# The ORF6 accessory protein contributes to SARS-CoV-2 virulence and pathogenicity in the naturally susceptible feline model of infection

## TL;DR

This study shows that the ORF6 protein in SARS-CoV-2 is important for its virulence and ability to cause disease in cats.

## Contribution

The study demonstrates that ORF6 is a key virulence factor by modulating host immune responses in a feline model.

## Key findings

- The rWA1ΔORF6 virus showed reduced cell-to-cell spread and lower innate immune inhibition compared to the parental rWA1 virus.
- Cats infected with rWA1ΔORF6 had subclinical infection, reduced virus shedding, and less lung inflammation compared to rWA1-infected cats.
- ORF6 deletion led to upregulated type I IFN signaling, which may explain reduced viral replication in infected cats.

## Abstract

In this study, the infection dynamics, replication, and pathogenicity of a recombinant virus containing a deletion of ORF6 (rWA1ΔORF6) on the backbone of the highly virulent SARS-CoV-2 WA1 virus (rWA1) were investigated and compared to the parental rWA1 virus. While both rWA1 and rWA1ΔORF6 viruses replicated efficiently in cultured cells, the rWA1ΔORF6 virus produced smaller plaques, suggesting reduced cell-to-cell spread. Luciferase reporter assays revealed immune-suppressing effects of ORF6 on interferon (IFN) and nuclear factor kappa B (NF-κB) signaling pathways. Pathogenesis assessment in cats revealed that animals inoculated with rWA1 were lethargic and presented with fever on days 2 and 4 post-infection (pi), whereas rWA1ΔORF6-inoculated animals developed subclinical infection. Additionally, animals inoculated with rWA1ΔORF6 presented reduced infectious virus shedding in nasal and oral secretions and broncho-alveolar lavage fluid when compared with the rWA1-inoculated cats. Similarly, the rWA1ΔORF6-inoculated cats presented reduced virus replication in the respiratory tract as evidenced by lower viral loads and reduced lung inflammation on days 3 and 5 pi when compared to rWA1-inoculated animals. Host gene transcriptomic analysis revealed distinct differentially expressed gene (DEG) profiles in the nasal turbinate of animals infected with rWA1 when compared to rWA1ΔORF6. Importantly, type I IFN signaling was significantly upregulated in rWA1ΔORF6-infected cats when compared to rWA1-inoculated animals, which could potentially contribute to the reduced replication of rWA1ΔORF6 in the upper and lower respiratory tracts of infected animals. Collectively, these results demonstrate that the SARS-CoV-2 ORF6 is an important virulence determinant of the virus, contributing to the modulation of host antiviral immune responses.

SARS-CoV-2 encodes several proteins that inhibit host IFN responses. The accessory protein ORF6 antagonizes IFN signaling by blocking the nucleocytoplasmic trafficking of key transcription factors. In this study, we showed that ORF6 plays an important role in SARS-CoV-2 pathogenesis. While both rWA1 and rWA1ΔORF6 viruses replicated efficiently in cell culture, the rWA1ΔORF6 presented impaired cell-to-cell spread and reduced innate immune inhibition compared to the parental rWA1. A pathogenesis study in the feline model revealed an attenuated phenotype of the rWA1ΔORF6, indicating that ORF6 is a major virulence determinant of SARS-CoV-2.