Abstract
Little is known of the patterns of expression of ACE2 and TMPRSS2 or the clinical characteristics of COVID-19 in patients with COVID-19 and colorectal cancer. We found in both bulk and single-cell RNA-seq profiles that ACE2 and TMPRSS2 were expressed at high levels on tumor and normal colorectal epithelial tissues. Clinically, patients with colorectal cancer and COVID-19 were more likely to have lymphopenia, higher respiratory rate, and high hypersensitive C-reactive protein levels than matched patients with COVID-19 but without cancer. These results suggest that patients with colorectal cancer may be particularly susceptible to SARS-CoV-2 infection. Further mechanistic studies are needed to support our findings.
Highlights
In late 2019, a new RNA coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), was found to have infected humans, and led to a worldwide outbreak of coronavirus disease (COVID-19)1,2
Cancer patients are known to be vulnerable to infection in general and may experience more serious consequences of COVID-1914–17, but little is known of whether ACE2 and TMPRSS2 are expressed in colorectal cancer tissues, or how infection with SARS-CoV-2 may affect the clinical course of patients with colorectal cancer
Among the 989 epithelial cells in colon cancer tissues, 12.3% expressed ACE2 and 38.5% expressed TMPRSS2 (Fig. 3A–B). These findings indicate that ACE2 and TMPRSS2 are expressed at high levels in both normal and cancerous colorectal tissues, suggesting that the colorectum may be susceptible to SARS-CoV-2 infection
Summary
Among the 989 epithelial cells in colon cancer tissues, 12.3% expressed ACE2 and 38.5% expressed TMPRSS2 (Fig. 3A–B). Apparent (though non-significant) differences between cancer patients and non-cancer controls included having high lactate dehydrogenase levels (60% vs 15%, P = 0.070); receipt of antiviral therapy (60% vs 35%, P = 0.358), glucocorticoids (80% vs 40%, P = 0.160), and mechanical ventilation (20% vs 5%, P = 0.367); having COVID-19 for longer than 30 days (60% vs 35%, P = 0.358); and having a higher death rate (20% vs 5%, P = 0.367) (Table 1). We further found that patients with colorectal cancer and COVID19 were more likely to have lymphopenia and higher respiratory rates and hypersensitive C-reactive protein levels than were patients with COVID-19 but without cancer These results suggest that patients with colorectal cancer may be vulnerable to infection with SARS-CoV-2 and extra precautions should be taken to prevent them from developing COVID-19
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