COVID-19-Related Chronic Bilateral Dacryoadenitis: A Clinicopathological Study

Area of Science:

• Ophthalmology
• Virology
• Pathology

Background:

• Ophthalmic manifestations of COVID-19 require further investigation.
• Understanding the pathological features of these aftereffects is crucial for patient treatment.

Observation:

• A case-control study examined lacrimal gland tissues from a COVID-19 patient and a control.
• Histopathology revealed inflammatory cell infiltration, lymphoid follicles, and germinal center formation in the COVID-19 patient's lacrimal gland.
• Eosinophilic material deposits in lacrimal gland ducts indicated glandular damage in the COVID-19 case.

Findings:

• SARS-CoV-2 nucleocapsid protein was found in inflammatory cells near lacrimal gland ducts.
• Strong expression of angiotensin-converting enzyme 2 (ACE2) was observed in the lacrimal gland.
• The control patient showed inflammation but lacked SARS-CoV-2 protein and ductal deposits.

Implications:

• ACE2 expression suggests the lacrimal gland is a potential target organ for SARS-CoV-2.
• SARS-CoV-2-positive inflammatory cells and glandular damage may represent a COVID-19-associated ophthalmic aftereffect.
• These findings highlight the importance of considering lacrimal gland pathology in COVID-19 patients with ocular symptoms.