Coronavirus Disease 2019 MESHD (
COVID-19 MESHD) is caused by severe acute
respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2), which infects host cells with help from the Viral Entry (VE) proteins
ACE2 HGNC,
HGNC, and
CTSL HGNC. Proposed risk factors for
viral infection MESHD, as well as the rate of disease progression, include age, sex,
chronic obstructive pulmonary disease MESHD,
cancer MESHD, and cigarette smoking. To investigate whether the proposed risk factors increase
viral infection MESHD by modulation of the VE genes, we examined gene expression profiles of 796 nasal and 1,673 bronchial samples across four
lung cancer MESHD screening cohorts containing individuals without
COVID-19 MESHD. Smoking was the only clinical factor reproducibly associated with the expression of any VE gene across cohorts.
ACE2 HGNC expression was significantly up-regulated with smoking in the bronchus but significantly down-regulated with smoking in the nose. Furthermore, expression of individual VE genes were not correlated between paired nasal and bronchial samples from the same patients. Single-cell RNA-seq of nasal brushings revealed that an
ACE2 HGNC gene module was detected in a variety of nasal secretory cells with the highest expression in the
C15orf48 HGNC+ secretory cells, while a
HGNC gene module was most highly expressed in nasal keratinizing epithelial cells. In contrast, single-cell RNA-seq of bronchial brushings revealed that
ACE2 HGNC and
HGNC gene modules were most enriched in
MUC5AC HGNC+ bronchial goblet cells. The
CTSL HGNC gene module was highly expressed in immune populations of both nasal and bronchial brushings. Deconvolution of bulk RNA-seq showed that the proportion of
MUC5AC HGNC+ goblet cells was increased in current smokers in both the nose and bronchus but proportions of nasal keratinizing epithelial cells,
C15orf48 HGNC+ secretory cells, and immune cells were not associated with smoking status. The complex association between VE gene expression and smoking in the nasal and bronchial epithelium revealed by our results may partially explain conflicting reports on the association between smoking and
SARS-CoV-2 infection MESHD.