Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Two Things about COVID-19 Might Need Attention

Version 1 : Received: 22 February 2020 / Approved: 23 February 2020 / Online: 23 February 2020 (10:30:06 CET)

How to cite: Jia, X.; Yin, C.; Lu, S.; Chen, Y.; Liu, Q.; Bai, J.; Lu, Y. Two Things about COVID-19 Might Need Attention. Preprints 2020, 2020020315 (doi: 10.20944/preprints202002.0315.v1). Jia, X.; Yin, C.; Lu, S.; Chen, Y.; Liu, Q.; Bai, J.; Lu, Y. Two Things about COVID-19 Might Need Attention. Preprints 2020, 2020020315 (doi: 10.20944/preprints202002.0315.v1).

Abstract

The spread of 2019 novel coronavirus disease (COVID-19) throughout the world has been a severe challenge for public health. The human angiotensin-converting enzyme 2 (ACE2) has a remarkably high affinity binding to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). By the search for network database and re-analysis of pubic data, we found the level of ACE2 expression in adipose tissue was higher than that in lung tissue, which indicated the adipose tissue might be vulnerable to SARS-CoV-2 as well; the levels of ACE2 expressed by adipocytes and adipose progenitor cells were similar between non-obese individuals and obese individuals, but obese individuals have more adiposes so as to increase the number of ACE2-expressing cells; the expression of ACE2 in tumor tissues posed by five different types of cancers increased significantly compared with that in adjacent tissues. Thus, we suggest that more attentions might be given to obese individuals and the five types of cancer patients during the outbreak of COVID-19.

Subject Areas

COVID-19; adipose tissue; cancer; ACE2

Comments (3)

Comment 1
Received: 7 April 2020
Commenter: Dr. David Johnson
The commenter has declared there is no conflict of interests.
Comment: We have wondered whether or not elderly obese patients experienced a higher incidence of cytokine storm and death than elderly non-obese patients in China.
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Comment 2
Received: 15 April 2020
Commenter: Jacquelynn C.
The commenter has declared there is no conflict of interests.
Comment: Obesity/RAAS studies have indicated DECREASED ACE2 expression in obese mice increasing inflammatory response

https://pubmed.ncbi.nlm.nih.gov/31484552/
https://diabetes.diabetesjournals.org/content/65/1/19
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Comment 3
Received: 20 April 2020
Commenter: Konstantinos Farsalinos (Click to see Publons profile: )
The commenter has declared there is no conflict of interests.
Comment: The authors try to apply the theory that ACE2 up-regulation is detrimental for COVID-19 into obese subjects. Even if adipose tissue had higher expression of ACE2 this cannot explain the severity of COVID-19 among obese individuals. COVID-19 is not a disease of adipose tissue.
This is an oversimplification and is against recent data suggesting that ACE2 up-regulation is protective against COVID-19 severity. Females, young people and children have higher ACE2 expression, and at the same time milder disease (https://www.frontiersin.org/articles/10.3389/fped.2020.00206/full).
Studies on SARS-CoV1 showed that after the cells are infected there is an immediate down-regulation (elimination) of ACE2, and this was the reason for the tissue damage (https://www.nature.com/articles/nm1267).
ACE2 is protective, not detrimental. You need to find a different hypothesis to explain the findings that obesity is a risk factor for COVID-19.
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