Multi-organ proteomic landscape of COVID-19 autopsies

The molecular pathology of multi-organ injuries in COVID-19 patients remains unclear, preventing effective therapeutics development. Here, we report a proteomic analysis of 144 autopsy samples from seven organs in 19 COVID-19 patients. We quantified 11,394 proteins in these samples, in which 5,336 were perturbed in the COVID-19 patients compared to controls. Our data showed that cathepsin L1, rather than ACE2, was significantly upregulated in the lung from the COVID-19 patients. Systemic hyperinflammation and dysregulation of glucose and fatty acid metabolism were detected in multiple organs. We also observed dysregulation of key factors involved in hypoxia, angiogenesis, blood coagulation, and fibrosis in multiple organs from the COVID-19 patients. Evidence for testicular injuries includes reduced Leydig cells, suppressed cholesterol biosynthesis, and sperm mobility. In summary, this study depicts a multi-organ proteomic landscape of COVID-19 autopsies that furthers our understanding of the biological basis of COVID-19 pathology. [Display omitted] •11,394 proteins are quantified in autopsy samples from 7 organs in 19 COVID-19 patients•Elevated expression of cathepsin L1 is detected in the COVID-19 lung tissue•Dysregulation of angiogenesis, coagulation, and fibrosis is detected in multiple organs•Systemic metabolic dysregulation is detected in multiple organs A proteomics analysis of 144 autopsy samples from seven organs in 19 COVID-19 patients shows elevated expression of cathepsin L1, rather than ACE2, in the lung tissue and highlights dysregulation of angiogenesis, coagulation, and fibrosis in multiple organs, in addition to systemic hyperinflammation.