PT - JOURNAL ARTICLE AU - Julian Buchrieser AU - Jeremy Dufloo AU - Mathieu Hubert AU - Blandine Monel AU - Delphine Planas AU - Maaran Michael Rajah AU - Cyril Planchais AU - Françoise Porrot AU - Florence Guivel-Benhassine AU - Sylvie Van der Werf AU - Nicoletta Casartelli AU - Hugo Mouquet AU - Timothée Bruel AU - Olivier Schwartz TI - Syncytia formation by SARS-CoV-2 infected cells AID - 10.1101/2020.07.14.202028 DP - 2020 Jan 01 TA - bioRxiv PG - 2020.07.14.202028 4099 - http://biorxiv.org/content/early/2020/07/14/2020.07.14.202028.short 4100 - http://biorxiv.org/content/early/2020/07/14/2020.07.14.202028.full AB - Severe cases of COVID-19 are associated with extensive lung damage and the presence of infected multinucleated syncytial pneumocytes. The viral and cellular mechanisms regulating the formation of these syncytia are not well understood. Here, we show that SARS-CoV-2 infected cells express the viral Spike protein (S) at their surface and fuse with ACE2-positive neighbouring cells. Expression of S without any other viral proteins triggers syncytia formation. Type-I interferon (IFN)-induced transmembrane proteins (IFITMs), a family of restriction factors that block the entry of many viruses, inhibit S-mediated fusion, with IFITM1 being more active than IFITM2 and IFITM3. On the contrary, the TMPRSS2 serine protease, which is known to enhance infectivity of cell-free virions, processes both S and ACE2 and increases syncytia formation by accelerating the fusion process. TMPRSS2 thwarts the antiviral effect of IFITMs. Our results show that the pathological effects of SARS-CoV-2 are modulated by cellular proteins that either inhibit or facilitate syncytia formation.One Sentence Summary Syncytia produced by SARS-CoV-2 infected cells and regulation of their formation by IFITMs and TMPRSS2.Competing Interest StatementThe authors have declared no competing interest.