Do adipocytes serve as a reservoir for severe acute respiratory syndrome coronavirus-2?

in Journal of Endocrinology
Authors:
Charlotte Steenblock Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany

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Nicole Bechmann Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Dresden, Germany

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Felix Beuschlein Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich (USZ) and University of Zurich (UZH), Zürich, Switzerland

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Christian Wolfrum Department of Health Sciences and Technology, Laboratory of Translational Nutrition Biology, Institute of Food, Nutrition and Health, ETH Zürich, Schwerzenbach, Switzerland

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Stefan R Bornstein Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich (USZ) and University of Zurich (UZH), Zürich, Switzerland
School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, UK

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Correspondence should be addressed to C Steenblock: charlotte.steenblock@uniklinikum-dresden.de

This paper is published as part of a themed collection on Insulin Resistance and Type 2 Diabetes Mellitus

DOI:
https://doi.org/10.1530/JOE-23-0027
Volume/Issue:
Volume 258: Issue 2
Article Type:
Research Article
Article ID:
e230027
Online Publication Date:
12 Jul 2023
Copyright:
© the author(s) 2023
Collections:
Insulin resistance and type 2 diabetes mellitus
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Obesity is associated with a higher risk of severe coronavirus disease 2019 (COVID-19) and increased mortality. In the current study, we have investigated the expression of ACE2, NRP1, and HMGB1, known to facilitate severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) cell entry, in adipose tissue from non-COVID-19 control patients with normal weight, overweight, and obesity. All factors were expressed, but no significant differences between the groups were observed. Furthermore, diabetes status and medications did not affect the expression of ACE2. Only in obese men, the expression of ACE2 in adipose tissue was higher than in obese women. In the adipose tissue from patients who died from COVID-19, SARS-CoV-2 was detected in the adipocytes even though the patients died more than 3 weeks after the acute infection. This suggests that adipocytes may act as reservoirs for the virus. In COVID-19 patients, the expression of NRP1 was increased in COVID-19 patients with overweight and obesity. Furthermore, we observed an increased infiltration with macrophages in the COVID-19 adipose tissues compared to control adipose tissue. In addition, crown-like structures of dying adipocytes surrounded by macrophages were observed in the adipose tissue from COVID-19 patients. These data suggest that in obese individuals, in addition to an increased mass of adipose tissue that could potentially be infected, increased macrophage infiltration due to direct infection with SARS-CoV-2 and sustained viral shedding, rather than preinfection ACE2 receptor expression, may be responsible for the increased severity and mortality of COVID-19 in patients with obesity.

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Print ISSN:
0022-0795
Online ISSN:
1479-6805
Copyright:
© the author(s) 2023
Article ID:
e230027
Article Type:
Research Article
Received Date:
26 Jan 2023
Accepted Date:
25 May 2023
Print Publication Date:
01 Aug 2023
Online Publication Date:
12 Jul 2023
Keywords:
COVID-19; SARS-CoV-2; obesity; metabolic disorders; insulin resistance; macrophages

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