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ResearchIn-Press PreviewImmunologyPulmonologyVirology Open Access | 10.1172/jci.insight.203283

SARS-CoV-2 infection produces an IL-33-dependent chronic eosinophilic pneumonia and muco-inflammatory airways disease in mice

Padraig E. Hawkins,1 Sarah R. Leist,2 Hong Dang,1 Minako Saito,1 Lisa C. Morton,1 Rodney C. Gilmore,1 Stephen A. Schworer,1 Ella F. Burns,1 Jason R. Rock,3 Robert S. Hagan,1 James J. Pestka,4 Alexandra Schäfer,2 Kenichi Okuda,1 Lauren K. Heine,5 Jack R. Harkema,6 Wanda K. O'Neal,1 Alessandra Livraghi-Butrico,1 Raymond J. Pickles,1 Ralph S. Baric,2 and Richard C. Boucher1

1Marsico Lung Institute/Cystic Fibrosis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

2Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

3Department of Immunology Discovery, Genentech, Inc., San Francisco, United States of America

4Department of Food Science and Human Nutrition, Michigan State University, East Lansing, United States of America

5Department of Pharmacology and Toxicology, Michigan State University, East Lansing, United States of America

6Department of Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, United States of America

Find articles by Hawkins, P. in: PubMed | Google Scholar

1Marsico Lung Institute/Cystic Fibrosis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

2Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

3Department of Immunology Discovery, Genentech, Inc., San Francisco, United States of America

4Department of Food Science and Human Nutrition, Michigan State University, East Lansing, United States of America

5Department of Pharmacology and Toxicology, Michigan State University, East Lansing, United States of America

6Department of Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, United States of America

Find articles by Leist, S. in: PubMed | Google Scholar |

1Marsico Lung Institute/Cystic Fibrosis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

2Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

3Department of Immunology Discovery, Genentech, Inc., San Francisco, United States of America

4Department of Food Science and Human Nutrition, Michigan State University, East Lansing, United States of America

5Department of Pharmacology and Toxicology, Michigan State University, East Lansing, United States of America

6Department of Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, United States of America

Find articles by Dang, H. in: PubMed | Google Scholar |

1Marsico Lung Institute/Cystic Fibrosis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

2Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

3Department of Immunology Discovery, Genentech, Inc., San Francisco, United States of America

4Department of Food Science and Human Nutrition, Michigan State University, East Lansing, United States of America

5Department of Pharmacology and Toxicology, Michigan State University, East Lansing, United States of America

6Department of Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, United States of America

Find articles by Saito, M. in: PubMed | Google Scholar

1Marsico Lung Institute/Cystic Fibrosis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

2Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

3Department of Immunology Discovery, Genentech, Inc., San Francisco, United States of America

4Department of Food Science and Human Nutrition, Michigan State University, East Lansing, United States of America

5Department of Pharmacology and Toxicology, Michigan State University, East Lansing, United States of America

6Department of Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, United States of America

Find articles by Morton, L. in: PubMed | Google Scholar

1Marsico Lung Institute/Cystic Fibrosis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

2Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

3Department of Immunology Discovery, Genentech, Inc., San Francisco, United States of America

4Department of Food Science and Human Nutrition, Michigan State University, East Lansing, United States of America

5Department of Pharmacology and Toxicology, Michigan State University, East Lansing, United States of America

6Department of Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, United States of America

Find articles by Gilmore, R. in: PubMed | Google Scholar

1Marsico Lung Institute/Cystic Fibrosis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

2Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

3Department of Immunology Discovery, Genentech, Inc., San Francisco, United States of America

4Department of Food Science and Human Nutrition, Michigan State University, East Lansing, United States of America

5Department of Pharmacology and Toxicology, Michigan State University, East Lansing, United States of America

6Department of Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, United States of America

Find articles by Schworer, S. in: PubMed | Google Scholar |

1Marsico Lung Institute/Cystic Fibrosis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

2Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

3Department of Immunology Discovery, Genentech, Inc., San Francisco, United States of America

4Department of Food Science and Human Nutrition, Michigan State University, East Lansing, United States of America

5Department of Pharmacology and Toxicology, Michigan State University, East Lansing, United States of America

6Department of Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, United States of America

Find articles by Burns, E. in: PubMed | Google Scholar

1Marsico Lung Institute/Cystic Fibrosis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

2Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

3Department of Immunology Discovery, Genentech, Inc., San Francisco, United States of America

4Department of Food Science and Human Nutrition, Michigan State University, East Lansing, United States of America

5Department of Pharmacology and Toxicology, Michigan State University, East Lansing, United States of America

6Department of Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, United States of America

Find articles by Rock, J. in: PubMed | Google Scholar

1Marsico Lung Institute/Cystic Fibrosis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

2Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

3Department of Immunology Discovery, Genentech, Inc., San Francisco, United States of America

4Department of Food Science and Human Nutrition, Michigan State University, East Lansing, United States of America

5Department of Pharmacology and Toxicology, Michigan State University, East Lansing, United States of America

6Department of Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, United States of America

Find articles by Hagan, R. in: PubMed | Google Scholar |

1Marsico Lung Institute/Cystic Fibrosis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

2Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

3Department of Immunology Discovery, Genentech, Inc., San Francisco, United States of America

4Department of Food Science and Human Nutrition, Michigan State University, East Lansing, United States of America

5Department of Pharmacology and Toxicology, Michigan State University, East Lansing, United States of America

6Department of Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, United States of America

Find articles by Pestka, J. in: PubMed | Google Scholar

1Marsico Lung Institute/Cystic Fibrosis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

2Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

3Department of Immunology Discovery, Genentech, Inc., San Francisco, United States of America

4Department of Food Science and Human Nutrition, Michigan State University, East Lansing, United States of America

5Department of Pharmacology and Toxicology, Michigan State University, East Lansing, United States of America

6Department of Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, United States of America

Find articles by Schäfer, A. in: PubMed | Google Scholar

1Marsico Lung Institute/Cystic Fibrosis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

2Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

3Department of Immunology Discovery, Genentech, Inc., San Francisco, United States of America

4Department of Food Science and Human Nutrition, Michigan State University, East Lansing, United States of America

5Department of Pharmacology and Toxicology, Michigan State University, East Lansing, United States of America

6Department of Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, United States of America

Find articles by Okuda, K. in: PubMed | Google Scholar |

1Marsico Lung Institute/Cystic Fibrosis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

2Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

3Department of Immunology Discovery, Genentech, Inc., San Francisco, United States of America

4Department of Food Science and Human Nutrition, Michigan State University, East Lansing, United States of America

5Department of Pharmacology and Toxicology, Michigan State University, East Lansing, United States of America

6Department of Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, United States of America

Find articles by Heine, L. in: PubMed | Google Scholar

1Marsico Lung Institute/Cystic Fibrosis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

2Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

3Department of Immunology Discovery, Genentech, Inc., San Francisco, United States of America

4Department of Food Science and Human Nutrition, Michigan State University, East Lansing, United States of America

5Department of Pharmacology and Toxicology, Michigan State University, East Lansing, United States of America

6Department of Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, United States of America

Find articles by Harkema, J. in: PubMed | Google Scholar

1Marsico Lung Institute/Cystic Fibrosis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

2Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

3Department of Immunology Discovery, Genentech, Inc., San Francisco, United States of America

4Department of Food Science and Human Nutrition, Michigan State University, East Lansing, United States of America

5Department of Pharmacology and Toxicology, Michigan State University, East Lansing, United States of America

6Department of Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, United States of America

Find articles by O'Neal, W. in: PubMed | Google Scholar

1Marsico Lung Institute/Cystic Fibrosis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

2Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

3Department of Immunology Discovery, Genentech, Inc., San Francisco, United States of America

4Department of Food Science and Human Nutrition, Michigan State University, East Lansing, United States of America

5Department of Pharmacology and Toxicology, Michigan State University, East Lansing, United States of America

6Department of Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, United States of America

Find articles by Livraghi-Butrico, A. in: PubMed | Google Scholar |

1Marsico Lung Institute/Cystic Fibrosis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

2Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

3Department of Immunology Discovery, Genentech, Inc., San Francisco, United States of America

4Department of Food Science and Human Nutrition, Michigan State University, East Lansing, United States of America

5Department of Pharmacology and Toxicology, Michigan State University, East Lansing, United States of America

6Department of Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, United States of America

Find articles by Pickles, R. in: PubMed | Google Scholar

1Marsico Lung Institute/Cystic Fibrosis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

2Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

3Department of Immunology Discovery, Genentech, Inc., San Francisco, United States of America

4Department of Food Science and Human Nutrition, Michigan State University, East Lansing, United States of America

5Department of Pharmacology and Toxicology, Michigan State University, East Lansing, United States of America

6Department of Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, United States of America

Find articles by Baric, R. in: PubMed | Google Scholar |

1Marsico Lung Institute/Cystic Fibrosis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

2Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, United States of America

3Department of Immunology Discovery, Genentech, Inc., San Francisco, United States of America

4Department of Food Science and Human Nutrition, Michigan State University, East Lansing, United States of America

5Department of Pharmacology and Toxicology, Michigan State University, East Lansing, United States of America

6Department of Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, United States of America

Find articles by Boucher, R. in: PubMed | Google Scholar

Published July 7, 2026 - More info

JCI Insight. https://doi.org/10.1172/jci.insight.203283.
Copyright © 2026, Hawkins et al. This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
Published July 7, 2026 - Version history
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Abstract

Post-acute sequelae of SARS-CoV-2 (PASC) occurs in subsets of individuals, including those with pre-existing lung disease. To investigate PASC pathogenesis and therapeutics in a chronic bronchitis mouse model (Scnn1b-Tg), Scnn1b-Tg and WT mice were inoculated with a mouse adapted SARS-CoV-2 virus (SARS-CoV-2MA10) and followed for 60 days. Viral titer, histology, immunohistochemistry (IHC), single-cell RNA sequencing, RNA in situ hybridization, and spatial transcriptomic profiling characterized disease pathologies. Scnn1b-Tg mice inoculated with SARS-CoV-2MA10 exhibited lower viral titers and less weight loss than WT mice. Airway epithelia of Scnn1b-Tg mice were less infected than epithelia of WT mice, reflecting increased airway mucus and enhanced epithelial antiviral activities in Scnn1b-Tg mice. However, Scnn1b-Tg mice subsequently exhibited heterogeneous airway and parenchymal disease with elevated Il33 expression characteristic of human eosinophilic pneumonia. Cohorts of infected mice were administered a monoclonal antibody targeting the IL-33 receptor (ST2) or enteral prednisone. Administration of an anti-ST2 monoclonal antibody mitigated development of eosinophilic pneumonia while enteral prednisone suppressed IL33 expression and disease. The eosinophilic pneumonia in Scnn1b-Tg mice after SARS-CoV-2MA10 infection mimics reports of eosinophilic pneumonia in humans post-SARS-CoV-2, suggesting targeting of IL-33 may be beneficial in treating post-viral eosinophilic pneumonia in humans.

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