Preprint Article Version 2 Preserved in Portico This version is not peer-reviewed

Expression and Clinical Significance of SARS-CoV-2 Human Targets in Lung Tissues: Normal, Primary Tumor and Metastasis

Version 1 : Received: 2 July 2020 / Approved: 3 July 2020 / Online: 3 July 2020 (08:41:44 CEST)
Version 2 : Received: 3 July 2020 / Approved: 6 July 2020 / Online: 6 July 2020 (10:14:03 CEST)

A peer-reviewed article of this Preprint also exists.

Journal reference: Current Cancer Drug Targets 2020
DOI: 10.2174/1568009620666201207145019


The recent COVID-19 outbreak in China led to a worldwide pandemic associated with a severe acute respiratory illness. A higher incidence of COVID-19 infection was demonstrated in cancer patients, including patients with lung cancer. This study was conducted to get insights into the reasons for this enhanced frequency of COVID-19 infection. Methods: Using different bioinformatic tools, the expression and methylation pattern of ACE2 and TMPRSS2 gene were analyzed in healthy and malignant tissues with a focus on lung adenocarcinoma (LUAD) and correlated to clinical parameters and smoking history. Results: ACE2 and TMPRSS2 were heterogeneously expressed across 36 healthy tissues with the highest expression in digestive, urinary and reproductive organs, while their expression was significantly lower in 36 cancer tissues. In LUAD, ACE2, but not TMPRSS2 was overexpressed, which inversely correlated to the promoter methylation. An age-dependent upregulation of ACE2 expression was found in LUAD compared to normal lung tissues. In a healthy lung, TMPRSS2 expression was dependent on sex and smoking history and downregulated in LUAD of smokers. Cancer progression was associated with decreased TMPRSS2, but unaltered ACE2 expression, while ACE2 expression in lung metastases of different cancers was higher than in metastasis of other sites. TMPRSS2, but not ACE2 expression, was associated with LUAD patients’ survival. Conclusions: Comprehensive molecular analyses revealed a heterogeneous, distinct expression and methylation profile of ACE2 and TMPRSS2 in healthy lung vs LUAD tissues across sex, age and smoking history, which is associated with clinical parameters and might have implications for COVID-19 disease.


COVID-19; metastasis; lung adenocarcinoma; smoking; aging; ACE2


MEDICINE & PHARMACOLOGY, Oncology & Oncogenics

Comments (1)

Comment 1
Received: 6 July 2020
Commenter: Barbara Seliger
Commenter's Conflict of Interests: Author
Comment: PDF version of our manuscript included with figures and tables.
A new abstract figure is enclosed.
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