SARS-CoV2 is the virus which causes COVID-19, the form of coronavirus which is now a global pandemic. The gene ACE2 is involved when SARS-CoV2 infection occurs and the eye is an important possible place of entry for the virus to get into the body. It is thought that the virus enters the eye through ACE2, but this remains unclear. We will look at gene expression in eye tissue to identify whether ACE2 is important in the eye and generate a picture of biomarkers of the eye which may predict disease severity. This will help in understanding the first steps in the mechanism of infection and potential targets for therapies. We will be using excess surgical tissue from the eyes of non COVID-19 patients undergoing surgery for other reasons.

Population-wide prophylactic vaccination is the principal means of quelling the COVID-19 pandemic. For this to succeed, knowledge of vaccine efficacy is imperative. Patients with lymphoid malignancies have an increased mortality risk from COVID-19. Many patients are apparently cured but have long-term immune defects. Our lack of knowledge of COVID-19 vaccination responses confers a morbidity and mortality risk in this population and significant societal impact. This study will assess COVID-19 vaccine efficacy defined by immunological responses (anti-spike IgG, virus neutralisation, T-cell recall).

Primary Immunodeficiencies (PIDs) are rare inherited diseases of the immune system that may lead to recurrent infections, malignancy or autoimmunity, all with a significantly impaired quality of life. There are currently over 200 different PIDs with approximately 250 different genes linked to these disorders. Through the NIHR/Wellcome Trust Southampton Clinical Research Facility for Experimental Medicine and Translational Medicine Laboratory, we will perform deep-phenotyping (detailed examination of possible pertinent findings of gene tests) of 20 patients with PID to gain additional understanding of the cause each patients’ rare immunological disease. This greater understanding will hopefully identify novel therapeutic targets and the initiation of personalised treatments. Previously at our centre we have shown that, by this approach, we can commence precision therapeutics for patients with PID that substantially reduced morbidity and mortality.