Molecular Alterations Prompted by SARS-CoV-2 Infection: Induction of Hyaluronan, Glycosaminoglycan and Mucopolysaccharide Metabolism

Arch Med Res. 2020 Oct;51(7):645-653. doi: 10.1016/j.arcmed.2020.06.011. Epub 2020 Jun 18.


Background: The SARS-CoV-2 is the etiological agent causing COVID-19 which has infected more than 2 million people with more than 200000 deaths since its emergence in December 2019. In the majority of cases patients are either asymptomatic or show mild to moderate symptoms and signs of a common cold. A subset of patients, however, develop a severe atypical pneumonia, with the characteristic ground-glass appearance on chest x-ray and computerized tomography, which evolves into an acute respiratory distress syndrome, that requires mechanical ventilation and eventually results in multiple organ failure and death. The Molecular pathogenesis of COVID-19 is still unknown.

Aim of the study: In the present work we performed a stringent metanalysis from the publicly available RNAseq data from bronchoalveolar cells and peripheral blood mononuclear cells to elucidate molecular alterations and cellular deconvolution to identify immune cell profiles.

Results: Alterations in genes involved in hyaluronan, glycosaminoglycan and mucopolysaccharides metabolism were over-represented in bronchoalveolar cells infected by SARS-CoV-2, as well as potential lung infiltration with neutrophils, T CD4+ cell and macrophages. The blood mononuclear cells presented a proliferative state. Dramatic reduction of NK and T lymphocytes, whereas an exacerbated increase in monocytes.

Conclusions: In summary our results revealed molecular pathogenesis of the SARS-CoV-2 infection to bronchoalveolar cells inducing the hyaluronan and glycosaminoglycan metabolism that could shape partially the components of the ground-glass opacities observed in CT. And the potential immune response profile in COVID-19.

Keywords: Bronchoalveolar transcriptome; COVID-19; Hyaluronan; SARS-CoV-2.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bronchoalveolar Lavage Fluid / cytology
  • COVID-19* / diagnostic imaging
  • COVID-19* / genetics
  • COVID-19* / metabolism
  • COVID-19* / pathology
  • Glycosaminoglycans* / genetics
  • Glycosaminoglycans* / metabolism
  • Humans
  • Hyaluronic Acid / genetics
  • Hyaluronic Acid / metabolism
  • Leukocytes, Mononuclear / cytology
  • Lung / diagnostic imaging
  • Lung / pathology
  • SARS-CoV-2


  • Glycosaminoglycans
  • Hyaluronic Acid