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      Comparison of the pathogenesis of SARS-CoV-2 infection in K18-hACE2 mouse and Syrian golden hamster models

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      Disease Models & Mechanisms
      The Company of Biologists Ltd
      SARS-CoV-2, Syrian golden hamster, K18-hACE2 mice

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          ABSTRACT

          Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiological agent of COVID-19, causes life-threatening disease. This novel coronavirus enters host cells via the respiratory tract, promoting the formation of severe pulmonary lesions and systemic disease. Few animal models can simulate the clinical signs and pathology of COVID-19 patients. Diverse preclinical studies using K18-hACE2 mice and Syrian golden hamsters, which are highly permissive to SARS-CoV-2 in the respiratory tract, are emerging; however, the systemic pathogenesis and cellular tropism of these models remain obscure. We intranasally infected K18-hACE2 mice and Syrian golden hamsters with SARS-CoV-2, and compared the clinical features, pathogenesis, cellular tropism and infiltrated immune-cell subsets. In K18-hACE2 mice, SARS-CoV-2 persistently replicated in alveolar cells and caused pulmonary and extrapulmonary disease, resulting in fatal outcomes. Conversely, in Syrian golden hamsters, transient SARS-CoV-2 infection in bronchial cells caused reversible pulmonary disease, without mortality. Our findings provide comprehensive insights into the pathogenic spectrum of COVID-19 using preclinical models.

          Abstract

          [Related article:] Editor's choice: We infected K18-hACE2 mice and Syrian golden hamsters with SARS-CoV-2 and obtained comprehensive insights into COVID-19 pathogenicity in these two representative COVID-19 preclinical models.

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          Most cited references45

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          Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study

          Summary Background An ongoing outbreak of pneumonia associated with the severe acute respiratory coronavirus 2 (SARS-CoV-2) started in December, 2019, in Wuhan, China. Information about critically ill patients with SARS-CoV-2 infection is scarce. We aimed to describe the clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia. Methods In this single-centered, retrospective, observational study, we enrolled 52 critically ill adult patients with SARS-CoV-2 pneumonia who were admitted to the intensive care unit (ICU) of Wuhan Jin Yin-tan hospital (Wuhan, China) between late December, 2019, and Jan 26, 2020. Demographic data, symptoms, laboratory values, comorbidities, treatments, and clinical outcomes were all collected. Data were compared between survivors and non-survivors. The primary outcome was 28-day mortality, as of Feb 9, 2020. Secondary outcomes included incidence of SARS-CoV-2-related acute respiratory distress syndrome (ARDS) and the proportion of patients requiring mechanical ventilation. Findings Of 710 patients with SARS-CoV-2 pneumonia, 52 critically ill adult patients were included. The mean age of the 52 patients was 59·7 (SD 13·3) years, 35 (67%) were men, 21 (40%) had chronic illness, 51 (98%) had fever. 32 (61·5%) patients had died at 28 days, and the median duration from admission to the intensive care unit (ICU) to death was 7 (IQR 3–11) days for non-survivors. Compared with survivors, non-survivors were older (64·6 years [11·2] vs 51·9 years [12·9]), more likely to develop ARDS (26 [81%] patients vs 9 [45%] patients), and more likely to receive mechanical ventilation (30 [94%] patients vs 7 [35%] patients), either invasively or non-invasively. Most patients had organ function damage, including 35 (67%) with ARDS, 15 (29%) with acute kidney injury, 12 (23%) with cardiac injury, 15 (29%) with liver dysfunction, and one (2%) with pneumothorax. 37 (71%) patients required mechanical ventilation. Hospital-acquired infection occurred in seven (13·5%) patients. Interpretation The mortality of critically ill patients with SARS-CoV-2 pneumonia is considerable. The survival time of the non-survivors is likely to be within 1–2 weeks after ICU admission. Older patients (>65 years) with comorbidities and ARDS are at increased risk of death. The severity of SARS-CoV-2 pneumonia poses great strain on critical care resources in hospitals, especially if they are not adequately staffed or resourced. Funding None.
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            Imbalanced Host Response to SARS-CoV-2 Drives Development of COVID-19

            Summary Viral pandemics, such as the one caused by SARS-CoV-2, pose an imminent threat to humanity. Because of its recent emergence, there is a paucity of information regarding viral behavior and host response following SARS-CoV-2 infection. Here we offer an in-depth analysis of the transcriptional response to SARS-CoV-2 compared with other respiratory viruses. Cell and animal models of SARS-CoV-2 infection, in addition to transcriptional and serum profiling of COVID-19 patients, consistently revealed a unique and inappropriate inflammatory response. This response is defined by low levels of type I and III interferons juxtaposed to elevated chemokines and high expression of IL-6. We propose that reduced innate antiviral defenses coupled with exuberant inflammatory cytokine production are the defining and driving features of COVID-19.
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              Impaired type I interferon activity and inflammatory responses in severe COVID-19 patients

              Coronavirus disease 2019 (COVID-19) is characterized by distinct patterns of disease progression suggesting diverse host immune responses. We performed an integrated immune analysis on a cohort of 50 COVID-19 patients with various disease severity. A unique phenotype was observed in severe and critical patients, consisting of a highly impaired interferon (IFN) type I response (characterized by no IFN-β and low IFN-α production and activity), associated with a persistent blood viral load and an exacerbated inflammatory response. Inflammation was partially driven by the transcriptional factor NF-κB and characterized by increased tumor necrosis factor (TNF)-α and interleukin (IL)-6 production and signaling. These data suggest that type-I IFN deficiency in the blood could be a hallmark of severe COVID-19 and provide a rationale for combined therapeutic approaches.
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                Author and article information

                Contributors
                Journal
                Dis Model Mech
                Dis Model Mech
                DMM
                Disease Models & Mechanisms
                The Company of Biologists Ltd
                1754-8403
                1754-8411
                1 November 2022
                11 November 2022
                11 November 2022
                : 15
                : 11
                : dmm049632
                Affiliations
                [ 1 ]Severance Biomedical Science Institute, Brain Korea 21 FOUR Project for Medical Science, Yonsei University College of Medicine , Seoul 03722, South Korea
                [ 2 ]Department of Nuclear Medicine, Seoul National University Bundang Hospital , Seongnam 13488, South Korea
                [ 3 ]Institute of Immunology and Immunological Diseases, Yonsei University College of Medicine , Seoul 03722, South Korea
                [ 4 ]Korea Mouse Phenotyping Center, Seoul National University , Seoul 08826, South Korea
                [ 5 ]Department of Microbiology, Yonsei University College of Medicine , Seoul 03722, South Korea
                [ 6 ]Laboratory of Developmental Biology and Genomics, Research Institute for Veterinary Science, and Brain Korea 21 FOUR Program for Creative Veterinary Science Research, College of Veterinary Medicine, Seoul National University , Seoul 08826, South Korea
                [ 7 ]Division of Biomedical Convergence, College of Biomedical Science, Kangwon National University , Chuncheon 24341, South Korea
                [ 8 ]Laboratory of Avian Diseases, Brain Korea 21 FOUR Program for Veterinary Science and Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University , Seoul 08826, South Korea
                [ 9 ]Preclinical Research Center, Seoul National University Bundang Hospital , Seongnam 13488, South Korea
                [ 10 ]Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital , Seongnam 13620, South Korea
                [ 11 ]Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam 13620, South Korea
                [ 12 ]Bionanotechnology Research Center, Korea Research Institute of Bioscience and Biotechnology , Daejeon 34141, South Korea
                [ 13 ]Department of Veterinary Medicine Virology Laboratory, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University , Seoul 08826, South Korea
                [ 14 ]Science Unit, International Vaccine Institute , Seoul 08826, South Korea
                [ 15 ]Department of Microbiology, Institute for Viral Diseases, Biosafety Center, Korea University College of Medicine , Seoul 02841, South Korea
                [ 16 ]Laboratory of Veterinary Toxicology, College of Veterinary Medicine, Seoul National University , Seoul 08826, South Korea
                [ 17 ]Department of Nuclear Medicine, Seoul National University , College of Medicine , Seoul 03080, South Korea
                [ 18 ]BIO-MAX Institute, Seoul National University , Seoul 08826, South Korea
                [ 19 ]Interdisciplinary Program for Bioinformatics, Seoul National University , Seoul 08826, South Korea
                Author notes
                [*]

                These authors contributed equally to this work

                Handling Editor: Sumana Sanyal

                Competing interests

                The authors declare no competing or financial interests.

                Author information
                http://orcid.org/0000-0002-9218-7372
                http://orcid.org/0000-0003-4806-6730
                http://orcid.org/0000-0002-6227-2058
                http://orcid.org/0000-0002-3883-8330
                http://orcid.org/0000-0002-2759-1061
                http://orcid.org/0000-0003-4004-2013
                http://orcid.org/0000-0002-0155-4190
                http://orcid.org/0000-0002-8294-3234
                http://orcid.org/0000-0001-6518-0602
                http://orcid.org/0000-0001-5292-1280
                http://orcid.org/0000-0003-1177-6958
                Article
                DMM049632
                10.1242/dmm.049632
                9672931
                36222118
                fefe836a-a294-428f-b4dc-becf23b5891d
                © 2022. Published by The Company of Biologists Ltd

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution and reproduction in any medium provided that the original work is properly attributed.

                History
                : 28 April 2022
                : 4 October 2022
                Funding
                Funded by: Korea Mouse Phenotyping Project;
                Award ID: NRF-2016M3A9D5A01952416
                Funded by: Yonsei University, http://dx.doi.org/10.13039/501100002573;
                Funded by: National Research Foundation of Korea, http://dx.doi.org/10.13039/501100003725;
                Award ID: 2021M3H9A1038083
                Categories
                Research Article

                Molecular medicine
                sars-cov-2,syrian golden hamster,k18-hace2 mice
                Molecular medicine
                sars-cov-2, syrian golden hamster, k18-hace2 mice

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