RT Journal Article SR Electronic T1 Systemic Tissue and Cellular Disruption from SARS-CoV-2 Infection revealed in COVID-19 Autopsies and Spatial Omics Tissue Maps JF bioRxiv FD Cold Spring Harbor Laboratory SP 2021.03.08.434433 DO 10.1101/2021.03.08.434433 A1 Jiwoon Park A1 Jonathan Foox A1 Tyler Hether A1 David Danko A1 Sarah Warren A1 Youngmi Kim A1 Jason Reeves A1 Daniel J. Butler A1 Christopher Mozsary A1 Joel Rosiene A1 Alon Shaiber A1 Ebrahim Afshinnekoo A1 Matthew MacKay A1 Yaron Bram A1 Vasuretha Chandar A1 Heather Geiger A1 Arryn Craney A1 Priya Velu A1 Ari M. Melnick A1 Iman Hajirasouliha A1 Afshin Beheshti A1 Deanne Taylor A1 Amanda Saravia-Butler A1 Urminder Singh A1 Eve Syrkin Wurtele A1 Jonathan Schisler A1 Samantha Fennessey A1 André Corvelo A1 Michael C. Zody A1 Soren Germer A1 Steven Salvatore A1 Shawn Levy A1 Shixiu Wu A1 Nicholas Tatonetti A1 Sagi Shapira A1 Mirella Salvatore A1 Massimo Loda A1 Lars F. Westblade A1 Melissa Cushing A1 Hanna Rennert A1 Alison J. Kriegel A1 Olivier Elemento A1 Marcin Imielinski A1 Alain C. Borczuk A1 Cem Meydan A1 Robert E. Schwartz A1 Christopher E. Mason YR 2021 UL http://biorxiv.org/content/early/2021/03/09/2021.03.08.434433.abstract AB The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) virus has infected over 115 million people and caused over 2.5 million deaths worldwide. Yet, the molecular mechanisms underlying the clinical manifestations of COVID-19, as well as what distinguishes them from common seasonal influenza virus and other lung injury states such as Acute Respiratory Distress Syndrome (ARDS), remains poorly understood. To address these challenges, we combined transcriptional profiling of 646 clinical nasopharyngeal swabs and 39 patient autopsy tissues, matched with spatial protein and expression profiling (GeoMx) across 357 tissue sections. These results define both body-wide and tissue-specific (heart, liver, lung, kidney, and lymph nodes) damage wrought by the SARS-CoV-2 infection, evident as a function of varying viral load (high vs. low) during the course of infection and specific, transcriptional dysregulation in splicing isoforms, T cell receptor expression, and cellular expression states. In particular, cardiac and lung tissues revealed the largest degree of splicing isoform switching and cell expression state loss. Overall, these findings reveal a systemic disruption of cellular and transcriptional pathways from COVID-19 across all tissues, which can inform subsequent studies to combat the mortality of COVID-19, as well to better understand the molecular dynamics of lethal SARS-CoV-2 infection and other viruses.Competing Interest StatementO.E. is scientific advisor and equity holder in Freenome, Owkin, Volastra Therapeutics and OneThree Biotech. R.E.S. is on the scientific advisory board of Miromatrix Inc and is a consultant and speaker for Alnylam Inc. L.S. is a scientific co-founder and paid consultant. C.M is a consultant for Onegevity Health. C.E.M. is a cofounder of Biotia and Onegevity Health. T.H, S.W., Y. K., and J.R. are employees of Nanostring Inc. The remaining authors declare no competing financial interests.