Comparative pathogenesis of COVID-19, MERS, and SARS in a nonhuman primate model
Barry Rockx, Thijs Kuiken, Sander Herfst, Theo M. Bestebroer, Mart M. Lamers, Bas B. Oude Munnink, Dennis de Meulder, Geert van Amerongen, Judith M. A. van den Brand, Nisreen M.A. Okba, Debby Schipper, Peter van Run, Lonneke Leijten, Reina S. Sikkema, Ernst J. Verschoor, Babs E. Verstrepen, Willy Bogers, Jan A. M. Langermans, Christian Drosten, Martje Fentener van Vlissingen, Ron A. M. Fouchier, Rik L. de Swart, Marion Koopmans, Bart L. Haagmans
Abstract
The current pandemic coronavirus, severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), was recently identified in patients with an acute respiratory syndrome, coronavirus disease 2019 (COVID-19). To compare its pathogenesis with that of previously emerging coronaviruses, we inoculated cynomolgus macaques with SARS-CoV-2 or Middle East respiratory syndrome (MERS)-CoV and compared the pathology and virology with historical reports of SARS-CoV infections. In SARS-CoV-2-infected macaques, virus was excreted from nose and throat in the absence of clinical signs and detected in type I and II pneumocytes in foci of diffuse alveolar damage and in ciliated epithelial cells of nasal, bronchial, and bronchiolar mucosae. In SARS-CoV infection, lung lesions were typically more severe, whereas they were milder in MERS-CoV infection, where virus was detected mainly in type II pneumocytes. These data show that SARS-CoV-2 causes COVID-19-like disease in macaques and provides a new model to test preventive and therapeutic strategies.