Differential susceptibility to SARS-CoV-2 in the normal nasal mucosa and in chronic sinusitis

Human nasal mucosa is susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Infection and serves as a reservoir for viral replication before spreading to other organs (e.g. the lung and brain) and transmission to other individuals. Chronic rhinosinusitis (CRS) is a common respiratory tract disease and there is evidence suggesting that susceptibility to SARS-CoV-2 Infection differs between the two known subtypes, eosinophilic CRS and non-ECRS (NECRS). However, the mechanism of SARS-CoV-2 Infection in the human nasal mucosa and its association with CRS has not been experimentally validated. In this study, we investigated whether the human nasal mucosa is susceptible to SARS-CoV-2 Infection and how different endotypes of CRS impact on viral Infection and progression. Primary human nasal mucosa tissue culture revealed highly efficient SARS-CoV-2 viral Infection and production, with particularly high susceptibility in the NECRS group. The gene expression differences suggested that human nasal mucosa is highly susceptible to SARS-CoV-2 Infection, presumably due to an increase in ACE2-expressing cells and a deficiency in Antiviral immune response, especially for NECRS. Importantly, patients with NECRS may be at a particularly high risk of viral Infection and transmission, and therefore, close monitoring should be considered.