1
|
de Melo GD, Lazarini F, Levallois S, Hautefort C, Michel V, Larrous F, Verillaud B, Aparicio C, Wagner S, Gheusi G, Kergoat L, Kornobis E, Donati F, Cokelaer T, Hervochon R, Madec Y, Roze E, Salmon D, Bourhy H, Lecuit M, Lledo PM. COVID-19-related anosmia is associated with viral persistence and inflammation in human olfactory epithelium and brain infection in hamsters. Sci Transl Med 2021; 13:eabf8396. [PMID: 33941622 PMCID: PMC8158965 DOI: 10.1126/scitranslmed.abf8396] [Citation(s) in RCA: 263] [Impact Index Per Article: 87.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/26/2021] [Accepted: 04/27/2021] [Indexed: 12/11/2022]
Abstract
Whereas recent investigations have revealed viral, inflammatory, and vascular factors involved in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) lung pathogenesis, the pathophysiology of neurological disorders in coronavirus disease 2019 (COVID-19) remains poorly understood. Olfactory and taste dysfunction are common in COVID-19, especially in mildly symptomatic patients. Here, we conducted a virologic, molecular, and cellular study of the olfactory neuroepithelium of seven patients with COVID-19 presenting with acute loss of smell. We report evidence that the olfactory neuroepithelium is a major site of SARS-CoV2 infection with multiple cell types, including olfactory sensory neurons, support cells, and immune cells, becoming infected. SARS-CoV-2 replication in the olfactory neuroepithelium was associated with local inflammation. Furthermore, we showed that SARS-CoV-2 induced acute anosmia and ageusia in golden Syrian hamsters, lasting as long as the virus remained in the olfactory epithelium and the olfactory bulb. Last, olfactory mucosa sampling from patients showing long-term persistence of COVID-19-associated anosmia revealed the presence of virus transcripts and of SARS-CoV-2-infected cells, together with protracted inflammation. SARS-CoV-2 persistence and associated inflammation in the olfactory neuroepithelium may account for prolonged or relapsing symptoms of COVID-19, such as loss of smell, which should be considered for optimal medical management of this disease.
Collapse
Affiliation(s)
| | - Françoise Lazarini
- Perception and Memory Unit, Institut Pasteur, CNRS UMR3571, 75015 Paris, France
| | - Sylvain Levallois
- Biology of Infection Unit, Institut Pasteur, Paris, France; Inserm U1117, 75015 Paris, France
| | - Charlotte Hautefort
- Otolaryngology-head and Neck Surgery Department, Hopital Lariboisiere, Assistance Publique - Hôpitaux de Paris, Inserm U1141, Université de Paris, 75010 Paris, France
| | - Vincent Michel
- Perception and Memory Unit, Institut Pasteur, CNRS UMR3571, 75015 Paris, France
- Institut de l'Audition, Institut Pasteur, Paris, France; Inserm U1120, 75012 Paris, France
| | - Florence Larrous
- Lyssavirus Epidemiology and Neuropathology Unit, Institut Pasteur, 75015 Paris, France
| | - Benjamin Verillaud
- Otolaryngology-head and Neck Surgery Department, Hopital Lariboisiere, Assistance Publique - Hôpitaux de Paris, Inserm U1141, Université de Paris, 75010 Paris, France
| | - Caroline Aparicio
- Emergency Department, Hôpital Lariboisière, Assistance Publique - Hôpitaux de Paris, Université de Paris, 75010 Paris, France
| | - Sebastien Wagner
- Perception and Memory Unit, Institut Pasteur, CNRS UMR3571, 75015 Paris, France
| | - Gilles Gheusi
- Perception and Memory Unit, Institut Pasteur, CNRS UMR3571, 75015 Paris, France
- Laboratory of Experimental and Comparative Ethology, Université Sorbonne Paris Nord, Villetaneuse, France
| | - Lauriane Kergoat
- Lyssavirus Epidemiology and Neuropathology Unit, Institut Pasteur, 75015 Paris, France
| | - Etienne Kornobis
- Plateforme Technologique Biomics – Centre de Ressources et Recherches Technologiques (C2RT), Institut Pasteur, 75015 Paris, France
- Hub de Bioinformatique et Biostatistique – Département Biologie Computationnelle, Institut Pasteur, USR 3756 CNRS, 75015 Paris, France
| | - Flora Donati
- National Reference Center for Respiratory Viruses, Institut Pasteur, 75015 Paris, France
- Molecular Genetics of RNA Viruses, CNRS UMR3569, University of Paris, Institut Pasteur, 75015 Paris, France
| | - Thomas Cokelaer
- Plateforme Technologique Biomics – Centre de Ressources et Recherches Technologiques (C2RT), Institut Pasteur, 75015 Paris, France
- Hub de Bioinformatique et Biostatistique – Département Biologie Computationnelle, Institut Pasteur, USR 3756 CNRS, 75015 Paris, France
| | - Rémi Hervochon
- Otolaryngology-head and Neck Surgery Department, GHU Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, 75013 Paris, France
| | - Yoann Madec
- Emerging Diseases Epidemiology Unit, Institut Pasteur, 75015 Paris, France
| | - Emmanuel Roze
- Sorbonne Université, AP-HP, Hôpital de la Pitié-Salpêtrière, Département de Neurologie, Inserm U1127, CNRS UMR 7225, Institut du Cerveau, 75013 Paris, France
| | - Dominique Salmon
- Infectious Diseases and Immunology Department, Cochin Hotel Dieu Hospital, Assistance Publique - Hôpitaux de Paris, Université de Paris, 75015 Paris, France
| | - Hervé Bourhy
- Lyssavirus Epidemiology and Neuropathology Unit, Institut Pasteur, 75015 Paris, France
| | - Marc Lecuit
- Biology of Infection Unit, Institut Pasteur, Paris, France; Inserm U1117, 75015 Paris, France
- Université de Paris, Necker-Enfants Malades University Hospital, Division of Infectious Diseases and Tropical Medicine, Institut Imagine, AP-HP, 75015 Paris, France
| | - Pierre-Marie Lledo
- Perception and Memory Unit, Institut Pasteur, CNRS UMR3571, 75015 Paris, France
| |
Collapse
|