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In the eye of the storm: SARS-CoV-2 infection and replication at the ocular surface?

Lyle Armstrong | Joseph Collin | Islam Mostafa | Rachel Queen |
Francisco C. Figueiredo | Majlinda Lako

Biosciences Institute, Faculty of Medical
Sciences, Newcastle University, Newcastle, UK.
Department of Ophthalmology, Royal Victoria
Infirmary and Newcastle University,
Newcastle, UK
.

Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) first emerged in
December 2019 and spread quickly causing the coronavirus disease 2019
(COVID-19) pandemic. Recent single cell RNA-Seq analyses have shown the pres-
ence of SARS-CoV-2 entry factors in the human corneal, limbal, and conjunctival
superficial epithelium, leading to suggestions that the human ocular surface may
serve as an additional entry gateway and infection hub for SARS-CoV-2. In this
article, we review the ocular clinical presentations of COVID-19 and the features of
the ocular surface that may underline the overall low ocular SARS-CoV-2 infection.
We critically evaluate the studies performed in nonhuman primates, ex vivo organ
culture ocular models, stem cell derived eye organoids and the differences in infec-
tion efficiency observed in different parts of human ocular surface epithelium. Finally,
we highlight the additional work that needs to be carried out to understand the
immune response of the ocular surface to SARS-CoV-2 infection, which can be trans-
lated into prophylactic treatments that may be applied to other organ systems.

https://doi.org/10.1002/sctm.20-0543

https://stemcellsjournals.onlinelibrary.wiley.com/doi/10.1002/sctm.20-0543

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