. A., Halwani, R., & Tleyjeh, I. M. (2021) · Frontiers in Immunology · doi:10.3389/fimmu.2021.686029 · Cited by 240 · see citing works
“This widespread damage in turn can be due to the wide distribution pattern of ACE2 (33), the cellular entry receptor for”
BackgroundInfluentialFrere, J. J., Serafini, R. A., Pryce, K. D., Zazhytska, M., Oishi, K., Golynker, I., Panis, M., Zimering, J. H., Horiuchi, S., Hoagland, D. A., et al. (2022) · Science Translational Medicine · doi:10.1126/scitranslmed.abq3059 · Cited by 233 · see citing works
“These findings are consistent with reports of human patients displaying SARS-CoV-2 RNAemia and systemic detection of SARS-CoV-2 RNA that could reflect deposition of viral-derived inflammatory material (26, 55).”
ResultSARS-CoV-2 causes a specific dysfunction of the kidney proximal tubule
Wérion, A., Belkhir, L., Perrot, M., Schmit, G., Aydın, S., Chen, Z., Penaloza, A., Greef, J. D., Yıldız, H., Pothen, L., et al. (2020) · Kidney International · doi:10.1016/j.kint.2020.07.019 · Cited by 232 · see citing works
Identifying who has long COVID in the USA: a machine learning approach using N3C data
Pfaff, E., Girvin, A. T., Bennett, T. D., Bhatia, A., Brooks, I. M., Deer, R., Dekermanjian, J., Jolley, S. E., Kahn, M. G., Kostka, K., et al. (2022) · The Lancet Digital Health · doi:10.1016/s2589-7500(22)00048-6 · Cited by 223 · see citing works
The blood-brain barrier is dysregulated in COVID-19 and serves as a CNS entry route for SARS-CoV-2
Krasemann, S., Haferkamp, U., Pfefferle, S., Woo, M. S., Heinrich, F., Schweizer, M., Appelt‐Menzel, A., Cubukova, A., Barenberg, J., Leu, J., et al. (2022) · Stem Cell Reports · doi:10.1016/j.stemcr.2021.12.011 · Cited by 231 · see citing works
“307 C BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). and findings remain controversial (Matschke et al., 2020; Meinhardt et al., 2021; Puelles et al., 2020; Song et al., 2021).”
InfluentialSelf-citation
- Authors
- Puelles, V. G., Lütgehetmann, M., Lindenmeyer, M. T., Sperhake, J. P., Wong, M. N., Allweiss, L., Chilla, S., Heinemann, A., Wanner, N., Liu, S., Braun, F., Lu, S., Pfefferle, S., Schröder, A. S., Edler, C., Gross, O., Glatzel, M., Wichmann, D., Wiech, T., Kluge, S., Pueschel, K., Aepfelbacher, M., & Huber, T. B.
- Affiliations
- University Medical Center Hamburg-Eppendorf (DE)
- Universitätsmedizin Göttingen (DE)
- Corresponding author
- Huber, Tobias B.
- ORCID
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2020-08-06
- Volume
- 383
- Issue
- 6
- Pages
- 590-592
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- PMC
- PMC7240771
- OpenAlex
- W3024126428
- Cited by
- 1,775
- References
- 4
- Citations by year
- 2026: 26 · 2025: 73 · 2024: 138 · 2023: 214 · 2022: 338 · 2021: 595 · 2020: 390
- FWCI
- 50.56
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- GoeScholar The Publication Server of the Georg-August-Universität Göttingen (Georg-August-Universität Göttingen) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Keywords
- SARS-CoV-2, COVID-19 pandemic, kidney, heart, liver, brain, autopsy findings, viral tissue distribution
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Aged, Aged, 80 and over, Autopsy, Brain, Female, Heart, Humans, Kidney, Liver, Lung, Male, Middle Aged, Pharynx, Pneumonia, Viral, Coronavirus Infections, Viral Load, Viral Tropism, Pandemics
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