Detection of severe acute respiratory syndrome Coronavirus-2 in the tears of patients with Coronavirus disease 2019

Abstract

Objectives Since there are few reports on the ocular involvement of coronavirus disease 2019 patients, this study aimed to assess the presence of severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) in the tears of patients with COVID-19. Methods In this prospective case series, nasopharyngeal and tear sampling of 43 patients with severe COVID-19 were performed. The quantitative reverse transcription polymerase chain reaction (RT-PCR) was conducted to detect SARS-CoV-2. Ocular and systemic signs and symptoms were recorded from their medical history. Results The mean age of patients was 56 ± 13 years. The average disease time from initiation of symptoms was 3.27 days, range: 1-7 days. Forty-one patients (95.3%) had fever at the time of sampling. Only one patient had conjunctivitis. Thirty (69.8%) nasopharyngeal and three (7%) tear samples were positive for SARS-CoV-2. The result of tear sample was positive in the patient with conjunctivitis. All patients with positive tear RT-PCR results had positive nasopharyngeal RT-PCR results. Conclusions Ocular manifestation was rare in this series of severe COVID-19 patients, however, 7% of the patients had viral RNA in their conjunctival secretions. Therefore, possibility of ocular transmission should be considered even in the absence of ocular manifestations.

Retinal involvement and ocular findings in COVID‐19 pneumonia patients 

“…Only in 4-7% of cases did PCR reveal the presence of SARS-CoV-2 from conjunctival swabs. 17,19,31,45 In all three patients presenting bilateral conjunctivitis that was observed in our study, the conjunctival swab was negative for SARS-CoV-2. Nevertheless, since other viruses (e.g., herpes and adenovirus) are known to induce and have been detected in conjunctivitis, we cannot exclude the transient presence of SARS-CoV-2 on the ocular surface at any time before or after our swab.…”

Ocular findings and retinal involvement in COVID-19 pneumonia patients: A cross-sectional study in an Italian referral centre

“…Only in 4-7% of cases PCR revealed the presence of SARS-CoV-2 from conjunctival swab. 17,19,31,44 In all three patients presenting bilateral conjunctivitis that were observed in our study, the conjunctival swab was negative for SARS-CoV-2. Nevertheless, since other viruses (e.g.…”

Potential sources, modes of transmission and effectiveness of prevention measures against SARS-CoV-2

“…One patient was described with persistent conjunctivitis with viral RNA detection until day 27 after symptom onset and confirmation of infectious virus in the first RNA-positive ocular sample [126]. Even though the virus can be detected rarely in the conjunctival sac at very low levels [127,128], there is no evidence that it can replicate locally [129]. That is why the conjunctiva were considered not to be the preferred gateway into the respiratory tract [130].…”