SARS-CoV-2 Infects the Brain Choroid Plexus and Disrupts the Blood-CSF Barrier in Human Brain Organoids

Cell Stem Cell. 2020 Dec 3;27(6):951-961.e5. doi: 10.1016/j.stem.2020.10.001. Epub 2020 Oct 13.

Abstract

Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, leads to respiratory symptoms that can be fatal. However, neurological symptoms have also been observed in some patients. The cause of these complications is currently unknown. Here, we use human-pluripotent-stem-cell-derived brain organoids to examine SARS-CoV-2 neurotropism. We find expression of viral receptor ACE2 in mature choroid plexus cells expressing abundant lipoproteins, but not in neurons or other cell types. We challenge organoids with SARS-CoV-2 spike pseudovirus and live virus to demonstrate viral tropism for choroid plexus epithelial cells but little to no infection of neurons or glia. We find that infected cells are apolipoprotein- and ACE2-expressing cells of the choroid plexus epithelial barrier. Finally, we show that infection with SARS-CoV-2 damages the choroid plexus epithelium, leading to leakage across this important barrier that normally prevents entry of pathogens, immune cells, and cytokines into cerebrospinal fluid and the brain.

Keywords: COVID-19; SARS-CoV-2; apolipoprotein; blood-CSF-barrier; cerebral organoids; choroid plexus organoids.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angiotensin-Converting Enzyme 2 / metabolism
  • Animals
  • Blood-Brain Barrier / virology*
  • Chlorocebus aethiops
  • Choroid Plexus / virology*
  • HEK293 Cells
  • Humans
  • Models, Biological
  • Organoids / virology
  • SARS-CoV-2 / physiology*
  • Vero Cells
  • Viral Tropism
  • Virus Internalization

Substances

  • ACE2 protein, human
  • Angiotensin-Converting Enzyme 2