Identification of SARS-CoV-2 on the ocular surface in a cohort of COVID-19 patients from Brazil

In this cross-sectional study, we investigate the presence of Severe Acute Respiratory Syndrome Coronavirus 2 Ribonucleic Acid (SARS-CoV-2 RNA) in the tears of hospitalized COVID-19 patients. After laboratory confirmation of SARS-CoV-2 infection by reverse transcription polymerase chain reaction (RT...

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Bibliographic Details
Published in:	Experimental biology and medicine (Maywood, N.J.) Vol. 246; no. 23; pp. 2495 - 2501
Main Authors:	Gasparini, Matheus S, dos Santos, Leandro M, Hamade, Ahmad MA, Gross, Luísa G, Favarato, Arthur P, de Vasconcellos, José PC, de Melo, Mônica B, Parise, Pierina L, Simeoni, Camila L, Silva, Natália B, da Silva Mori, Marcelo A, Vieira, André S, dos Santos Farias, Alessandro, Granja, Fabiana, Schreiber, Angelica Z, Moretti, Maria L, Proença-Modena, José L, Alves, Mônica
Format:	Journal Article
Language:	English
Published:	London, England SAGE Publications 01-12-2021
Subjects:	Adult Aged Brazil COVID-19 - complications COVID-19 - pathology COVID-19 - virology COVID-19 Nucleic Acid Testing - statistics & numerical data Eye - virology Eye Infections, Viral - epidemiology Eye Infections, Viral - pathology Eye Infections, Viral - virology Female Humans Male Middle Aged Original Research SARS-CoV-2 - genetics SARS-CoV-2 - pathogenicity Tears - virology Viral Load Brazil COVID-19 viral Coronavirus eye infections
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Summary:	In this cross-sectional study, we investigate the presence of Severe Acute Respiratory Syndrome Coronavirus 2 Ribonucleic Acid (SARS-CoV-2 RNA) in the tears of hospitalized COVID-19 patients. After laboratory confirmation of SARS-CoV-2 infection by reverse transcription polymerase chain reaction (RT-PCR) analysis, tear samples from both eyes of each patient were collected using conjunctival swab for RT-PCR. Detailed demographic profile, systemic and ocular symptoms, comorbidities, clinical, ancillary, and ocular manifestations were evaluated. Of the 83 patients enrolled in the study, 7 (8.43%) had SARS-CoV-2 RNA detected in the tear samples. Neutrophils’ count, C-reactive protein, and D-dimer were higher in patients with SARS-CoV-2 detected in tears than in patients without virus in ocular surface samples. One patient with SARS-CoV-2 in tears showed mild ocular eyelid edema, hyperemia, and chemosis. No relevant ocular manifestations were detected in the other patients. Although the levels of viral RNA on ocular surface samples were low for most patients (5/7), with positivity only for gene N and CT higher than 30, two patients were positive for all viral targets tested (N, E, and RpRd), with viral load near 1 × 105 ePFU/mL, indicating that the ocular transmission of SARS-CoV-2 is a possibility that needs to be considered, especially in the hospital environment. Further studies need to be conducted to demonstrate whether infective viral particles could be isolated from tears.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Authors contributed equally as first authors.
ISSN:	1535-3702 1535-3699
DOI:	10.1177/15353702211024651