Cited by 1,163COVID-19 Clinical Research StudiesSARS-CoV-2 and COVID-19 ResearchRenin-Angiotensin System Studies

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The ACE2 expression in human heart indicates new potential mechanism of heart injury among patients infected with SARS-CoV-2

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Chen, Liang, Li, Xiangjie, Chen, Mingquan, Feng, Yi, Xiong, Chenglong·2020·Cardiovascular Research

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Abstract

A new type of pneumonia caused by a novel coronavirus SARS-CoV-2 outbreaks recently in China and spreads into many other countries. This disease, named as COVID-19, is similar to patients infected by SARS-CoV and MERS-CoV, and nearly 20% of patients developed severe condition. Cardiac injury is a prevalent complication of severe patients, exacerbating the disease severity in coronavirus disease 2019 (COVID-19) patients. Angiotensin-converting enzyme 2 (ACE2), the key host cellular receptor of SARS-CoV-2, has been identified in multiple organs, but its cellular distribution in human heart is not illuminated clearly. This study performed the first state-of-art single cell atlas of adult human heart, and revealed that pericytes with high expression of ACE2 might act as the target cardiac cell of SARS-CoV-2. The pericytes injury due to virus infection may result in capillary endothelial cells dysfunction, inducing microvascular dysfunction. And patients with basic heart failure disease showed increased ACE2 expression at both mRNA and protein levels, meaning that if infected by the virus these patients may have higher risk of heart attack and critically ill condition. The finding of this study explains the high rate of severe cases among COVID-19 patients with basic cardiovascular disease; and these results also perhaps provide important reference to clinical treatment of cardiac injury among severe patients infected by SARS-CoV-2.

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Authors: Chen, L., Li, X., Chen, M., Feng, Y., & Xiong, C.
Affiliations: Fudan University (CN)
Renmin University of China (CN)
Corresponding author: Chen, Liang
Xiong, Chenglong
ORCID: Chen, Liang
Li, Xiangjie
Chen, Mingquan
Feng, Yi
Xiong, Chenglong
Venue: Cardiovascular Research
Publisher: Oxford University Press (OUP)
Published: 2020-03-30
Volume: 116
Issue: 6
Pages: 1097-1100
ISSN: 0008-6363 (ISSN-L)
1755-3245
DOI: 10.1093/cvr/cvaa078
PMC: PMC7184507
OpenAlex: W3014027512
Cited by: 1,163
References: 7
Citations by year: 2026: 19 · 2025: 32 · 2024: 64 · 2023: 148 · 2022: 210 · 2021: 332 · 2020: 355
FWCI: 34.28
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
Locations: Cardiovascular Research (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: National Natural Science Foundation of China (81872673)
National Key Research and Development Program of China (2017YFC1200203)
Fudan University
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 › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
Keywords: ACE2, SARS-CoV-2, COVID-19 pandemic, cardiac injury, pericytes, microvascular dysfunction, heart failure, viral receptor expression, myocardial injury
MeSH terms: Betacoronavirus, Receptors, Coronavirus, Angiotensin-Converting Enzyme 2, COVID-19, SARS-CoV-2, Heart, Heart Diseases, Humans, Peptidyl-Dipeptidase A, Myocardium, Pneumonia, Viral, Receptors, Virus, Gene Expression, Coronavirus Infections, Pericytes, Gene Expression Profiling, Pandemics, Spike Glycoprotein, Coronavirus

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The ACE2 expression in human heart indicates new potential mechanism of heart injury among patients infected with SARS-CoV-2

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