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Digestive Symptoms of COVID-19 and High Expression of ACE2 in Digestive Tract Organs

18 Pages Posted: 20 Apr 2020

See all articles by Mei Chu

Mei Chu

Guangzhou Medical University - Guangzhou Eighth People's Hospital

Jiabin Xu

Sun Yat-Sen University (SYSU) - Department of Oral and Maxillofacial Surgery; Guangdong Provincial Key Laboratory of Stomatology

Fan Zhong

Guangzhou Medical University - Guangzhou Eighth People's Hospital

Xinghua Tan

Guangzhou Medical University - Guangzhou Eighth People's Hospital

Guofang Tang

Guangzhou Medical University - Guangzhou Eighth People's Hospital

Jianbo Mai

Guangzhou Medical University - Guangzhou Eighth People's Hospital

Niangmei Lai

Guangzhou Medical University - Guangzhou Eighth People's Hospital

Chenyu Guan

Sun Yat-Sen University (SYSU) - Department of Oral and Maxillofacial Surgery; Guangdong Provincial Key Laboratory of Stomatology

Yujie Liang

Sun Yat-Sen University (SYSU) - Department of Oral and Maxillofacial Surgery; Guangdong Provincial Key Laboratory of Stomatology

Gui-qing Liao

Sun Yat-Sen University (SYSU) - Guanghua School of Stomatology; Guangdong Provincial Key Laboratory of Stomatology

More...

Abstract

A novel coronavirus (SARS-CoV-2) was identified in December 2019, Wuhan, China. This new coronavirus has resulted in numerous cases of Coronavirus Disease 2019 (COVID-19) throughout the world. Apart from fever and respiratory symptoms, digestive symptoms could be observed in patients with COVID-19. Angiotensin-converting enzyme 2 (ACE2) was reported to be the receptor of SARS-CoV-2. Aim to more comprehensively investigate the digestive symptoms in COVID-19 patients, and the potential pathogenic route of the SARS-CoV-2 infection in digestive tract organs (from oral cavity to gut), we investigated the digestive symptoms of 48 patients with COVID-19, and explored ACE2 expression in digestive tract cancers and lung cancers, based on a series of bulk and single-cell RNA sequencing data from public databases. We found that 25% (12/48) patients with COVID-19 suffered from digestive symptoms, among which pharyngalgia (7/48) was the most common manifestation, followed by diarrhea (3/48), anorexia (3/48), and nausea (1/48). The bulk RNA sequencing analysis indicated that digestive tract organs had higher ACE2 expression than lung and expression of ACE2 in lung increases with age. Single-cell RNA-Seq results showed that ACE2-positive-cell ratio in digestive tract organs was significantly higher than that in lung; ACE2 expression was higher in tumor cells than that in NC tissues; in gastric tissues, ACE2 expression was gradually increased from chronic gastritis, metaplasia to early cancer. Our data may provide a theoretical basis for the screening of SARS-CoV-2 susceptible population, and for the clinical classification for treatment of patients with COVID-19.

Funding Statement: This work was supported by the Guangdong Financial Fund for High-Caliber Hospital Construction.

Declaration of Interests: The authors have no conflicts of interest.

Ethics Approval Statement: This study was approved by the institutional ethics board of Guangzhou Eighth People’s Hospital (No. 202006139).

Keywords: COVID-19; SARS-CoV-2; ACE2; Oral cavity; Digestive tract; TCGA; Single-cell Sequencing

Suggested Citation

Chu, Mei and Xu, Jiabin and Zhong, Fan and Tan, Xinghua and Tang, Guofang and Mai, Jianbo and Lai, Niangmei and Guan, Chenyu and Liang, Yujie and Liao, Gui-qing, Digestive Symptoms of COVID-19 and High Expression of ACE2 in Digestive Tract Organs (4/7/2020). Available at SSRN: https://ssrn.com/abstract=3572849 or http://dx.doi.org/10.2139/ssrn.3572849

Mei Chu

Guangzhou Medical University - Guangzhou Eighth People's Hospital

Guangzhou, 510080
China

Jiabin Xu

Sun Yat-Sen University (SYSU) - Department of Oral and Maxillofacial Surgery

China

Guangdong Provincial Key Laboratory of Stomatology

Guangzhou
China

Fan Zhong

Guangzhou Medical University - Guangzhou Eighth People's Hospital

Guangzhou, 510080
China

Xinghua Tan

Guangzhou Medical University - Guangzhou Eighth People's Hospital

Guangzhou, 510080
China

Guofang Tang

Guangzhou Medical University - Guangzhou Eighth People's Hospital

Guangzhou, 510080
China

Jianbo Mai

Guangzhou Medical University - Guangzhou Eighth People's Hospital

Guangzhou, 510080
China

Niangmei Lai

Guangzhou Medical University - Guangzhou Eighth People's Hospital

Guangzhou, 510080
China

Chenyu Guan

Sun Yat-Sen University (SYSU) - Department of Oral and Maxillofacial Surgery

China

Guangdong Provincial Key Laboratory of Stomatology

Guangzhou
China

Yujie Liang

Sun Yat-Sen University (SYSU) - Department of Oral and Maxillofacial Surgery ( email )

China

Guangdong Provincial Key Laboratory of Stomatology ( email )

Guangzhou
China

Gui-qing Liao (Contact Author)

Sun Yat-Sen University (SYSU) - Guanghua School of Stomatology ( email )

135, Xingang Xi Road
Guangzhou, Guangdong 510275
China

Guangdong Provincial Key Laboratory of Stomatology ( email )

Guangzhou
China

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