SARS-CoV-2 in the pancreas and the impaired islet function in COVID-19 patients

Ningfei Ji; Mingshun Zhang; Liang Ren; Yunyun Wang; Bicheng Hu; Jie Xiang; Yingyun Gong; Chaojie Wu; Guoqiang Qu; Wenqiu Ding; Zhiqiang Yin; Shan Li; Zhengxia Wang; Lianzheng Zhou; Xueqin Chen; Yuan Ma; Jinhai Tang; Yun Liu; Liang Liu; Mao Huang

doi:10.1080/22221751.2022.2059400

SARS-CoV-2 in the pancreas and the impaired islet function in COVID-19 patients

Emerg Microbes Infect. 2022 Dec;11(1):1115-1125. doi: 10.1080/22221751.2022.2059400.

Authors

Ningfei Ji¹, Mingshun Zhang², Liang Ren³, Yunyun Wang³, Bicheng Hu⁴, Jie Xiang^{5

6}, Yingyun Gong⁷, Chaojie Wu¹, Guoqiang Qu⁸, Wenqiu Ding¹, Zhiqiang Yin⁹, Shan Li¹, Zhengxia Wang¹, Lianzheng Zhou¹, Xueqin Chen¹, Yuan Ma¹, Jinhai Tang¹⁰, Yun Liu¹¹, Liang Liu³, Mao Huang¹

Affiliations

¹ Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.
² Key Laboratory of Antibody Techniques, National Health Commission, Department of Immunology, Nanjing Medical University, Nanjing, People's Republic of China.
³ Department of Forensic Medicine, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, People's Republic of China.
⁴ Department of Laboratory, Wuhan No. 1 Hospital, Wuhan, People's Republic of China.
⁵ Department of Laboratory, Wuhan Jinyintan Hospital, Wuhan, People's Republic of China.
⁶ Diagnosis and Treatment Research Center of Wuhan Infectious Disease of Chinese Academy of Medical Sciences, Wuhan, People's Republic of China.
⁷ Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.
⁸ Hubei Chongxin Judicial Expertise Center, Wuhan, People's Republic of China.
⁹ Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.
¹⁰ Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.
¹¹ Department of Medical Informatics, School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, People's Republic of China.

Abstract

Diabetes mellitus (DM) is one of the most common underlying diseases that may aggravates COVID-19. In the present study, we explored islet function, the presence of SARS-CoV-2 and pathological changes in the pancreas of patients with COVID-19. Oral glucose tolerance tests (OGTTs) and the C-peptide release test demonstrated a decrease in glucose-stimulated C-peptide secretory capacity and an increase in HbA1c levels in patients with COVID-19. The prediabetic conditions appeared to be more significant in the severe group than in the moderate group. SARS-CoV-2 receptors (ACE2, CD147, TMPRSS2 and neuropilin-1) were expressed in pancreatic tissue. In addition to SARS-CoV-2 virus spike protein and virus RNA, coronavirus-like particles were present in the autophagolysosomes of pancreatic acinar cells of a patient with COVID-19. Furthermore, the expression and distribution of various proteins in pancreatic islets of patients with COVID-19 were altered. These data suggest that SARS-CoV-2 in the pancreas may directly or indirectly impair islet function.

Keywords: Covid-19; diabetes; islet; pancreas; sARS-CoV-2.

MeSH terms

C-Peptide / metabolism
COVID-19*
Diabetes Mellitus* / metabolism
Humans
Pancreas
SARS-CoV-2

Substances

C-Peptide

Grants and funding

This work was supported by Jiangsu Provincial Key Research and Development Program: [Grant Number BE2020616]; Ministry of Science and Technology of China: [Grant Number 2020YFC0844700].