The SARS-CoV-2 pandemic has caused unparalleled disruption of global behavior and significant loss of life. To minimize SARS-CoV-2 spread, understanding the mechanisms of infection from all possible routes of entry is essential. While aerosol transmission is thought to be the primary route of spread, viral particles have been detected in ocular fluid, suggesting that the eye may be a vulnerable point of viral entry. To this end, we confirmed SARS-CoV-2 entry factor and antigen expression in post-mortem COVID-19 patient ocular surface tissue and observed productive viral replication in cadaver samples and eye organoid cultures, most notably in limbal regions. Transcriptional analysis of ex vivo infected ocular surface cells and hESC-derived eye cultures revealed robust induction of NF-κB in infected cells as well as diminished type I/III interferon signaling. Together these data suggest that the eye can be directly infected by SARS-CoV-2 and implicate limbus as a portal for viral entry.

SARS-CoV-2 大流行对全球行为造成了空前的破坏和重大的生命损失。为了最大限度地减少 SARS-CoV-2 的传播，了解所有可能的进入途径的感染机制至关重要。虽然气溶胶传播被认为是主要传播途径，但已在眼液中检测到病毒颗粒，这表明眼睛可能是病毒进入的脆弱点。为此，我们证实了 SARS-CoV-2 进入因子和抗原在死后 COVID-19 患者眼表组织中的表达，并在尸体样本和眼部类器官培养物中观察到有效的病毒复制，最显着的是在角膜缘区域。离体转录分析受感染的眼表细胞和 hESC 衍生的眼培养物显示受感染细胞中 NF-κB 的强烈诱导以及 I / III 型干扰素信号传导减弱。这些数据共同表明，眼睛可以直接被 SARS-CoV-2 感染，并暗示角膜缘是病毒进入的门户。