LOW VULNERABILITY OF THE POSTERIOR EYE SEGMENT TO SARS-COV-2 INFECTION: Chorioretinal SARS-CoV-2 Vulnerability

Retina. 2022 Feb 1;42(2):236-243. doi: 10.1097/IAE.0000000000003320.

Abstract

Purpose: Retinal manifestations have been described in COVID-19 patients, but it is unknown whether SARS-CoV-2, the causal agent in COVID-19, can directly infect posterior ocular tissues. Here, we investigate SARS-CoV-2 host factor gene expression levels and their distribution across retinal and choroidal cell types.

Methods: Query of single-cell RNA sequencing data from human retina and choroid.

Results: We find no relevant expression of two key genes involved in SARS-CoV-2 entry, ACE2 and TMPRSS2, in retinal cell types. By contrast, scarce expression levels could be detected in choroidal vascular cells.

Conclusion: Given the current understanding of viral host cell entry, these findings suggest a low vulnerability of the posterior eye segment to SARS-CoV-2 with a potential weak spot in the vasculature, which could play a putative causative role in ocular lesions in COVID-19 patients. This may qualify the vasculature of the human posterior eye segment as an in vivo biomarker for life-threatening vascular occlusions in COVID-19 patients.

MeSH terms

  • COVID-19 / epidemiology*
  • COVID-19 / virology
  • Eye Infections, Viral / epidemiology
  • Eye Infections, Viral / pathology
  • Eye Infections, Viral / virology*
  • Gene Expression Regulation, Viral*
  • Humans
  • Posterior Eye Segment / pathology
  • Posterior Eye Segment / virology*
  • RNA, Viral / genetics
  • Retinal Ganglion Cells / pathology
  • Retinal Ganglion Cells / virology
  • SARS-CoV-2*
  • Serine Endopeptidases / biosynthesis
  • Serine Endopeptidases / genetics*
  • Virus Internalization*

Substances

  • RNA, Viral
  • Serine Endopeptidases
  • TMPRSS2 protein, human