[PDF][PDF] SARS-CoV-2 infects human pluripotent stem cell-derived cardiomyocytes, impairing electrical and mechanical function

S Marchiano, TY Hsiang, A Khanna, T Higashi… - Stem cell reports, 2021 - cell.com
S Marchiano, TY Hsiang, A Khanna, T Higashi, LS Whitmore, J Bargehr, H Davaapil…
Stem cell reports, 2021cell.com
COVID-19 patients often develop severe cardiovascular complications, but it remains
unclear if these are caused directly by viral infection or are secondary to a systemic
response. Here, we examine the cardiac tropism of SARS-CoV-2 in human pluripotent stem
cell-derived cardiomyocytes (hPSC-CMs) and smooth muscle cells (hPSC-SMCs). We find
that that SARS-CoV-2 selectively infects hPSC-CMs through the viral receptor ACE2,
whereas in hPSC-SMCs there is minimal viral entry or replication. After entry into …
Summary
COVID-19 patients often develop severe cardiovascular complications, but it remains unclear if these are caused directly by viral infection or are secondary to a systemic response. Here, we examine the cardiac tropism of SARS-CoV-2 in human pluripotent stem cell-derived cardiomyocytes (hPSC-CMs) and smooth muscle cells (hPSC-SMCs). We find that that SARS-CoV-2 selectively infects hPSC-CMs through the viral receptor ACE2, whereas in hPSC-SMCs there is minimal viral entry or replication. After entry into cardiomyocytes, SARS-CoV-2 is assembled in lysosome-like vesicles and egresses via bulk exocytosis. The viral transcripts become a large fraction of cellular mRNA while host gene expression shifts from oxidative to glycolytic metabolism and upregulates chromatin modification and RNA splicing pathways. Most importantly, viral infection of hPSC-CMs progressively impairs both their electrophysiological and contractile function, and causes widespread cell death. These data support the hypothesis that COVID-19-related cardiac symptoms can result from a direct cardiotoxic effect of SARS-CoV-2.
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