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Introduction: Recently, many people said that after being infected with the new crown virus, symptoms such as sore eyes, redness, tears and even blurred vision appeared, and some people were diagnosed with viral keratitis
.
From 15 days to 2 months after the onset of new crown infection or symptoms, eye symptoms
are most likely to appear.
So, how is this eye discomfort related to the new coronavirus? Research published by Nature Communications confirms that the new coronavirus not only exhibits ocular tendency, but also enters the host's eye in various ways, invades along nerves, and causes eye and multi-organ symptoms
.
Masks can block the transmission of respiratory viruses, but how can eye infections be prevented? Omicron is the predominant global epidemic strain, and its infection brings systemic symptoms
.
The lancet published a large prospective observational study quantifying
the symptoms of 63,000 people infected with the new coronavirus.
It was found that the most commonly reported symptoms of Delta infection were runny nose (81.
6%), headache (77.
9%), sneezing (70.
7%), sore throat (60.
8%), and loss of smell (52.
7%); The most commonly reported symptoms of Omicron infection were runny nose (76.
5%), headache (77%), sore throat (70.
5%), sneezing (63.
3%), persistent cough (49.
8%), and hoarseness (42.
6%); Compared with Delta, Omicron mainly affected the upper respiratory tract, reducing the incidence of olfactory loss (52.
7% vs 16.
7%) and hospitalization (2.
6% vs 1.
9%), and increasing the incidence of sore throat (60.
8% vs 70.
5%); In terms of eye discomfort, even if vaccinated, 24.
8%-27.
7% of people infected with the new crown will still have symptoms
.
Figure 1 Main symptoms of new crown infected people (Source: [1])
Respiratory viruses such as D subgroup adenovirus and H7 subtype influenza virus have shown ocular tendencies and cause human eye diseases
.
The mucous membranes of the eyes are directly exposed to infectious aerosols, so the eyes are considered a potential route of transmission of
the new coronavirus 。 A cross-sectional study in Italy reported the presence of viral RNA in conjunctival swabs in 52 of 91 patients with new crown infection, with a higher detection rate in severely ill patients; Other cross-sectional studies conducted in China and Brazil, as well as autopsies, have also reported the detection of viral RNA in patients' conjunctival swabs or aqueous humors; The new coronavirus can infect human embryonic stem cell-derived ocular epithelial cells and human conjunctival epithelial cells; In animal experiments, rhesus monkeys infected with the new coronavirus through the conjunctiva developed mild new coronary pneumonia
.
Therefore, it is necessary to study whether the eye can be used as a primary or secondary point of new coronavirus infection to guide prevention or treatment strategies
against the spread of the new coronavirus.
Animal models confirm that the new coronavirus invades along nerves, causing retinal inflammationOn December 12, 2022, Nature Communications published a study titled " Ocular tropism of SARS-CoV-2 in animal models with retinal inflammation via neuronal invasion following intranasal inoculation"
.
The study, led by a joint research team from the Korea Institute of Chemical Technology, the Korea Institute of Biological Science and Biotechnology, Agriffith University in Australia and the University of Sydney, used K18-hACE2 transgenic mice and wild-type Syrian hamsters to assess ocular tropism and the likelihood of
ocular transmission of the new coronavirus.
order to study whether the eye disease in K18-hACE2 mice is caused by the new coronavirus infection, the researchers used 104 PFU novel coronavirus (GISAID: EPI_ISL_407193) infects mice
intranasally.
By observing the weight, survival rate, and virus titers of the eyes/lungs/spleen/brain of the mice several days after infection, it was found that the new coronavirus was present in the eyes of the mice, and the new coronavirus infected the eyes of mice through retinal ganglion cells, and there was no sex specificity
.
02 New coronavirus infection produces retinal tissue lesions and inflammatory responseThe
researchers found through the histopathology and inflammation analysis of mouse eyes that the new coronavirus infection significantly increased the thickness of the retina by 1.
62 times, and induced the accumulation of infiltrative inflammatory cells in ganglion cells, inner layer and outer nuclear layer
.
Levels of pro-inflammatory cytokines and chemokines in the brain are significantly increased compared to the lungs, and the viral load in the lungs is comparable to
that of eye diseases.
These findings suggest that intranasal infection of the new coronavirus causes retinal inflammation in mice, promoting the production
of pro-inflammatory cytokines and chemokines.
However, retinal inflammation caused by coronavirus infection does not worsen retinal degeneration or vision loss
.
03The new coronavirus infects the eyes and brain through the trigeminal nerve and optic nerve, causing multi-organ lesions
, and how does the new coronavirus go from intranasal infection to invasion of the brain and eyes? The researchers injected mice with 10 4 PFU of the new coronavirus through different routes (intranasal, endotracheal, intracerebral, ocular and intravenous) and assessed viral load
at different sites on the third and sixth days after infection.
It was found that the first to die (the second day of injection) were mice injected in the brain, and copies of viral RNA were found in the eyeball, brain, trigeminal nerve and optic nerve, and the copy number of viral RNA in the lung was relatively lower than that in other tissues
。 suggests that the virus can migrate from the brain to the eye via the trigeminal and optic nerves; The level of new coronavirus RNA in the eyes of mice injected intranasally increased significantly on the third to sixth days after infection, and the virus titers in the trigeminal nerve and optic nerve were monitored at similar levels as in the brain and eyes, indicating that the virus can spread from the nasal cavity to the brain and eyes through the trigeminal nerve and optic nerve.
Increased viral RNA titers were also detected in the eyeball, brain, trigeminal nerve, and optic nerve on the sixth day of endotracheal injection, indicating that the virus travels from the lungs to the eye and brain
via the trigeminal nerve and optic nerve.
Since the optic nerve and trigeminal nerve connect the brain and nasal cavity, the new coronavirus infected in the nose spreads to the brain and eyes through the trigeminal nerve and optic nerve, causing pathological changes
in multiple organs.
However, this transmission is unidirectional, i.
e.
eye infections do not cause infections
of the center and lungs.
In summary, after the new crown infection of the eye, it will induce an increase in the levels of pro-inflammatory cytokines and chemokines, resulting in eye discomfort and retinal inflammation, and even blurred vision and decreased
depth perception.
In addition, the new coronavirus has ocular tropism, which can spread from the lungs to the brain and eyes
through a network of trigeminal and optic nerves.
Essay | competition
Symptom prevalence, duration, and risk of hospital admission in individuals infected with SARS-CoV-2 during periods of omicron and delta variant dominance: a prospective observational study from the ZOE COVID Study.
Lancet.
2022 Apr 23; 399(10335):1618-1624.
doi: 10.
1016/S0140-6736(22)00327-0.
Epub 2022 Apr 7.
PMID: 35397851; PMCID: PMC8989396.
[2]Jeong GU, Kwon HJ, Ng WH, et al.
Ocular tropism of SARS-CoV-2 in animal models with retinal inflammation via neuronal invasion following intranasal inoculation.
Nat Commun.
2022 Dec 12; 13(1):7675.
doi: 10.
1038/s41467-022-35225-1.
PMID: 36509737; PMCID: PMC9743116.
.
From 15 days to 2 months after the onset of new crown infection or symptoms, eye symptoms
are most likely to appear.
So, how is this eye discomfort related to the new coronavirus? Research published by Nature Communications confirms that the new coronavirus not only exhibits ocular tendency, but also enters the host's eye in various ways, invades along nerves, and causes eye and multi-organ symptoms
.
Masks can block the transmission of respiratory viruses, but how can eye infections be prevented? Omicron is the predominant global epidemic strain, and its infection brings systemic symptoms
.
The lancet published a large prospective observational study quantifying
the symptoms of 63,000 people infected with the new coronavirus.
It was found that the most commonly reported symptoms of Delta infection were runny nose (81.
6%), headache (77.
9%), sneezing (70.
7%), sore throat (60.
8%), and loss of smell (52.
7%); The most commonly reported symptoms of Omicron infection were runny nose (76.
5%), headache (77%), sore throat (70.
5%), sneezing (63.
3%), persistent cough (49.
8%), and hoarseness (42.
6%); Compared with Delta, Omicron mainly affected the upper respiratory tract, reducing the incidence of olfactory loss (52.
7% vs 16.
7%) and hospitalization (2.
6% vs 1.
9%), and increasing the incidence of sore throat (60.
8% vs 70.
5%); In terms of eye discomfort, even if vaccinated, 24.
8%-27.
7% of people infected with the new crown will still have symptoms
.
Figure 1 Main symptoms of new crown infected people (Source: [1])
Respiratory viruses such as D subgroup adenovirus and H7 subtype influenza virus have shown ocular tendencies and cause human eye diseases
.
The mucous membranes of the eyes are directly exposed to infectious aerosols, so the eyes are considered a potential route of transmission of
the new coronavirus 。 A cross-sectional study in Italy reported the presence of viral RNA in conjunctival swabs in 52 of 91 patients with new crown infection, with a higher detection rate in severely ill patients; Other cross-sectional studies conducted in China and Brazil, as well as autopsies, have also reported the detection of viral RNA in patients' conjunctival swabs or aqueous humors; The new coronavirus can infect human embryonic stem cell-derived ocular epithelial cells and human conjunctival epithelial cells; In animal experiments, rhesus monkeys infected with the new coronavirus through the conjunctiva developed mild new coronary pneumonia
.
Therefore, it is necessary to study whether the eye can be used as a primary or secondary point of new coronavirus infection to guide prevention or treatment strategies
against the spread of the new coronavirus.
Animal models confirm that the new coronavirus invades along nerves, causing retinal inflammationOn December 12, 2022, Nature Communications published a study titled " Ocular tropism of SARS-CoV-2 in animal models with retinal inflammation via neuronal invasion following intranasal inoculation"
.
The study, led by a joint research team from the Korea Institute of Chemical Technology, the Korea Institute of Biological Science and Biotechnology, Agriffith University in Australia and the University of Sydney, used K18-hACE2 transgenic mice and wild-type Syrian hamsters to assess ocular tropism and the likelihood of
ocular transmission of the new coronavirus.
Figure 1 Research results (Source: [1])
order to study whether the eye disease in K18-hACE2 mice is caused by the new coronavirus infection, the researchers used 104 PFU novel coronavirus (GISAID: EPI_ISL_407193) infects mice
intranasally.
By observing the weight, survival rate, and virus titers of the eyes/lungs/spleen/brain of the mice several days after infection, it was found that the new coronavirus was present in the eyes of the mice, and the new coronavirus infected the eyes of mice through retinal ganglion cells, and there was no sex specificity
.
02 New coronavirus infection produces retinal tissue lesions and inflammatory responseThe
researchers found through the histopathology and inflammation analysis of mouse eyes that the new coronavirus infection significantly increased the thickness of the retina by 1.
62 times, and induced the accumulation of infiltrative inflammatory cells in ganglion cells, inner layer and outer nuclear layer
.
Levels of pro-inflammatory cytokines and chemokines in the brain are significantly increased compared to the lungs, and the viral load in the lungs is comparable to
that of eye diseases.
These findings suggest that intranasal infection of the new coronavirus causes retinal inflammation in mice, promoting the production
of pro-inflammatory cytokines and chemokines.
However, retinal inflammation caused by coronavirus infection does not worsen retinal degeneration or vision loss
.
03The new coronavirus infects the eyes and brain through the trigeminal nerve and optic nerve, causing multi-organ lesions
, and how does the new coronavirus go from intranasal infection to invasion of the brain and eyes? The researchers injected mice with 10 4 PFU of the new coronavirus through different routes (intranasal, endotracheal, intracerebral, ocular and intravenous) and assessed viral load
at different sites on the third and sixth days after infection.
It was found that the first to die (the second day of injection) were mice injected in the brain, and copies of viral RNA were found in the eyeball, brain, trigeminal nerve and optic nerve, and the copy number of viral RNA in the lung was relatively lower than that in other tissues
。 suggests that the virus can migrate from the brain to the eye via the trigeminal and optic nerves; The level of new coronavirus RNA in the eyes of mice injected intranasally increased significantly on the third to sixth days after infection, and the virus titers in the trigeminal nerve and optic nerve were monitored at similar levels as in the brain and eyes, indicating that the virus can spread from the nasal cavity to the brain and eyes through the trigeminal nerve and optic nerve.
Increased viral RNA titers were also detected in the eyeball, brain, trigeminal nerve, and optic nerve on the sixth day of endotracheal injection, indicating that the virus travels from the lungs to the eye and brain
via the trigeminal nerve and optic nerve.
Since the optic nerve and trigeminal nerve connect the brain and nasal cavity, the new coronavirus infected in the nose spreads to the brain and eyes through the trigeminal nerve and optic nerve, causing pathological changes
in multiple organs.
However, this transmission is unidirectional, i.
e.
eye infections do not cause infections
of the center and lungs.
In summary, after the new crown infection of the eye, it will induce an increase in the levels of pro-inflammatory cytokines and chemokines, resulting in eye discomfort and retinal inflammation, and even blurred vision and decreased
depth perception.
In addition, the new coronavirus has ocular tropism, which can spread from the lungs to the brain and eyes
through a network of trigeminal and optic nerves.
Essay | competition
Typesetting| Qiao Weijun
End
References: [1] Menni C, Valdes AM, Polidori L, et al.Symptom prevalence, duration, and risk of hospital admission in individuals infected with SARS-CoV-2 during periods of omicron and delta variant dominance: a prospective observational study from the ZOE COVID Study.
Lancet.
2022 Apr 23; 399(10335):1618-1624.
doi: 10.
1016/S0140-6736(22)00327-0.
Epub 2022 Apr 7.
PMID: 35397851; PMCID: PMC8989396.
[2]Jeong GU, Kwon HJ, Ng WH, et al.
Ocular tropism of SARS-CoV-2 in animal models with retinal inflammation via neuronal invasion following intranasal inoculation.
Nat Commun.
2022 Dec 12; 13(1):7675.
doi: 10.
1038/s41467-022-35225-1.
PMID: 36509737; PMCID: PMC9743116.
