Macrophage Migration Inhibitory Factor (MIF) Overexpression Induced by SARS-CoV-2 Infection Promotes Neural Regeneration in Human Brain Organoids

Abstract While SARS-CoV-2 primarily targets the respiratory system, its neurological effects have become a significant clinical concern. Postmortem analyses reveal astrogliosis, neuronal death, and blood-brain barrier dysfunction, yet the interplay between neural injury and endogenous repair remains unclear. Here, we employed human embryonic stem cell–derived brain organoids to examine viral tropism, bystander effects, and regenerative responses following infection. Single-cell transcriptomics and histological assays showed that SARS-CoV-2 productively infects neurons, neural progenitors, astroglia, and choroid plexus cells, triggering widespread apoptosis and senescence in both infected and neighboring cells. Despite low infection rates, organoids activated robust regenerative programs, including axon guidance, Wnt pathway signaling in mature neurons, and radial glia proliferation. Importantly, macrophage migration inhibitory factor (MIF) emerged as a key mediator, being strongly upregulated in both infected and uninfected cells, particularly in the choroid plexus. Recombinant MIF promoted dendritic outgrowth and cortical progenitor activation in uninfected organoids. Computational analyses indicated that MIF stimulates neural regenerative via EGFR signaling and upregulates its own expression in non-infected cells. These findings identify MIF as a molecular link between SARS-CoV-2-induced neural damage and regenerative activation in cortical cells.