To further understand the special population of ACE2-expressing AT2, we performed gene ontology enrichment analysis to study which biological processes are involved with this cell population by comparing them with the AT2 cells not expressing ACE2. Surprisingly, we found that multiple viral process-related GO are significantly over-presented, including “positive regulation of viral process” (P value=0.001), “viral life cycle” (P value=0.005), “virion assembly” (P value=0.03) and “positive regulation of viral genome replication” (P value=0.04). These highly expressed viral process-related genes in ACE2-expressing AT2 include: SLC1A5, CXADR, CAV2, NUP98, CTBP2, GSN,HSPA1B,STOM, RAB1B, HACD3, ITGB6, IST1,NUCKS1,TRIM27, APOE, SMARCB1,UBP1,CHMP1A,NUP160,HSPA8,DAG1,STAU1,ICAM1,CHMP5,D EK, VPS37B, EGFR, CCNK, PPIA, IFITM3, PPIB, TMPRSS2, UBC, LAMP1 and CHMP3. Therefore, it seems that the 2019-nCov has cleverly evolved to hijack this population of AT2 cells for its reproduction and transmission.



We further compared the characteristics of the donors and their ACE2 expressing patterns. No association was detected between the ACE2-expressing cell number and the age or smoking status of donors. Of note, the 2 male donors have a higher ACE2-expressing cell ratio than all other 6 female donors (1.66% vs. 0.41% of all cells, P value=0.07, Mann Whitney Test). In addition, the distribution of ACE2 is also more widespread in male donors than females: at least 5 different types of cells in male lung express this receptor, while only 2~4 types of cells in female lung express the receptor. This result is highly consistent with the epidemic investigation showing that most of the confirmed 2019-nCov infected patients were men (30 vs. 11, by Jan 2, 2020).



We also noticed that the only Asian donor (male) has a much higher ACE2-expressing cell ratio than white and African American donors (2.50% vs. 0.47% of all cells). This might explain the observation that the new Coronavirus pandemic and previous SARS-Cov pandemic are concentrated in the Asian area.

I would have thought it would be in Economics, perhaps even Literature, but it appears my first Nobel Prize will be in Physiology or Medicine. You see, everyone is understandably concerned about Corona-chan, but then it occurred to me, as we all know, race is just a social construct Therefore, to significantly improve the resistance of the population to Corona-chan and end the risk of a global pandemic, all that is necessary is for the Asian men in the areas at risk of infection to begin identifying as African-American women.I shall await my Nobel Prize in Physiology or Medicine with serene confidence.