Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can cause coronavirus disease 2019 (COVID-19), an influenza-like disease that is primarily thought to infect the lungs with transmission through the respiratory route. However, clinical evidence suggests that the intestine may present another viral target organ. Indeed, the SARS-CoV-2 receptor angiotensin-converting enzyme 2 (ACE2) is highly expressed on differentiated enterocytes. In human small intestinal organoids (hSIOs), enterocytes were readily infected by SARS-CoV and SARS-CoV-2, as demonstrated by confocal and electron microscopy. Enterocytes produced infectious viral particles, whereas messenger RNA expression analysis of hSIOs revealed induction of a generic viral response program. Therefore, the intestinal epithelium supports SARS-CoV-2 replication, and hSIOs serve as an experimental model for coronavirus infection and biology.

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Lamers, M.M, Beumer, J. (Joep), van der Vaart, J. (Jelte), Knoops, K. (Kèvin), Puschhof, J. (Jens), Breugem, T.I. (Tim I.), … Clevers, H.C. (2020). SARS-CoV-2 productively infects human gut enterocytes. Science, 369(6499), 50–54. doi:10.1126/science.abc1669