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SARS-CoV-2, COVID-19, and the Eye

December 2021 will mark the second anniversary of initial reports from Wuhan, China, of human infection by Severe Acute Respiratory Distress Syndrome Coronavirus-2 (SARSCoV-2), a novel positive-sense, single-stranded enveloped RNA virus transmitted via respiratory droplets and contaminated vectors, or fomites. As of this writing in August 2021, the pandemic has produced over 200 million confirmed cases from more than 200 countries, resulting in more than 4 million identified deaths. As nearly half of these reported cases were from the United States and Europe – inhabitants of which together total just under 15% of the planet’s population, there is good reason to believe that many regional rates of SARSCoV-2 infection and of COVID-19-associated morbidity and mortality are spuriously low – particularly those from the developing world. While asymptomatic infection often occurs, the most prominent signs of symptomatic SARS-CoV-2 infection tend to be constitutional and respiratory, including fever, fatigue, anorexia, malaise, myalgias, sore throat, headache, nasal congestion, cough, and shortness of breath. Suggestive sentinel symptoms identified early in the pandemic as population-based Google search patterns pointed to strong regional correlations between online queries for specific complaints and SARS-CoV -2 infection rates included loss of smell, or anosmia, and eye pain. Recent reports have since documented several additional ocular findings during or shortly after SARS-CoV-2 infection, as summarized recently – including in an invited review by Jevnikar et al. that appears in this issue of Ocular Immunology and Inflammation (OII). This review, together with seven Letters and 14 Articles in the pages that follow, confirmed the occurrence of symptomatic, often painful, conjunctivitis in a minority of patients, and supported early reports of rare retinal vascular occlusion and various forms of ocular inflammation, observations bolster by the demonstration of SARS-CoV-2 DNA and/or viral particles in the vitreous or retina of patients with confirmed COVID-19. Our expectation is that the ocular complications of both acute and chronic or so-called long haul COVID will be both better defined and expanded over the coming months and years. Our hope is that many of the studies in this and subsequent issues of OII will serve as a foundation for future investigations. Acknowledgments