Abstract P2188: Covid-19 Plasma Exposure Causes Transcriptional, Morphological, And Functional Changes Within The Pulmonary Microvascular Endothelium

Abstract

Introduction and Aims: While primarily a pulmonary disease, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can affect multiple organ systems, including the vasculature. Thus far studies have successfully characterised the whole organ compartment, however, our understanding of the mechanisms associated with COVID-19 infection and its impact on pulmonary microvasculature (pMV) remains incomplete. In human pulmonary microvascular endothelial cells (HPMVEC) treated with plasma from patients hospitalised with COVID-19, we aimed to evaluate transcriptional, morphological and functional changes, and to provide a mechanism for the excess mortality in patients with COVID-19 and how it may inform therapeutic advancement. Methods and Results: Plasma acquired from hospitalised patients with COVID-19 was compared to plasma from patients hospitalised without COVID-19 but with other acute illnesses, such as COPD. Exposure to plasma from patients with COVID-19 caused a significant functional decline in HPMVEC, with a decrease in both cell viability on the WST-1 cell-proliferation assay (n=75, p= 0.013) and cell-to-cell barrier function measured by electric cell-substrate impedance sensing (n=3, p = 0.033) . High content imaging using the cell painting image-based assay showed a phenotypic change in nuclear (n=4, p=0.019) and nucleic acid (n=4, p=0.022) morphology, indicative of a deterioration in core biological processes including protein transcription and metabolic output. Comparative deep RNA-sequencing of HPMVECs treated with COVID-19 plasma (n=5) confirmed upregulation of genes, notably IFIT5 and SFMBT1 . These genes are known to negatively regulate transcription and respond to viral infection, respectively, further demonstrating the phenotypic and transcriptional decline in the pulmonary microvasculature in patients with COVID-19. Conclusion and Impact: Our findings suggest that core biological processes are disrupted in the lung microvascular endothelium during severe COVID-19 disease contributing to aggravated disease. From a translational perspective, this knowledge could provide insight into possible treatment opportunities and prognostic tools that may directly target the dysregulated endothelium.