Case ReportAcute Corneal Endothelial Graft Rejection With Coinciding COVID-19 InfectionJin, Sierra X. MD; Juthani, Viral V. MDAuthor Information Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY. Correspondence: Viral Juthani, MD, Montefiore Medical Center/Albert Einstein College of Medicine, 3332 Rochambeau Ave 3rd Floor, Bronx, NY 10467 (e-mail: [email protected]). The authors have no funding or conflicts of interest to disclose. Cornea: January 2021 - Volume 40 - Issue 1 - p 123-124 doi: 10.1097/ICO.0000000000002556 Buy Metrics Abstract Purpose: To report a case of acute corneal endothelial graft rejection with the concurrent onset of coronavirus disease 2019 (COVID-19) symptoms. Methods: Case report. Results: A 31-year-old African American woman with a history of asthma, sleep apnea, obesity (body mass index of 40), and bilateral keratoconus was noted to have acute corneal endothelial graft rejection 3 months after uncomplicated penetrating keratoplasty of the left eye. The patient developed dysgeusia and subjective fever on the same day as ocular discomfort, and she was subsequently diagnosed with COVID-19 with only these 2 classic symptoms of the viral infection. Conclusions: Severe acute respiratory syndrome coronavirus 2 is known to cause conjunctivitis and has demonstrated transmissibility through ocular secretions. Acute immune and inflammatory dysregulations have been seen in cases of COVID-19 through various mechanisms. COVID-19 infection may potentially compromise ocular immune privilege contributing to acute corneal graft rejection. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.