Comparative Pathogenesis Of COVID-19, MERS And SARS In A Non-Human Primate Model

Rockx, Barry; Kuiken, Thijs; Herfst, Sander; Bestebroer, Theo; Lamers, Mart M.; de Meulder, Dennis; van Amerongen, Geert; van den Brand, Judith; Okba, Nisreen M.A.; Schipper, Debby; van Run, Peter; Leijten, Lonneke; Verschoor, Ernst; Verstrepen, Babs; Langermans, Jan; Drosten, Christian; van Vlissingen, Martje Fentener; Fouchier, Ron; de Swart, Rik; Koopmans, Marion; Haagmans, Bart L.

A novel coronavirus, SARS-CoV-2, was recently identified in patients with an acute respiratory syndrome, COVID-19. To compare its pathogenesis with that of previously emerging coronaviruses, we inoculated cynomolgus macaques with SARS-CoV-2 or MERS-CoV and compared with historical SARS-CoV infections. In SARS-CoV-2-infected macaques, virus was excreted from nose and throat in absence of clinical signs, and detected in type I and II pneumocytes in foci of diffuse alveolar damage and mucous glands of the nasal cavity. In SARS-CoV-infection, lung lesions were typically more severe, while they were milder in MERS-CoV infection, where virus was detected mainly in type II pneumocytes. These data show that SARS-CoV-2 can cause a COVID-19-like disease, and suggest that the severity of SARS-CoV-2 infection is intermediate between that of SARS-CoV and MERS-CoV. One Sentence Summary SARS-CoV-2 infection in macaques results in COVID-19-like disease with prolonged virus excretion from nose and throat in absence of clinical signs.