2021-08-16

Departments of Pathology, Molecular and Cell-Based Medicine, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, 10029, USA. Electronic address: siraj.eljamal@mssm.edu.; Departments of Pathology, Molecular and Cell-Based Medicine, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, 10029, USA.; Department of Neurology, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, 10029 USA.; Departments of Pathology, Molecular and Cell-Based Medicine, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, 10029, USA.; Departments of Pathology, Molecular and Cell-Based Medicine, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, 10029, USA.; Department of Microbiology, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, 10029, USA.; Departments of Pathology, Molecular and Cell-Based Medicine, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, 10029, USA.; Departments of Pathology, Molecular and Cell-Based Medicine, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, 10029, USA.; Departments of Pathology, Molecular and Cell-Based Medicine, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, 10029, USA.; Departments of Pathology, Molecular and Cell-Based Medicine, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, 10029, USA.; Department of Microbiology, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, 10029, USA; Global Health and Emerging Pathogens Institute, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, 10029, USA.; Department of Microbiology, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, 10029, USA; Global Health and Emerging Pathogens Institute, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, 10029, USA.; Department of Microbiology, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, 10029, USA; Global Health and Emerging Pathogens Institute, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, 10029, USA.; Department of Microbiology, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, 10029, USA; Global Health and Emerging Pathogens Institute, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, 10029, USA.; Department of Microbiology, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, 10029, USA; Global Health and Emerging Pathogens Institute, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, 10029, USA; Biomedical Translation Research Center, Academia Sinica, Taipei, 11571, Taiwan.; Department of Microbiology, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, 10029, USA.; Department of Genetics and Genomic Sciences, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, 10029, USA.; Department of Genetics and Genomic Sciences, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, 10029, USA; Sema4, Stamford, CT, 10029, USA.; Department of Neurology, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, 10029 USA.; Department of Microbiology, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, 10029, USA; Global Health and Emerging Pathogens Institute, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, 10029, USA; Department of Medicine, Division of Infectious Diseases, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, 10029, USA; The Tisch Cancer Institute, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, 10029, USA.; Departments of Pathology, Molecular and Cell-Based Medicine, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, 10029, USA.; Departments of Pathology, Molecular and Cell-Based Medicine, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, 10029, USA.; Departments of Pathology, Molecular and Cell-Based Medicine, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, 10029, USA. Electronic address: William.westra@moutsinai.org.

Coronavirus disease 2019 (COVID-19) is an ongoing pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although viral infection is known to trigger inflammatory processes contributing to tissue injury and organ failure, it is unclear whether direct viral damage is needed to sustain cellular injury. An understanding of pathogenic mechanisms has been handicapped by the absence of optimized methods to visualize the presence and distribution of SARS-CoV-2 in damaged tissues. We first developed a positive control cell line (Vero E6) to validate SARS-CoV-2 detection assays. We then evaluated multiple organs (lungs, kidneys, heart, liver, brain, intestines, lymph nodes, and spleen) from fourteen COVID-19 autopsy cases using immunohistochemistry (IHC) for the spike and the nucleoprotein proteins, and RNA in situ hybridization (RNA ISH) for the spike protein mRNA. Tissue detection assays were compared with quantitative polymerase chain reaction (qPCR)-based