• Jie Zhou, Cun Li, Xiaojuan Liu, Man Chun Chiu, Xiaoyu Zhao, Dong Wang, Yuxuan Wei, Andrew Lee, Anna Jinxia Zhang, Hin Chu, Jian-Piao Cai, Cyril Chik-Yan Yip, Ivy Hau-Yee Chan, Kenneth Kak-Yuen Wong, Owen Tak-Yin Tsang, Kwok-Hung Chan, Jasper Fuk-Woo Chan, Kelvin Kai-Wang To, Honglin Chen, and Kwok Yung Yuen.
• State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Hong Kong, China. jiezhou@hku.hk.
• Nat. Med. 2020 Jul 1; 26 (7): 1077-1083.

AbstractA novel coronavirus-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-emerged in humans in Wuhan, China, in December 2019 and has since disseminated globally1,2. As of April 16, 2020, the confirmed case count of coronavirus disease 2019 (COVID-19) had surpassed 2 million. Based on full-genome sequence analysis, SARS-CoV-2 shows high homology to SARS-related coronaviruses identified in horseshoe bats1,2. Here we show the establishment and characterization of expandable intestinal organoids derived from horseshoe bats of the Rhinolophus sinicus species that can recapitulate bat intestinal epithelium. These bat enteroids are fully susceptible to SARS-CoV-2 infection and sustain robust viral replication. Development of gastrointestinal symptoms in some patients with COVID-19 and detection of viral RNA in fecal specimens suggest that SARS-CoV-2 might cause enteric, in addition to respiratory, infection3,4. Here we demonstrate active replication of SARS-CoV-2 in human intestinal organoids and isolation of infectious virus from the stool specimen of a patient with diarrheal COVID-19. Collectively, we established the first expandable organoid culture system of bat intestinal epithelium and present evidence that SARS-CoV-2 can infect bat intestinal cells. The robust SARS-CoV-2 replication in human intestinal organoids suggests that the human intestinal tract might be a transmission route of SARS-CoV-2.

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