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Mucociliary transport deficiency and disease progression in Syrian hamsters with SARS-CoV-2 infection
Qian Li, Kadambari Vijaykumar, Scott E. Phillips, Shah S. Hussain, Nha V. Huynh, Courtney M. Fernandez-Petty, Jacelyn E. Peabody Lever, Jeremy B. Foote, Janna Ren, Javier Campos-Gómez, Farah Abou Daya, Nathaniel W. Hubbs, Harrison Kim, Ezinwanne Onuoha, Evan R. Boitet, Lianwu Fu, Hui Min Leung, Linhui Yu, Thomas W. Detchemendy, Levi T. Schaefers, Jennifer L. Tipper, Lloyd J. Edwards, Sixto M. Leal Jr., Kevin S. Harrod, Guillermo J. Tearney, Steven M. Rowe
Qian Li, Kadambari Vijaykumar, Scott E. Phillips, Shah S. Hussain, Nha V. Huynh, Courtney M. Fernandez-Petty, Jacelyn E. Peabody Lever, Jeremy B. Foote, Janna Ren, Javier Campos-Gómez, Farah Abou Daya, Nathaniel W. Hubbs, Harrison Kim, Ezinwanne Onuoha, Evan R. Boitet, Lianwu Fu, Hui Min Leung, Linhui Yu, Thomas W. Detchemendy, Levi T. Schaefers, Jennifer L. Tipper, Lloyd J. Edwards, Sixto M. Leal Jr., Kevin S. Harrod, Guillermo J. Tearney, Steven M. Rowe
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Research Article COVID-19

Mucociliary transport deficiency and disease progression in Syrian hamsters with SARS-CoV-2 infection

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Abstract

Substantial clinical evidence supports the notion that ciliary function in the airways is important in COVID-19 pathogenesis. Although ciliary damage has been observed in both in vitro and in vivo models, the extent or nature of impairment of mucociliary transport (MCT) in in vivo models remains unknown. We hypothesize that SARS-CoV-2 infection results in MCT deficiency in the airways of golden Syrian hamsters that precedes pathological injury in lung parenchyma. Micro-optical coherence tomography was used to quantitate functional changes in the MCT apparatus. Both genomic and subgenomic viral RNA pathological and physiological changes were monitored in parallel. We show that SARS-CoV-2 infection caused a 67% decrease in MCT rate as early as 2 days postinfection (dpi) in hamsters, principally due to 79% diminished airway coverage of motile cilia. Correlating quantitation of physiological, virological, and pathological changes reveals steadily descending infection from the upper airways to lower airways to lung parenchyma within 7 dpi. Our results indicate that functional deficits of the MCT apparatus are a key aspect of COVID-19 pathogenesis, may extend viral retention, and could pose a risk factor for secondary infection. Clinically, monitoring abnormal ciliated cell function may indicate disease progression. Therapies directed toward the MCT apparatus deserve further investigation.

Authors

Qian Li, Kadambari Vijaykumar, Scott E. Phillips, Shah S. Hussain, Nha V. Huynh, Courtney M. Fernandez-Petty, Jacelyn E. Peabody Lever, Jeremy B. Foote, Janna Ren, Javier Campos-Gómez, Farah Abou Daya, Nathaniel W. Hubbs, Harrison Kim, Ezinwanne Onuoha, Evan R. Boitet, Lianwu Fu, Hui Min Leung, Linhui Yu, Thomas W. Detchemendy, Levi T. Schaefers, Jennifer L. Tipper, Lloyd J. Edwards, Sixto M. Leal Jr., Kevin S. Harrod, Guillermo J. Tearney, Steven M. Rowe

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Figure 2

Lung injury after SARS-CoV-2 infection in hamsters.

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Lung injury after SARS-CoV-2 infection in hamsters.
Golden Syrian hamste...
Golden Syrian hamsters were inoculated as in Figure 1, and lung damage was assessed by lung to body weight ratio (A, n = 18, 2, 12, and 8 for mock, 2, 4, and 7 dpi, respectively), gross pathology (B, representative of n = 18, 12, and 10 for mock, 4, and 7 dpi, respectively), and histopathological analysis of the left lung, including representative H&E images (C–E, representatives of n = 18, 12, and 8 for mock, 4, and 7 dpi, respectively) and quantitation by a blinded pathologist (F, n = 16, 4, 12, and 8 for mock, 2, 4, and 7 dpi, respectively). (C) Total magnification ×100 (top) and ×200 (bottom) of lungs from mock, 4 dpi, and 7 dpi displaying progression to interstitial pneumonia. (D) Total magnification ×400 of alveolus and alveolar interstitium displaying type II pneumocyte hyperplasia (red arrows) and mononuclear infiltrate (blue arrows) and (E) a small-caliber artery displaying perivascular edema, hemorrhage (green arrows), and intimal arteritis (blue arrows). Scale bar: 50 μm. Error bars indicate SEM. Squares indicate males and circles females. (A and F) P < 0.0001 by 1-way ANOVA. *P < 0.05; **P < 0.01; ***P < 0.001; ****P < 0.0001 by Tukey’s post hoc test.

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