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      CD209L/L-SIGN and CD209/DC-SIGN Act as Receptors for SARS-CoV-2

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          Abstract

          As the COVID-19 pandemic continues to spread, investigating the processes underlying the interactions between SARS-CoV-2 and its hosts is of high importance. Here, we report the identification of CD209L/L-SIGN and the related protein CD209/DC-SIGN as receptors capable of mediating SARS-CoV-2 entry into human cells. Immunofluorescence staining of human tissues revealed prominent expression of CD209L in the lung and kidney epithelia and endothelia. Multiple biochemical assays using a purified recombinant SARS-CoV-2 spike receptor-binding domain (S-RBD) or S1 encompassing both N termal domain and RBD and ectopically expressed CD209L and CD209 revealed that CD209L and CD209 interact with S-RBD. CD209L contains two N-glycosylation sequons, at sites N92 and N361, but we determined that only site N92 is occupied. Removal of the N-glycosylation at this site enhances the binding of S-RBD with CD209L. CD209L also interacts with ACE2, suggesting a role for heterodimerization of CD209L and ACE2 in SARS-CoV-2 entry and infection in cell types where both are present. Furthermore, we demonstrate that human endothelial cells are permissive to SARS-CoV-2 infection, and interference with CD209L activity by a knockdown strategy or with soluble CD209L inhibits virus entry. Our observations demonstrate that CD209L and CD209 serve as alternative receptors for SARS-CoV-2 in disease-relevant cell types, including the vascular system. This property is particularly important in tissues where ACE2 has low expression or is absent and may have implications for antiviral drug development.

          Abstract

          In human endothelial cells, CD209L acts as a receptor for SARS-CoV-2; together with ACE2, it can function as a co-receptor. Blocking CD209L activity inhibited virus entry, indicating a novel target for development of antiviral drugs.

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          Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

          Summary Background A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. Methods All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. Findings By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0–58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0–13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. Interpretation The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. Funding Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.
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            Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

            Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p<0·0001), and d-dimer greater than 1 μg/mL (18·42, 2·64–128·55; p=0·0033) on admission. Median duration of viral shedding was 20·0 days (IQR 17·0–24·0) in survivors, but SARS-CoV-2 was detectable until death in non-survivors. The longest observed duration of viral shedding in survivors was 37 days. Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.
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              Is Open Access

              A pneumonia outbreak associated with a new coronavirus of probable bat origin

              Since the outbreak of severe acute respiratory syndrome (SARS) 18 years ago, a large number of SARS-related coronaviruses (SARSr-CoVs) have been discovered in their natural reservoir host, bats 1–4 . Previous studies have shown that some bat SARSr-CoVs have the potential to infect humans 5–7 . Here we report the identification and characterization of a new coronavirus (2019-nCoV), which caused an epidemic of acute respiratory syndrome in humans in Wuhan, China. The epidemic, which started on 12 December 2019, had caused 2,794 laboratory-confirmed infections including 80 deaths by 26 January 2020. Full-length genome sequences were obtained from five patients at an early stage of the outbreak. The sequences are almost identical and share 79.6% sequence identity to SARS-CoV. Furthermore, we show that 2019-nCoV is 96% identical at the whole-genome level to a bat coronavirus. Pairwise protein sequence analysis of seven conserved non-structural proteins domains show that this virus belongs to the species of SARSr-CoV. In addition, 2019-nCoV virus isolated from the bronchoalveolar lavage fluid of a critically ill patient could be neutralized by sera from several patients. Notably, we confirmed that 2019-nCoV uses the same cell entry receptor—angiotensin converting enzyme II (ACE2)—as SARS-CoV.
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                Author and article information

                Journal
                ACS Cent Sci
                ACS Cent Sci
                oc
                acscii
                ACS Central Science
                American Chemical Society
                2374-7943
                2374-7951
                30 June 2021
                : acscentsci.0c01537
                Affiliations
                []Department of Pathology, School of Medicine, Boston University Medical Campus , Boston, Massachusetts 02118, United States
                []Renal Section, Department of Medicine, Boston University Medical Center , Boston, Massachusetts 02118, United States
                [§ ]Department of Microbiology, Boston University School of Medicine , Boston, Massachusetts 02118, United States
                []National Emerging Infectious Diseases Laboratories (NEIDL), Boston University , Boston, Massachusetts 02118, United States
                []Center for Biomedical Mass Spectrometry, Boston University School of Medicine , Boston, Massachusetts 02118, United States
                [# ]Ragon Institute of MGH, MIT, and Harvard , Cambridge, Massachusetts 02139, United States
                []Department of Microbiology, Harvard Medical School , Boston, Massachusetts 02115, United States
                Author notes
                [* ]Mailing address: Prof. Catherine E. Costello, Center for Biomedical Mass Spectrometry, Boston University School of Medicine, 670 Albany Street, rm 511, Boston, Massachusetts 02118-2646, United States; Tel: (617) 358-2433; Fax: (617) 358-2416; Email: cecmsms@ 123456bu.edu .
                [* ]Mailing address: Prof. Nader Rahimi, Department of Pathology, Boston University School of Medicine, 670 Albany Street, rm 510, Boston, Massachusetts 02118-2646, United States; Tel: (617) 358-2432; Fax: (617) 414-7914; Email: nrahimi@ 123456bu.edu .
                Author information
                https://orcid.org/0000-0001-5514-9652
                https://orcid.org/0000-0003-1594-5122
                https://orcid.org/0000-0002-6745-1725
                Article
                10.1021/acscentsci.0c01537
                8265543
                34341769
                83eea27b-9c03-4dc8-8574-e3cd39431171
                © 2021 The Authors. Published by American Chemical Society

                This article is made available via the PMC Open Access Subset for unrestricted RESEARCH re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                : 12 November 2020
                Funding
                Funded by: National Institute on Aging, doi 10.13039/100000049;
                Award ID: R01 AG060890
                Funded by: Evans Center for Interdisciplinary Biomedical Research, Boston University, doi NA;
                Award ID: NA
                Funded by: Evergrande Massachusetts Consortium on Pathogenesis Readines, doi NA;
                Award ID: 280870.5116795.0025
                Funded by: Department of Pathology, Boston University, doi NA;
                Award ID: NA
                Funded by: National Center for Advancing Translational Sciences, doi 10.13039/100006108;
                Award ID: 1 UL1 TR001430
                Funded by: National Institute of Allergy and Infectious Diseases, doi 10.13039/100000060;
                Award ID: R01 AI146779
                Funded by: National Institute of Allergy and Infectious Diseases, doi 10.13039/100000060;
                Award ID: R01 AI133486
                Funded by: National Institute of Allergy and Infectious Diseases, doi 10.13039/100000060;
                Award ID: R01 AI064099
                Funded by: National Institute of General Medical Sciences, doi 10.13039/100000057;
                Award ID: R24 GM134210
                Funded by: National Cancer Institute, doi 10.13039/100000054;
                Award ID: R21 CA193958
                Funded by: National Cancer Institute, doi 10.13039/100000054;
                Award ID: R21 CA191970
                Funded by: NIH Office of the Director, doi 10.13039/100000052;
                Award ID: S10 OD021728
                Funded by: National Heart, Lung, and Blood Institute, doi 10.13039/100000050;
                Award ID: R01 HL132325
                Categories
                Research Article
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                oc0c01537

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