SARS-CoV-2 productively infects primary human immune system cells in vitro and in COVID-19 patients

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Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with a hyperinflammatory state and lymphocytopenia, a hallmark that appears as both signature and prognosis of disease severity outcome. Although cytokine storm and a sustained inflammatory state are commonly associated with immune cell depletion, it is still unclear whether direct SARS-CoV-2 infection of immune cells could also play a role in this scenario by harboring viral replication. We found that monocytes, as well as both B and T lymphocytes, were susceptible to SARS-CoV-2 infection in vitro, accumulating double-stranded RNA consistent with viral RNA replication and ultimately leading to expressive T cell apoptosis. In addition, flow cytometry and immunofluorescence analysis revealed that SARS-CoV-2 was frequently detected in monocytes and B lymphocytes from coronavirus disease 2019 (COVID-19) patients. The rates of SARS-CoV-2-infected monocytes in peripheral blood mononuclear cells from COVID-19 patients increased over time from symptom onset, with SARS-CoV-2-positive monocytes, B cells, and CD4+ T lymphocytes also detected in postmortem lung tissue. These results indicated that SARS-CoV-2 infection of blood-circulating leukocytes in COVID-19 patients might have important implications for disease pathogenesis and progression, immune dysfunction, and virus spread within the host.

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  1. SciScore for 10.1101/2020.07.28.225912: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: Ethical statement and COVID-19 patients: The study was approved by the National Ethics Committee (CONEP, CAAE: 30248420.9.0000.5440 and 31797820.8.0000.5440).
    Consent: Written informed consent was obtained for both patients and healthy controls.
    IACUC: The protocol for production of mouse hyperimmune serum were carried out with 8-week-old male mice following the institutional guidelines on ethics in animal experiments and was approved by the University of São Paulo Ethics Committee for Animal Experimental Research -CETEA (Protocol no. 001/2020-1).
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variableProduction of mouse anti-SARS-CoV-2 hyperimmune serum: Male C57Bl/6 mice were bred and maintained under specific pathogen-free conditions at the animal facility of the Ribeirão Preto Medical School (FMRP) at University of São Paulo.
    Cell Line Authenticationnot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    A total of 29 hospitalized patients were enrolled, all with clinical and radiological features of COVID-19 and confirmed SARS-CoV-2 infection by RT-PCR in respiratory secretions, with detection of specific IgM or IgG antibodies to SARS-CoV-2.
    IgG
    suggested: None
    In parallel, PBMCs were treated with 0.5ug/ml Camostat (Sigma Aldrich, cat. SML005) or with 10 uM of anti-ACE2 antibody (Rhea Biotech, cat.
    anti-ACE2
    suggested: None
    To determine the phenotype of SARS-CoV-2-infected cells, we used primary antibodies for CD4 (Abcam cat. ab133616), CD8 (Abcam cat. ab4055), CD14 (Abcam cat. ab133335), CD19 (Abcam cat. ab134114), CD20 (Abcam cat. ab103573).
    CD4
    suggested: (Abcam Cat# ab133616, RRID:AB_2750883)
    CD8
    suggested: (Abcam Cat# ab4055, RRID:AB_304247)
    CD14
    suggested: None
    CD19
    suggested: (Abcam Cat# ab134114, RRID:AB_2801636)
    CD20
    suggested: (Abcam Cat# ab103573, RRID:AB_10859291)
    Secondary antibodies used were polyclonal anti-rabbit conjugated with 488 (Thermo Fisher cat.
    anti-rabbit
    suggested: None
    Flow cytometry: Unseparated whole blood leukocyte samples from COVID-19 patients or healthy donors infected in vitro with SARS-CoV-2 were surface stained with Fixable Viability Dye eFluor™ 780 (eBioscience) and monoclonal antibodies specific for CD3 (APC eBioscience cat.
    CD3
    suggested: None
    SARS-CoV-2 antibodies were detected with secondary anti-Mouse Alexa488.
    SARS-CoV-2
    suggested: None
    anti-Mouse
    suggested: (Bioss Cat# bsm-4579M-Alexa488, RRID:AB_11071160)
    Sequential immunoperoxidase labeling and erasing (SIMPLE) [12] was then performed to determine the immunophenotypes of SARS-CoV-2 infected cells, using antibodies to CD4 (Abcam cat. ab133616), CD20 (Abcam cat. ab103573), CD14 (Abcam cat. ab133335) and IL-6 (BD cat. 554400).
    IL-6
    suggested: (BD Biosciences Cat# 554400, RRID:AB_398549)
    Experimental Models: Cell Lines
    SentencesResources
    In order to confirm inactivation, titration of the inactivated product was done both by TCID50 and by plaque assay in Vero-E6 cells with 5-day incubation, without any cytopathic effects.
    Vero-E6
    suggested: None
    Animal serum conversion was evaluated by indirect immunofluorescence using slide preparations of SARS-CoV-2 infected Caco-2 cells, fixed with 4% paraformaldehyde and AlexaFluor 488-labelled rabbit anti-mouse secondary antibody.
    Caco-2
    suggested: None
    To detect viral antigens in cells, we used serum from a recovered COVID-19 patient, which was first tested for specificity by immunofluorescence in SARS-CoV-2 infected Vero CCL81 cells (Supplementary Fig 1B).
    Vero CCL81
    suggested: None
    Experimental Models: Organisms/Strains
    SentencesResources
    Production of mouse anti-SARS-CoV-2 hyperimmune serum: Male C57Bl/6 mice were bred and maintained under specific pathogen-free conditions at the animal facility of the Ribeirão Preto Medical School (FMRP) at University of São Paulo.
    C57Bl/6
    suggested: None
    Software and Algorithms
    SentencesResources
    Results of viral RNA quantifications by one-step qRT-PCR were plotted with GraphPad® Prism 8.4.2 software.
    GraphPad® Prism
    suggested: (GraphPad Prism, RRID:SCR_002798)
    The quantity of SARS-CoV-2-positive cells of different phenotypes was quantified by using the analyze particles tool from Fiji by ImageJ.
    Fiji
    suggested: (Fiji, RRID:SCR_002285)
    All data were acquired using a Verse or Canto flow cytometers (BD Biosciences) and subsequent analysis was done using FlowJo (TreeStar) software.
    FlowJo
    suggested: (FlowJo, RRID:SCR_008520)
    Sequential immunoperoxidase labeling and erasing (SIMPLE) [12] was then performed to determine the immunophenotypes of SARS-CoV-2 infected cells, using antibodies to CD4 (Abcam cat. ab133616), CD20 (Abcam cat. ab103573), CD14 (Abcam cat. ab133335) and IL-6 (BD cat. 554400).
    SIMPLE
    suggested: (SIMPLE, RRID:SCR_009389)
    Images were pseudocolored and overlaid in the first image of the preparation counterstained with hematoxylin using ImageJ v1.50b (NIH, USA) and Adobe Photoshop CS5 software (Adobe Systems, San Jose, CA, USA).
    ImageJ
    suggested: (ImageJ, RRID:SCR_003070)
    Adobe Photoshop
    suggested: (Adobe Photoshop, RRID:SCR_014199)
    Statistical analysis: All descriptive statistics, patient stratification, and positive cell frequencies were done using GraphPad Prism Software, version 6.0.
    GraphPad Prism
    suggested: (GraphPad Prism, RRID:SCR_002798)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).


    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.


    Results from Barzooka: We found bar graphs of continuous data. We recommend replacing bar graphs with more informative graphics, as many different datasets can lead to the same bar graph. The actual data may suggest different conclusions from the summary statistics. For more information, please see Weissgerber et al (2015).


    Results from JetFighter: Please consider improving the rainbow (“jet”) colormap(s) used on pages 33, 35, 37, 30 and 31. At least one figure is not accessible to readers with colorblindness and/or is not true to the data, i.e. not perceptually uniform.


    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. SciScore for 10.1101/2020.07.28.225912: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementThe study was approved by the National Ethics Committee (CONEP, CAAE: 30248420.9.0000.5440 and 31797820.8.0000.5440).Randomizationnot detected.Blindingnot detected.Power Analysisnot detected.Sex as a biological variableMale C57Bl/6 mice were bred and maintained under specific pathogen-free conditions at the animal facility of the Ribeirão Preto Medical School (FMRP) at University of São Paulo.Cell Line Authenticationnot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    A total of 29 hospitalized patients were enrolled, all with clinical and radiological features of COVID-19 and confirmed SARS-CoV-2 infection by RT-PCR in respiratory secretions, with detection of specific IgM or IgG antibodies to SARS-CoV-2.
    IgG
    suggested: None
    SARS-CoV-2
    suggested: None
    To determine the phenotype of SARSCoV-2-infected cells, we used primary antibodies for CD4 (Abcam cat. ab133616), CD8 (Abcam cat.
    CD4
    suggested: (Abcam Cat# ab133616, RRID:AB_2750883)
    CD8
    suggested: None
    Secondary antibodies used were polyclonal anti-rabbit conjugated with 488 (Thermo Fisher cat.
    anti-rabbit
    suggested: None
    Unseparated whole blood leukocyte samples from COVID-19 patients or healthy donors infected in vitro with SARS-CoV-2 were surface stained with Fixable Viability Dye eFluor™ 780 (eBioscience) and monoclonal antibodies specific for CD3 (APC eBioscience cat.
    CD3
    suggested: None
    SARS-CoV-2 antibodies were detected with secondary anti-Mouse Alexa488.
    anti-Mouse
    suggested: (Bioss Cat# bsm-4579M-Alexa488, RRID:AB_11071160)
    Experimental Models: Cell Lines
    SentencesResources
    Animal serum conversion was evaluated by indirect immunofluorescence using slide preparations of SARS-CoV-2 infected Caco-2 cells, fixed with 4% paraformaldehyde and AlexaFluor 488-labelled rabbit anti-mouse secondary antibody.
    Caco-2
    suggested: None
    P1 was diluted 1:1000 in Dulbecco’s modified Eagle’s medium (DMEM) and inoculated in Vero-E6 cells monolayers to produce the P2 stock.
    Vero-E6
    suggested: None
    To detect viral antigens in cells, we used serum from a recovered COVID-19 patient, which was first tested for specificity by immunofluorescence in SARS-CoV-2 infected Vero CCL81 cells (Supplementary Fig 1B).
    Vero CCL81
    suggested: None
    Experimental Models: Organisms/Strains
    SentencesResources
    Male C57Bl/6 mice were bred and maintained under specific pathogen-free conditions at the animal facility of the Ribeirão Preto Medical School (FMRP) at University of São Paulo.
    C57Bl/6
    suggested: None
    Software and Algorithms
    SentencesResources
    Results of viral RNA ® quantifications by one-step qRT-PCR were plotted with GraphPad® Prism 8.4.2 software.
    GraphPad® Prism
    suggested: (GraphPad Prism, RRID:SCR_002798)
    The quantity of SARS-CoV-2-positive cells of different phenotypes was quantified by using the analyze particles tool from Fiji by ImageJ.
    Fiji
    suggested: (Fiji, RRID:SCR_002285)
    All data were acquired using a Verse or Canto flow cytometers (BD Biosciences) and subsequent analysis was done using FlowJo (TreeStar) software.
    FlowJo
    suggested: (FlowJo, RRID:SCR_008520)
    Sequential immunoperoxidase labeling and erasing (SIMPLE) [12] was then performed to determine the immunophenotypes of SARS-CoV-2 infected cells, using antibodies to CD4 (Abcam cat.
    SIMPLE
    suggested: (Simpleaffy, RRID:SCR_001302)
    Images were pseudocolored and overlaid in the first image of the preparation counterstained with hematoxylin using ImageJ v1.50b (NIH, USA) and Adobe Photoshop CS5 software (Adobe Systems, San Jose, CA, USA).
    ImageJ
    suggested: (ImageJ, RRID:SCR_003070)
    Adobe Photoshop
    suggested: (Adobe Photoshop, RRID:SCR_014199)
    All descriptive statistics, patient stratification, and positive cell frequencies were done using GraphPad Prism Software, version 6.0.
    GraphPad Prism
    suggested: (GraphPad Prism, RRID:SCR_002798)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).


    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.


    Results from Barzooka: We found bar graphs of continuous data. We recommend replacing bar graphs with more informative graphics, as many different datasets can lead to the same bar graph. The actual data may suggest different conclusions from the summary statistics. For more information, please see Weissgerber et al (2015).


    Results from JetFighter: Please consider improving the rainbow (“jet”) colormap used on pages 29, 30, 32, 34 and 36. At least one figure is not accessible to readers with colorblindness and/or is not true to the data, i.e. not perceptually uniform.


    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. SciScore for 10.1101/2020.07.28.225912: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementThe study was approved by the National Ethics Committee (CONEP, CAAE: 30248420.9.0000.5440 and 31797820.8.0000.5440).Randomizationnot detected.Blindingnot detected.Power Analysisnot detected.Sex as a biological variableMale C57Bl/6 mice were bred and maintained under specific pathogen-free conditions at the animal facility of the Ribeirão Preto Medical School (FMRP) at University of São Paulo.Cell Line Authenticationnot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    A total of 29 hospitalized patients were enrolled, all with clinical and radiological features of COVID-19 and confirmed SARS-CoV-2 infection by RT-PCR in respiratory secretions, with detection of specific IgM or IgG antibodies to SARS-CoV-2.
    IgG
    suggested: None
    Animal serum conversion was evaluated by indirect immunofluorescence using slide preparations of SARS-CoV-2 infected Caco-2 cells, fixed with 4% paraformaldehyde and AlexaFluor 488-labelled rabbit anti-mouse secondary antibody.
    anti-mouse
    suggested: None
    To determine the phenotype of SARSCoV-2-infected cells, we used primary antibodies for CD4 (Abcam cat. ab133616), CD8 (Abcam cat.
    CD4
    suggested: (Abcam Cat# ab133616, RRID:AB_2750883)
    CD8
    suggested: None
    Secondary antibodies used were polyclonal anti-rabbit conjugated with 488 (Thermo Fisher cat.
    anti-rabbit
    suggested: None
    Unseparated whole blood leukocyte samples from COVID-19 patients or healthy donors infected in vitro with SARS-CoV-2 were surface stained with Fixable Viability Dye eFluor™ 780 (eBioscience) and monoclonal antibodies specific for CD3 (APC eBioscience cat.
    CD3
    suggested: None
    Tissue sections from paraffin-embedded lung fragments obtained from two COVID-19 fatal cases were tested by immunohistochemistry (IHC) using anti-SARS-CoV-2 polyclonal antibody for in situ detection of SARS-CoV-2.
    anti-SARS-CoV-2
    suggested: None
    Experimental Models: Cell Lines
    SentencesResources
    Animal serum conversion was evaluated by indirect immunofluorescence using slide preparations of SARS-CoV-2 infected Caco-2 cells, fixed with 4% paraformaldehyde and AlexaFluor 488-labelled rabbit anti-mouse secondary antibody.
    Caco-2
    suggested: None
    P1 was diluted 1:1000 in Dulbecco’s modified Eagle’s medium (DMEM) and inoculated in Vero-E6 cells monolayers to produce the P2 stock.
    Vero-E6
    suggested: None
    To detect viral antigens in cells, we used serum from a recovered COVID-19 patient, which was first tested for specificity by immunofluorescence in SARS-CoV-2 infected Vero CCL81 cells (Supplementary Fig 1B).
    Vero CCL81
    suggested: None
    Experimental Models: Organisms/Strains
    SentencesResources
    Three C57Bl/6 mice were inoculated intramuscularly with an emulsion containing the equivalent of 106 TCID50 of inactivated SARS-CoV-2 in complete Freund's adjuvant (CFA, BD, cat. 263810) diluted 1:1 in PBS.
    C57Bl/6
    suggested: None
    Software and Algorithms
    SentencesResources
    Results of viral RNA ® quantifications by one-step qRT-PCR were plotted with GraphPad® Prism 8.4.2 software.
    GraphPad® Prism
    suggested: (GraphPad Prism, RRID:SCR_002798)
    The quantity of SARS-CoV-2-positive cells of different phenotypes was quantified by using the analyze particles tool from Fiji by ImageJ.
    Fiji
    suggested: (Fiji, RRID:SCR_002285)
    ImageJ
    suggested: (ImageJ, RRID:SCR_003070)
    All data were acquired using a Verse or Canto flow cytometers (BD Biosciences) and subsequent analysis was done using FlowJo (TreeStar) software.
    FlowJo
    suggested: (FlowJo, RRID:SCR_008520)
    Sequential immunoperoxidase labeling and erasing (SIMPLE) [12] was then performed to determine the immunophenotypes of SARS-CoV-2 infected cells, using antibodies to CD4 (Abcam cat.
    SIMPLE
    suggested: (Simpleaffy, RRID:SCR_001302)
    Images were pseudocolored and overlaid in the first image of the preparation counterstained with hematoxylin using ImageJ v1.50b (NIH, USA) and Adobe Photoshop CS5 software (Adobe Systems, San Jose, CA, USA).
    Adobe Photoshop
    suggested: (Adobe Photoshop, RRID:SCR_014199)
    All descriptive statistics, patient stratification, and positive cell frequencies were done using GraphPad Prism Software, version 6.0.
    GraphPad Prism
    suggested: (GraphPad Prism, RRID:SCR_002798)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).


    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.


    Results from Barzooka: We found bar graphs of continuous data. We recommend replacing bar graphs with more informative graphics, as many different datasets can lead to the same bar graph. The actual data may suggest different conclusions from the summary statistics. For more information, please see Weissgerber et al (2015).


    Results from JetFighter: Please consider improving the rainbow (“jet”) colormap used on pages 29, 30, 32, 34 and 36. At least one figure is not accessible to readers with colorblindness and/or is not true to the data, i.e. not perceptually uniform.


    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore is not a substitute for expert review. SciScore checks for the presence and correctness of RRIDs (research resource identifiers) in the manuscript, and detects sentences that appear to be missing RRIDs. SciScore also checks to make sure that rigor criteria are addressed by authors. It does this by detecting sentences that discuss criteria such as blinding or power analysis. SciScore does not guarantee that the rigor criteria that it detects are appropriate for the particular study. Instead it assists authors, editors, and reviewers by drawing attention to sections of the manuscript that contain or should contain various rigor criteria and key resources. For details on the results shown here, including references cited, please follow this link.

  4. SciScore for 10.1101/2020.07.28.225912: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementThe study was approved by the National Ethics Committee (CONEP, CAAE: 30248420.9.0000.5440 and 31797820.8.0000.5440).Randomizationnot detected.Blindingnot detected.Power Analysisnot detected.Sex as a biological variableMale C57Bl/6 mice were bred and maintained under specific pathogen-free conditions at the animal facility of the Ribeirão Preto Medical School (FMRP) at University of São Paulo.Cell Line Authenticationnot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    A total of 29 hospitalized patients were enrolled, all with clinical and radiological features of COVID-19 and confirmed SARS-CoV-2 infection by RT-PCR in respiratory secretions, with detection of specific IgM or IgG antibodies to SARS-CoV-2.
    IgG
    suggested: None
    To determine the phenotype of SARSCoV-2-infected cells, we used primary antibodies for CD4 (Abcam cat. ab133616), CD8 (Abcam cat.
    CD8
    suggested: None
    Secondary antibodies used were polyclonal anti-rabbit conjugated with 488 (Thermo Fisher cat.
    anti-rabbit
    suggested: None
    Unseparated whole blood leukocyte samples from COVID-19 patients or healthy donors infected in vitro with SARS-CoV-2 were surface stained with Fixable Viability Dye eFluor™ 780 (eBioscience) and monoclonal antibodies specific for CD3 (APC eBioscience cat.
    CD3
    suggested: None
    SARS-CoV-2 antibodies were detected with secondary anti-Mouse Alexa488.
    anti-Mouse
    suggested: (Bioss Cat# bsm-4579M-Alexa488, RRID:AB_11071160)
    Tissue sections from paraffin-embedded lung fragments obtained from two COVID-19 fatal cases were tested by immunohistochemistry (IHC) using anti-SARS-CoV-2 polyclonal antibody for in situ detection of SARS-CoV-2.
    anti-SARS-CoV-2
    suggested: None
    Sequential immunoperoxidase labeling and erasing (SIMPLE) [12] was then performed to determine the immunophenotypes of SARS-CoV-2 infected cells, using antibodies to CD4 (Abcam cat.
    CD4
    suggested: None
    Experimental Models: Cell Lines
    SentencesResources
    Animal serum conversion was evaluated by indirect immunofluorescence using slide preparations of SARS-CoV-2 infected Caco-2 cells, fixed with 4% paraformaldehyde and AlexaFluor 488-labelled rabbit anti-mouse secondary antibody.
    Caco-2
    suggested: None
    P1 was diluted 1:1000 in Dulbecco’s modified Eagle’s medium (DMEM) and inoculated in Vero-E6 cells monolayers to produce the P2 stock.
    Vero-E6
    suggested: None
    To detect viral antigens in cells, we used serum from a recovered COVID-19 patient, which was first tested for specificity by immunofluorescence in SARS-CoV-2 infected Vero CCL81 cells (Supplementary Fig 1B).
    Vero CCL81
    suggested: None
    Experimental Models: Organisms/Strains
    SentencesResources
    Male C57Bl/6 mice were bred and maintained under specific pathogen-free conditions at the animal facility of the Ribeirão Preto Medical School (FMRP) at University of São Paulo.
    C57Bl/6
    suggested: None
    Software and Algorithms
    SentencesResources
    Results of viral RNA ® quantifications by one-step qRT-PCR were plotted with GraphPad® Prism 8.4.2 software.
    GraphPad® Prism
    suggested: (GraphPad Prism, RRID:SCR_002798)
    The quantity of SARS-CoV-2-positive cells of different phenotypes was quantified by using the analyze particles tool from Fiji by ImageJ.
    Fiji
    suggested: (Fiji, RRID:SCR_002285)
    ImageJ
    suggested: (ImageJ, RRID:SCR_003070)
    All data were acquired using a Verse or Canto flow cytometers (BD Biosciences) and subsequent analysis was done using FlowJo (TreeStar) software.
    FlowJo
    suggested: (FlowJo, RRID:SCR_008520)
    Sequential immunoperoxidase labeling and erasing (SIMPLE) [12] was then performed to determine the immunophenotypes of SARS-CoV-2 infected cells, using antibodies to CD4 (Abcam cat.
    SIMPLE
    suggested: (Simpleaffy, RRID:SCR_001302)
    Images were pseudocolored and overlaid in the first image of the preparation counterstained with hematoxylin using ImageJ v1.50b (NIH, USA) and Adobe Photoshop CS5 software (Adobe Systems, San Jose, CA, USA).
    Adobe Photoshop
    suggested: (Adobe Photoshop, RRID:SCR_014199)
    Correlation analysis, one-way ANOVA, two-way ANOVA, linear regressions, Holm-Sidak, and Bonferroni post-tests were also performed using GraphPad Prism.
    GraphPad Prism
    suggested: (GraphPad Prism, RRID:SCR_002798)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).


    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.


    Results from Barzooka: We found bar graphs of continuous data. We recommend replacing bar graphs with more informative graphics, as many different datasets can lead to the same bar graph. The actual data may suggest different conclusions from the summary statistics. For more information, please see Weissgerber et al (2015).


    Results from JetFighter: Please consider improving the rainbow (“jet”) colormap used on pages 29, 30, 32, 34 and 36. At least one figure is not accessible to readers with colorblindness and/or is not true to the data, i.e. not perceptually uniform.


    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore is not a substitute for expert review. SciScore checks for the presence and correctness of RRIDs (research resource identifiers) in the manuscript, and detects sentences that appear to be missing RRIDs. SciScore also checks to make sure that rigor criteria are addressed by authors. It does this by detecting sentences that discuss criteria such as blinding or power analysis. SciScore does not guarantee that the rigor criteria that it detects are appropriate for the particular study. Instead it assists authors, editors, and reviewers by drawing attention to sections of the manuscript that contain or should contain various rigor criteria and key resources. For details on the results shown here, including references cited, please follow this link.

  5. SciScore for 10.1101/2020.07.28.225912: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementThe study was approved by the National Ethics Committee (CONEP, CAAE: 30248420.9.0000.5440 and 31797820.8.0000.5440).Randomizationnot detected.Blindingnot detected.Power Analysisnot detected.Sex as a biological variableMale C57Bl/6 mice were bred and maintained under specific pathogen-free conditions at the animal facility of the Ribeirão Preto Medical School (FMRP) at University of São Paulo.Cell Line Authenticationnot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    A total of 29 hospitalized patients were enrolled, all with clinical and radiological features of COVID-19 and confirmed SARS-CoV-2 infection by RT-PCR in respiratory secretions, with detection of specific IgM or IgG antibodies to SARS-CoV-2.
    IgG
    suggested: None
    Animal serum conversion was evaluated by indirect immunofluorescence using slide preparations of SARS-CoV-2 infected Caco-2 cells, fixed with 4% paraformaldehyde and AlexaFluor 488-labelled rabbit anti-mouse secondary antibody.
    anti-mouse
    suggested: None
    To determine the phenotype of SARSCoV-2-infected cells, we used primary antibodies for CD4 (Abcam cat. ab133616), CD8 (Abcam cat.
    CD8
    suggested: None
    Secondary antibodies used were polyclonal anti-rabbit conjugated with 488 (Thermo Fisher cat.
    anti-rabbit
    suggested: None
    Unseparated whole blood leukocyte samples from COVID-19 patients or healthy donors infected in vitro with SARS-CoV-2 were surface stained with Fixable Viability Dye eFluor™ 780 (eBioscience) and monoclonal antibodies specific for CD3 (APC eBioscience cat.
    CD3
    suggested: None
    SARS-CoV-2 antibodies were detected with secondary anti-Mouse Alexa488.
    SARS-CoV-2
    suggested: None
    Sequential immunoperoxidase labeling and erasing (SIMPLE) [12] was then performed to determine the immunophenotypes of SARS-CoV-2 infected cells, using antibodies to CD4 (Abcam cat.
    CD4
    suggested: None
    Experimental Models: Cell Lines
    SentencesResources
    Animal serum conversion was evaluated by indirect immunofluorescence using slide preparations of SARS-CoV-2 infected Caco-2 cells, fixed with 4% paraformaldehyde and AlexaFluor 488-labelled rabbit anti-mouse secondary antibody.
    Caco-2
    suggested: None
    P1 was diluted 1:1000 in Dulbecco’s modified Eagle’s medium (DMEM) and inoculated in Vero-E6 cells monolayers to produce the P2 stock.
    Vero-E6
    suggested: None
    To detect viral antigens in cells, we used serum from a recovered COVID-19 patient, which was first tested for specificity by immunofluorescence in SARS-CoV-2 infected Vero CCL81 cells (Supplementary Fig 1B).
    Vero CCL81
    suggested: None
    Experimental Models: Organisms/Strains
    SentencesResources
    Three C57Bl/6 mice were inoculated intramuscularly with an emulsion containing the equivalent of 106 TCID50 of inactivated SARS-CoV-2 in complete Freund's adjuvant (CFA, BD, cat. 263810) diluted 1:1 in PBS.
    C57Bl/6
    suggested: None
    Software and Algorithms
    SentencesResources
    Results of viral RNA ® quantifications by one-step qRT-PCR were plotted with GraphPad® Prism 8.4.2 software.
    GraphPad® Prism
    suggested: (GraphPad Prism, RRID:SCR_002798)
    The quantity of SARS-CoV-2-positive cells of different phenotypes was quantified by using the analyze particles tool from Fiji by ImageJ.
    Fiji
    suggested: (Fiji, RRID:SCR_002285)
    All data were acquired using a Verse or Canto flow cytometers (BD Biosciences) and subsequent analysis was done using FlowJo (TreeStar) software.
    FlowJo
    suggested: (FlowJo, RRID:SCR_008520)
    Sequential immunoperoxidase labeling and erasing (SIMPLE) [12] was then performed to determine the immunophenotypes of SARS-CoV-2 infected cells, using antibodies to CD4 (Abcam cat.
    SIMPLE
    suggested: (Simpleaffy, RRID:SCR_001302)
    Images were pseudocolored and overlaid in the first image of the preparation counterstained with hematoxylin using ImageJ v1.50b (NIH, USA) and Adobe Photoshop CS5 software (Adobe Systems, San Jose, CA, USA).
    ImageJ
    suggested: (ImageJ, RRID:SCR_003070)
    Adobe Photoshop
    suggested: (Adobe Photoshop, RRID:SCR_014199)
    Correlation analysis, one-way ANOVA, two-way ANOVA, linear regressions, Holm-Sidak, and Bonferroni post-tests were also performed using GraphPad Prism.
    GraphPad Prism
    suggested: (GraphPad Prism, RRID:SCR_002798)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).


    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.


    Results from Barzooka: We found bar graphs of continuous data. We recommend replacing bar graphs with more informative graphics, as many different datasets can lead to the same bar graph. The actual data may suggest different conclusions from the summary statistics. For more information, please see Weissgerber et al (2015).


    Results from JetFighter: Please consider improving the rainbow (“jet”) colormap used on pages 29, 30, 32, 34 and 36. At least one figure is not accessible to readers with colorblindness and/or is not true to the data, i.e. not perceptually uniform.


    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore is not a substitute for expert review. SciScore checks for the presence and correctness of RRIDs (research resource identifiers) in the manuscript, and detects sentences that appear to be missing RRIDs. SciScore also checks to make sure that rigor criteria are addressed by authors. It does this by detecting sentences that discuss criteria such as blinding or power analysis. SciScore does not guarantee that the rigor criteria that it detects are appropriate for the particular study. Instead it assists authors, editors, and reviewers by drawing attention to sections of the manuscript that contain or should contain various rigor criteria and key resources. For details on the results shown here, including references cited, please follow this link.