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Can cilia provide an entry gateway for SARS-CoV-2 to human ciliated cells?
Physiological Genomics  (IF3.107),  Pub Date : 2021-04-15, DOI: 10.1152/physiolgenomics.00015.2021
Raghad Buqaileh, Hannah Saternos, Sidney Ley, Arianna Aranda, Kathleen Forero, Wissam A. AbouAlaiwi

A world-wide coronavirus pandemic is in full swing and, at the time of writing, there are only few treatments that have been successful in clinical trials, but no effective anti-viral treatment has been approved. Because of its lethality, it is important to understand the current strain's effects and mechanisms not only in the respiratory system, but in other affected organ systems as well. Past coronavirus outbreaks caused by SARS-CoV and MERS-CoV inflicted life-threatening acute kidney injuries (AKI) on their hosts leading to significant mortality rates, which went somewhat overlooked in the face of the severe respiratory effects. Recent evidence has emphasized renal involvement in SARS-CoV-2, stressing that kidneys are damaged in COVID-19 patients. The mechanism by which this virus inflicts AKI is still unclear, but evidence from other coronavirus strains may hold some clues. Two theories exist for the proposed mechanism of AKI: 1) the AKI is a secondary effect to reduced blood and oxygen levels causing hyperinflammation and 2) the AKI is due to cytotoxic effects. Kidneys express angiotensin-converting enzyme-2 (ACE2), the confirmed SARS-CoV-2 target receptor as well as collectrin, an ACE2 homologue, that localizes to the primary cilium, an organelle historically targeted by coronaviruses. While the available literature suggests that kidney damage is leading to higher mortality rates in COVID-19 patients, especially in those with pre-existing kidney and cardiovascular diseases, the pathogenesis of COVID-19 is still being investigated. Here, we present brief literature review supporting our proposed hypothesis of a possible link between SARS-CoV-2 cellular infection and cilia.