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. 2021 Jan 30:19:1063-1071.
doi: 10.1016/j.csbj.2021.01.039. eCollection 2021.

The paradoxical problem with COVID-19 ocular infection: Moderate clinical manifestation and potential infection risk

Jiawei Shen  1   2 , Jian Wu  1 , Yang Yang  1 , Pengcheng Wang  3   4 , Tao Luo  1 , Yanju Guo  1 , Jun Zhao  1 , Wei Dai  1 , Ying Han  1 , Peiran Zhu  1 , Qiuyue Wu  1 , Weiwei Li  1 , Andrew Chen  5 , Chunyan Xue  2 , Xinyi Xia  1   6
Affiliations

The paradoxical problem with COVID-19 ocular infection: Moderate clinical manifestation and potential infection risk

Jiawei Shen et al. Comput Struct Biotechnol J. .

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which induced mainly the respiratory damage also caused ocular surface symptoms. However, the detailed description of ocular manifestations, severity fluctuations in confirmed COVID-19 adult patients still lacked. We analyzed onset clinical symptoms and duration, ocular symptoms, needs for medication, outcomes in 28 conjunctivitis patients who were extracted from 3198 COVID-19 patients hospitalized in Huoshenshan Hospital and Taikangtongji Hospital, Wuhan, China. The expression levels of ACE2, TMPRSS2, ANPEP, DPP4, NRP1 on fetal and adult ocular surface and mouse lacrimal glands were assessed by single cell seq analysis. Our results indicated that conjunctivitis was a rare and self-limited complication in adults with COVID-19 while the existence of coronavirus receptors on human ocular surface and mouse lacrimal glands indicated the risk of SARS-CoV-2 infection. Our research firstly examined SARS-CoV-2 receptors, including the new discovered one, NRP1, on the fetal ocular surface and in the mouse lacrimal glands.

Keywords: COVID-19; Ocular infection; SARS-CoV-2.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

None
Graphical abstract
Fig. 1
Fig. 1
Baseline information and clinical characteristics of 28 COVID-19 patients with conjunctivitis. A, The age distribution of 28 COVID-19 patients with conjunctivitis. B, The underlying diseases of 28 COVID-19 patients with conjunctivitis. C, Ocular symptoms and signs presented during SARS-CoV-2 infection. D, The distribution of conjunctivitis course length in 28 COVID-19 patients with conjunctivitis. E, Treatment of conjunctivitis among 28 COVID-19 patients with conjunctivitis since ocular symptoms onset. F, The comparison of conjunctivitis course length using different drug treatments in 28 COVID-19 patients with conjunctivitis. Ns, stands for no statistical significance.
Fig. 2
Fig. 2
The relationship between severity of COVID-19 and conjunctivitis onset. A, The change of body temperature among 7 patients whose conjunctivitis courses were over 1 day. B, The change of SpO2 among 7 patients. C, The body temperature of 28 COVID-19 patients with conjunctivitis on the onset day of ocular symptoms. D, The SpO2 of 28 COVID-19 patients with conjunctivitis on the onset day of ocular symptoms. E, The value of SARS-CoV-2 specific IgM and IgG of 11 COVID-19 patients with conjunctivitis. The value of pots over the dotted line was higher than normal. F, The comparison of COVID-19 course between patients with conjunctivitis and without. Ns, stands for no statistical significance.
Fig. 3
Fig. 3
Single-cell RNA seq analysis of human cornea-conjunctiva tissues of adults and fetuses. A, The UMAP cluster map shows the clustering of different cells in the cornea-conjunctiva tissues. B, Differences in percentage of expression of ACE2, TMPRSS2, ANPEP and DPP4 in cornea- conjunctiva cells of adults and fetuses. C, Expression and distribution of ACE2, TMPRSS2, ANPEP and DPP4 in different cell clusters in the cornea-conjunctiva tissues. CTRL, adult cornea-conjunctiva tissues; STIM, fetal cornea-conjunctiva tissues.
Fig. 4
Fig. 4
Single-cell RNA seq analysis of mouse lacrimal glands. A, The UMAP cluster map shows the clustering of different types of cells in the lacrimal glands. B,C, Expression and distribution of Ace2, Tmprss2, Anpep, Dpp4 and Nrp1 in different cell clusters in the lacrimal glands.
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