Abstract

Gastrointestinal symptoms are common in COVID-19 patients but the nature of the gut immune response to SARS-CoV-2 remains poorly characterized, partly due to the difficulty of obtaining biopsy specimens from infected individuals. In lieu of tissue samples, we measured cytokines, inflammatory markers, viral RNA, microbiome composition, and antibody responses in stool samples from a cohort of 44 hospitalized COVID-19 patients. SARS-CoV-2 RNA was detected in stool of 41% of patients and more frequently in patients with diarrhea. Patients who survived had lower fecal viral RNA than those who died. Strains isolated from stool and nasopharynx of an individual were the same. Compared to uninfected controls, COVID-19 patients had higher fecal levels of IL-8 and lower levels of fecal IL-10. Stool IL-23 was higher in patients with more severe COVID-19 disease, and we found evidence of intestinal virus-specific IgA responses associated with more severe disease. We provide evidence for an ongoing humeral immune response to SARS-CoV-2 in the gastrointestinal tract, but little evidence of overt inflammation.

Details

Title
Limited intestinal inflammation despite diarrhea, fecal viral RNA and SARS-CoV-2-specific IgA in patients with acute COVID-19
Author
Britton, Graham J 1 ; Chen-Liaw, Alice 1 ; Cossarini Francesca 2 ; Livanos, Alexandra E 3 ; Spindler, Matthew P 1 ; Plitt Tamar 1 ; Eggers, Joseph 4 ; Mogno Ilaria 1 ; Gonzalez-Reiche, Ana S 5 ; Siu, Sophia 1 ; Tankelevich, Michael 3 ; Tal, Grinspan Lauren 6 ; Dixon, Rebekah E 6 ; Jha Divya 3 ; van de Guchte Adriana 5 ; Khan, Zenab 5 ; Martinez-Delgado, Gustavo 3 ; Amanat Fatima 7 ; Hoagland, Daisy A 8 ; tenOever, Benjamin R 9 ; Dubinsky, Marla C 6 ; Merad Miriam 10 ; van Bakel Harm 5 ; Krammer Florian 11 ; Bongers Gerold 4 ; Mehandru Saurabh 3 ; Faith, Jeremiah J 1 

 Icahn School of Medicine at Mount Sinai, Precision Immunology Institute, New York, USA (GRID:grid.59734.3c) (ISNI:0000 0001 0670 2351); Icahn School of Medicine at Mount Sinai, Icahn Institute for Data Science and Genomic Technology, New York, USA (GRID:grid.59734.3c) (ISNI:0000 0001 0670 2351) 
 Icahn School of Medicine at Mount Sinai, Precision Immunology Institute, New York, USA (GRID:grid.59734.3c) (ISNI:0000 0001 0670 2351); Icahn School of Medicine at Mount Sinai, Division of Infectious Disease, Department of Medicine, New York, USA (GRID:grid.59734.3c) (ISNI:0000 0001 0670 2351) 
 Icahn School of Medicine at Mount Sinai, Precision Immunology Institute, New York, USA (GRID:grid.59734.3c) (ISNI:0000 0001 0670 2351); Icahn School of Medicine at Mount Sinai, The Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, New York, USA (GRID:grid.59734.3c) (ISNI:0000 0001 0670 2351) 
 Icahn School of Medicine at Mount Sinai, Department of Oncological Sciences, New York, USA (GRID:grid.59734.3c) (ISNI:0000 0001 0670 2351) 
 Icahn School of Medicine at Mount Sinai, Icahn Institute for Data Science and Genomic Technology, New York, USA (GRID:grid.59734.3c) (ISNI:0000 0001 0670 2351) 
 Icahn School of Medicine at Mount Sinai, The Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, New York, USA (GRID:grid.59734.3c) (ISNI:0000 0001 0670 2351) 
 Icahn School of Medicine at Mount Sinai, Department of Microbiology, New York, USA (GRID:grid.59734.3c) (ISNI:0000 0001 0670 2351); Icahn School of Medicine at Mount Sinai, Graduate School of Biomedical Sciences, New York, USA (GRID:grid.59734.3c) (ISNI:0000 0001 0670 2351) 
 Icahn School of Medicine at Mount Sinai, Department of Microbiology, New York, USA (GRID:grid.59734.3c) (ISNI:0000 0001 0670 2351); Icahn School of Medicine at Mount Sinai, Graduate School of Biomedical Sciences, New York, USA (GRID:grid.59734.3c) (ISNI:0000 0001 0670 2351); Icahn School of Medicine at Mount Sinai, Virus Engineering Center for Therapeutics and Research, New York, USA (GRID:grid.59734.3c) (ISNI:0000 0001 0670 2351) 
 Icahn School of Medicine at Mount Sinai, Department of Microbiology, New York, USA (GRID:grid.59734.3c) (ISNI:0000 0001 0670 2351); Icahn School of Medicine at Mount Sinai, Virus Engineering Center for Therapeutics and Research, New York, USA (GRID:grid.59734.3c) (ISNI:0000 0001 0670 2351); Icahn School of Medicine at Mount Sinai, Global Health and Emerging Pathogens Institute, New York, USA (GRID:grid.59734.3c) (ISNI:0000 0001 0670 2351) 
10  Icahn School of Medicine at Mount Sinai, Precision Immunology Institute, New York, USA (GRID:grid.59734.3c) (ISNI:0000 0001 0670 2351); Icahn School of Medicine at Mount Sinai, Department of Oncological Sciences, New York, USA (GRID:grid.59734.3c) (ISNI:0000 0001 0670 2351) 
11  Icahn School of Medicine at Mount Sinai, Department of Microbiology, New York, USA (GRID:grid.59734.3c) (ISNI:0000 0001 0670 2351); Icahn School of Medicine at Mount Sinai, Global Health and Emerging Pathogens Institute, New York, USA (GRID:grid.59734.3c) (ISNI:0000 0001 0670 2351) 
Publication year
2021
Publication date
2021
Publisher
Nature Publishing Group
e-ISSN
20452322
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2544995852
Copyright
© The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.