SARS-CoV-2 infection induces beta cell transdifferentiation

Xuming Tang, Skyler Uhl, Tuo Zhang, Dongxiang Xue, Bo Li, J. Jeya Vandana, Joshua A. Acklin, Lori L. Bonnycastle, Narisu Narisu, Michael R. Erdos, Yaron Bram, Vasuretha Chandar, Angie Chi Nok Chong, Lauretta A. Lacko, Zaw Min, Jean K. Lim, Alain C. Borczuk, Jenny Xiang, Ali Naji, Francis S. CollinsTodd Evans, Chengyang Liu, Benjamin R. tenOever, Robert E. Schwartz, Shuibing Chen

Research output: Contribution to journalArticlepeer-review

100 Scopus citations


Recent clinical data have suggested a correlation between coronavirus disease 2019 (COVID-19) and diabetes. Here, we describe the detection of SARS-CoV-2 viral antigen in pancreatic beta cells in autopsy samples from individuals with COVID-19. Single-cell RNA sequencing and immunostaining from ex vivo infections confirmed that multiple types of pancreatic islet cells were susceptible to SARS-CoV-2, eliciting a cellular stress response and the induction of chemokines. Upon SARS-CoV-2 infection, beta cells showed a lower expression of insulin and a higher expression of alpha and acinar cell markers, including glucagon and trypsin1, respectively, suggesting cellular transdifferentiation. Trajectory analysis indicated that SARS-CoV-2 induced eIF2-pathway-mediated beta cell transdifferentiation, a phenotype that could be reversed with trans-integrated stress response inhibitor (trans-ISRIB). Altogether, this study demonstrates an example of SARS-CoV-2 infection causing cell fate change, which provides further insight into the pathomechanisms of COVID-19.

Original languageEnglish
Pages (from-to)1577-1591.e7
JournalCell Metabolism
Issue number8
StatePublished - 3 Aug 2021


  • COVID-19
  • EgIF2
  • PRSS1
  • diabetes
  • human islets
  • insulin
  • trypsin 1


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