SARS-CoV-2 infection of human iPSC–derived cardiac cells reflects cytopathic features in hearts of patients with COVID-19

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Science Translational Medicine  21 Apr 2021:
Vol. 13, Issue 590, eabf7872
DOI: 10.1126/scitranslmed.abf7872

Clues from cardiac cells

Cardiac damage has been identified in individuals infected with SARS-CoV-2. Perez-Bermejo et al. studied cytopathic features of infection using human induced pluripotent stem cell (hiPSC)–derived cells and samples of heart tissue from patients. They found that hiPSC-derived cardiomyocytes were readily infected with SARS-CoV-2, whereas fibroblasts and endothelial cells were not. Infection altered gene expression and caused sarcomeric fragmentation. Autopsy samples revealed myofibrillar disruptions in the hearts of individuals infected with COVID-19 who had confirmed myocarditis and individuals who did not have cardiac involvement, with features similar to those seen in hiPSC-derived infected cells. Results support use of hiPSC-derived cells to study SARS-CoV-2–induced cardiac damage.


Although coronavirus disease 2019 (COVID-19) causes cardiac dysfunction in up to 25% of patients, its pathogenesis remains unclear. Exposure of human induced pluripotent stem cell (iPSC)–derived heart cells to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) revealed productive infection and robust transcriptomic and morphological signatures of damage, particularly in cardiomyocytes. Transcriptomic disruption of structural genes corroborates adverse morphologic features, which included a distinct pattern of myofibrillar fragmentation and nuclear disruption. Human autopsy specimens from patients with COVID-19 reflected similar alterations, particularly sarcomeric fragmentation. These notable cytopathic features in cardiomyocytes provide insights into SARS-CoV-2–induced cardiac damage, offer a platform for discovery of potential therapeutics, and raise concerns about the long-term consequences of COVID-19 in asymptomatic and severe cases.

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