• Charlotte Steenblock
  • Stefanie Richter
  • Ilona Berger
  • Marko Barovic
  • Janine Schmid
  • Undine Schubert
  • Natalia Jarzebska
  • Anne von Massenhausen
  • Andreas Linkermann
  • Annette Schurmann
  • Jessica Pablik
  • Katja Evert
  • Roman Rodionov
  • Natalia Semenova
  • Vsevolod Zinslering
  • Gustavo Baretton
  • Dirk Lindemann
  • Michaele Solimena
  • Barbara Ludwig
  • Stefan Bornstein
Here we report a possible mechanistic link between coronavirus disease 2019 (COVID-19) and diabetes. In addition to its known role on the respiratory system, the human coronavirus SARS-CoV-2 has been shown to affect the endocrine system including the pancreas 1-4. It has been suggested that the virus can induce type 1 diabetes 5-8. Therefore, we isolated human pancreatic islets and examined the expression of angiotensin-converting enzyme 2 (ACE2) and the protease TMPRSS2, known to be important for SARS-CoV-2 entry 9. Furthermore, we investigated the expression of an alternative entry receptor, dipeptidyl peptidase-4 (DPP4 also known as CD26) 10. We found all three proteins expressed in pancreatic beta-cells and confirmed that beta-cells are permissive to infection with SARS-CoV-2 pseudoviruses. Additionally, we performed a comprehensive analysis of ACE2, TMPRSS2 and DPP4 expression in pancreata of 10 patients who died of COVID-19. We report significant variation between the samples and detected the highest levels of ACE2 and DPP4 expression in patients exhibiting SARS-CoV-2 infiltration shown by confocal microscopy, RNAscope and electron microscopy. Furthermore, necroptotic cell death was observed in beta-cells of the COVID-19 patients. Taken together, these data suggest that SARS-CoV-2 viral infection of pancreatic beta-cells may trigger necroptosis and islet impairment.
Original languageEnglish
JournalNature Metabolism
Early online dateOct 2020
StatePublished - 2020

    Research areas

  • COVID-19

ID: 71408021