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Temperature dependence of the SARS-CoV-2 affinity to human ACE2 determines COVID-19 progression and clinical outcome

Zhou et al., Computational and Structural Biotechnology Journal, doi:10.1016/j.csbj.2020.12.005
Dec 2021  
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In Silico and In Vitro study showing decreased SARS-CoV-2 binding affinity to the human ACE2 receptor at higher temperature (40°C vs. 37°C). Molecular dynamics simulations, surface plasmon resonance experiments, and pseudovirus cell entry assays support the temperature-dependent binding and cellular entry of SARS-CoV-2.
Analysis of clinical data showed that patients with higher fever had lower viral load. Authors hypothesize that the decreased SARS-CoV-2 infectivity at higher temperature may partly explain better clinical outcomes observed with fever in COVID-19 patients.
These results support the position that unnecessary use of fever-reducing medications such as aspirin may be detrimental. Negative effects may be offset by antiviral activity for specific medications.
3 preclinical studies support the efficacy of aspirin for COVID-19:
Study covers thermotherapy, acetaminophen, ibuprofen, indomethacin, and aspirin.
Zhou et al., 31 Dec 2021, peer-reviewed, 7 authors. Contact: zhangqw@jnu.edu.cn, dong_ming@grmh-gdl.cn, zhanggong-uni@qq.com.
This PaperAspirinAll
Temperature dependence of the SARS-CoV-2 affinity to human ACE2 determines COVID-19 progression and clinical outcome
Zhonghua Zhou, Ziyi Yang, Junxian Ou, Hong Zhang, Qiwei Zhang, Ming Dong, Gong Zhang
Computational and Structural Biotechnology Journal, doi:10.1016/j.csbj.2020.12.005
The SARS-CoV-2 virus and its homolog SARS-CoV penetrate human cells by binding of viral spike protein and human angiotensin converting enzyme II (ACE2). SARS-CoV causes high fever in almost all patients, while SARS-CoV-2 does not. Moreover, analysis of the clinical data revealed that the higher body temperature is a protective factor in COVID-19 patients, making us to hypothesize a temperature-dependent binding affinity of SARS-CoV-2 to human ACE2 receptor. In this study, our molecular dynamics simulation and protein surface plasmon resonance cohesively proved the SARS-CoV-2-ACE2 binding was less affinitive and stable under 40 °C (~18 nM) than the optimum temperature 37 °C (6.2 nM), while SARS-CoV-ACE2 binding was not (6.4 nM vs. 8.5 nM), which evidenced the temperature-dependent affinity and explained that higher temperature is related to better clinical outcome. The decreased infection at higher temperature was also validated by pseudovirus entry assay using Vero and Caco-2 cells. We also demonstrated the structural basis of the distinct temperature-dependence of the two coronaviruses. Furthermore, the meta-analysis revealed a milder inflammatory response happened in the early stage of COVID-19, which explained the low fever tendency of COVID-19 and indicated the co-evolution of the viral protein structure and the inflammatory response. The temperature dependence of the binding affinity also indicated that higher body temperature at early stages might be beneficial to the COVID-19 patients.
Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Appendix A. Supplementary data Supplementary data to this article can be found online at https://doi.org/10.1016/j.csbj.2020.12.005 .
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