AI Article Synopsis
- - The study investigates the effects of direct SARS-CoV-2 infection on heart cells, specifically human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs), to understand how the virus contributes to cardiac issues like arrhythmias and sudden cardiac death.
- - Researchers found that exposing hiPSC-CMs to the SARS-CoV-2 spike protein results in the formation of larger multinucleated cells, prolonged action potential duration, and abnormal calcium handling, which can lead to increased risks of heart arrhythmias.
- - Treatment with a furin protease inhibitor or mutations to the spike protein reversed these cellular disruptions, suggesting that targeting the spike protein may help mitigate cardiac risks associated with COVID-19.
Article Abstract
Background: SARS-CoV-2-mediated COVID-19 may cause sudden cardiac death (SCD). Factors contributing to this increased risk of potentially fatal arrhythmias include thrombosis, exaggerated immune response, and treatment with QT-prolonging drugs. However, the intrinsic arrhythmic potential of direct SARS-CoV-2 infection of the heart remains unknown.
Objective: To assess the cellular and electrophysiological effects of direct SARS-CoV-2 infection of the heart using human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs).
Methods: hiPSC-CMs were transfected with recombinant SARS-CoV-2 spike protein (CoV-2 S) or CoV-2 S fused to a modified Emerald fluorescence protein (CoV-2 S-mEm). Cell morphology was visualized using immunofluorescence microscopy. Action potential duration (APD) and cellular arrhythmias were measured by whole cell patch-clamp. Calcium handling was assessed using the Fluo-4 Ca2+ indicator.
Results: Transfection of hiPSC-CMs with CoV-2 S-mEm produced multinucleated giant cells (syncytia) displaying increased cellular capacitance (75±7 pF, n = 10 vs. 26±3 pF, n = 10; P<0.0001) consistent with increased cell size. The APD90 was prolonged significantly from 419±26 ms (n = 10) in untransfected hiPSC-CMs to 590±67 ms (n = 10; P<0.05) in CoV-2 S-mEm-transfected hiPSC-CMs. CoV-2 S-induced syncytia displayed delayed afterdepolarizations, erratic beating frequency, and calcium handling abnormalities including calcium sparks, large "tsunami"-like waves, and increased calcium transient amplitude. After furin protease inhibitor treatment or mutating the CoV-2 S furin cleavage site, cell-cell fusion was no longer evident and Ca2+ handling returned to normal.
Conclusion: The SARS-CoV-2 spike protein can directly perturb both the cardiomyocyte's repolarization reserve and intracellular calcium handling that may confer the intrinsic, mechanistic substrate for the increased risk of SCD observed during this COVID-19 pandemic.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9994677 | PMC |
| http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0282151 | PLOS |
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