This report adheres to the tenets of the Declaration of Helsinki. We believe this is a unique neuro-ophthalmic manifestation of SARS-CoV-2 and the first such case to be reported in the literature. Herein, we describe a case of a young man presenting with bilateral severe optic neuritis and myelitis, determined to be simultaneously SARS-CoV-2 and myelin oligodendrocyte glycoprotein (MOG) IgG antibody positive. Additional reports of COVID-19 presenting as Miller Fisher syndrome ( 10), Guillain–Barré syndrome ( 11), and Kawasaki syndrome ( 13) offer specific examples of this virus's ability to dysregulate the immune system. Moreover, a recent report of SARS-CoV-2 preceding antiphospholipid antibody syndrome ( 9) leading to thrombus formation underscores the potential for this infectious agent to trigger autoantibody production. The neuroinvasive potential of SARS-CoV-1, MERS-CoV, and other coronaviruses has been described, and it has been hypothesized that SARS-CoV-2 may be able to directly access the central nervous system (CNS) through a transsynaptic route given considerable sequence homology, and that this may be a mechanism of respiratory failure in COVID-19 ( 5). ![]() ![]() There is an ever-growing body of literature describing other organs as sites of damage caused by this family of viruses, including cardiac ( 2), gastrointestinal ( 3), neurological ( 4– 11), and ophthalmic ( 12– 14) involvement. The coronavirus family of viruses, including SARS coronavirus 1 (SARS-CoV-1) and Middle East respiratory syndrome coronavirus (MERS-CoV), is most well known for causing respiratory syndromes, with severe cases leading to acute respiratory distress syndrome (ARDS). As the number of infections grows, so does our knowledge of possible clinical symptoms, signs, and manifestations. The outbreak of the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiological agent of coronavirus disease 2019 (COVID-19), was first reported in late December 2019 in Wuhan, China, ( 1) and has since transformed into a rapidly evolving global pandemic.
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