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Recent studies have found that the pathogen of COVID\u201019, severe acute respiratory syndrome coronavirus 2 (SARS\u2010CoV\u20102), shares the same cell receptor angiotensin converting enzyme II (ACE2) as\u00a0SARS\u2010CoV. The pathological investigation of COVID\u201019 deaths showed that the lungs had characteristics of pulmonary fibrosis. However, how SARS\u2010CoV\u20102 spreads from the lungs to other organs has not yet been determined. Here, we performed an unbiased evaluation of cell\u2010type\u2010specific expression of ACE2 in healthy and fibrotic lungs, as well as in normal and failed adult human hearts, using published single\u2010cell RNA\u2010seq data. We found that ACE2 expression in fibrotic lungs mainly locates in arterial vascular cells, which might provide a route for bloodstream spreading of SARS\u2010CoV\u20102. Failed human hearts have a higher percentage of ACE2\u2010expressing cardiomyocytes, and SARS\u2010CoV\u20102 might attack cardiomyocytes through the bloodstream in patients with heart failure. Moreover, ACE2 was highly expressed in cells infected by respiratory syncytial virus or Middle East respiratory syndrome coronavirus and in mice treated by lipopolysaccharide. Our findings indicate that patients with pulmonary fibrosis, heart failure, and virus infection have a higher risk and are more susceptible to SARS\u2010CoV\u20102 infection. The SARS\u2010CoV\u20102 might attack other organs by getting into the bloodstream. This study provides new insights into SARS\u2010CoV\u20102 blood entry and heart injury and might propose a therapeutic strategy to prevent patients from developing severe complications.<\/jats:p>","DOI":"10.1002\/jcp.29802","type":"journal-article","created":{"date-parts":[[2020,6,8]],"date-time":"2020-06-08T10:15:48Z","timestamp":1591611348000},"page":"9884-9894","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["Single\u2010cell RNA analysis on ACE2 expression provides insights into SARS\u2010CoV\u20102 potential entry into\u00a0the bloodstream and heart injury"],"prefix":"10.1002","volume":"235","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6479-8221","authenticated-orcid":false,"given":"Jieyu","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Physiology and Pathophysiology, School of Basic Medical Sciences Fudan University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiangxiang","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Physiology and Pathophysiology, School of Basic Medical Sciences Fudan University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qinhan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Physiology and Pathophysiology, School of Basic Medical Sciences Fudan University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liliang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Forensic Medicine, School of Basic Medical Sciences Fudan University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhaohua","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Zhongshan Hospital of Fudan University, The Shanghai Institute of Cardiovascular Diseases Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Zhongshan Hospital of Fudan University, The Shanghai Institute of Cardiovascular Diseases Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yue","family":"Qin","sequence":"additional","affiliation":[{"name":"Department of Physiology and Pathophysiology, School of Basic Medical Sciences Fudan University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinyue","family":"Zhang","sequence":"additional","affiliation":[{"name":"Institute of Neuroscience, State Key Laboratory of Neuroscience, CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai Research Center for Brain Science and Brain\u2010Inspired Intelligence, Shanghai Institutes for Biological Sciences Chinese Academy of Sciences Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinhong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Physiology and Pathophysiology, School of Basic Medical Sciences Fudan University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiuling","family":"Zhi","sequence":"additional","affiliation":[{"name":"Department of Physiology and Pathophysiology, School of Basic Medical Sciences Fudan University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8588-0235","authenticated-orcid":false,"given":"Dan","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Physiology and Pathophysiology, School of Basic Medical Sciences Fudan University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,6,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.res.87.5.e1"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/path.1570"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2020.02.052"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(20)30183-5"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.7554\/eLife.51413"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-020-2180-5"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature02145"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.virol.2019.10.007"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-020-06731-x"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-020-0868-6"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2020.02.058"},{"key":"e_1_2_9_13_1","doi-asserted-by":"crossref","unstructured":"Wan S. 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Aveolar macrophage activation and cytokine storm in the pathogenesis of severe COVID\u201019 25 March preprint (Version 1) available at Research Square.https:\/\/doi.org\/10.21203\/rs.3.rs-19346\/v1","DOI":"10.21203\/rs.3.rs-19346\/v1"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.1585"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41556-019-0446-7"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.3786"},{"key":"e_1_2_9_18_1","doi-asserted-by":"crossref","unstructured":"Wu Z. &McGoogan J. M.(2020). Characteristics of and important lessons from the coronavirus disease 2019 (COVID\u201019) Outbreak in China: Summary of a report of 72\u2009314 cases from the chinese center for disease control and prevention.Journal of the American Medical Association.https:\/\/doi.org\/10.1001\/jama.2020.2648","DOI":"10.1001\/jama.2020.2648"},{"key":"e_1_2_9_19_1","doi-asserted-by":"crossref","unstructured":"Zhao Y. 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