Initially it was thought that COVID-19 was predominantly a disease only transmitted via the respiratory route. However, clinical evidence suggests that the intestine may also be a viral target organ. The SARS-CoV-2 receptor, angiotensin converting enzyme 2 (ACE2), is highly expressed on differentiated enterocytes. The authors found that in a model of human small intestinal organoids (hSIOs), enterocytes could be readily infected by both SARS-CoV and SARS-CoV-2, as demonstrated by confocal- and electron-microscopy. Significant titres of infectious viral particles were detected. mRNA expression analyses identified strong induction of a generic viral response programme. Therefore it does appear that the intestinal epithelium could support SARS-CoV-2 replication, with hSIOs acting as an experimental model for coronavirus infection and biology.
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