Presence of SARS-CoV-2 Viral RNA in Aqueous Humor of Asymptomatic Individuals

Koo, Ellen; Eghrari, Allen O.; Dzhaber, Daliya; Shah, Anita N.; Fout, Elizabeth; Dubovy, Sander R.; Maestre-Mesa, Jorge; Miller, Darlene

doi:10.1016/j.ajo.2021.05.008

Cited by 32 publications

(39 citation statements)

References 17 publications

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“…In the present study, we detected SARS-CoV-2 RNA in 50% of the examined conjunctival specimens and in 30% of the examined IVBs. Our results are in accordance with previous studies that found SARS-CoV-2 RNA within the eye [ 18 , 19 , 24 ]. In other studies, SARS-CoV-2 RNA was not detected in conjunctiva and vitreous [ 17 , 20 , 21 , 23 , 36 ].…”

Section: Discussionsupporting

confidence: 94%

“…In our study, SARS-CoV-2 RNA could be detected intraocularly up to 78 h after death and up to 94 days after the first positive test. A recent report by Koo et al showed that SARS-CoV-2 RNA was present in the aqueous humor of asymptomatically infected subjects despite negative nasal swab tests [ 24 ]. This raises the question whether and how long SARS-CoV-2 can persist in immune-privileged niches like the eye without causing any symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…SARS-CoV-2 involvement of the ocular surface is highly relevant particularly when planning and performing ophthalmic surgery, as infectious aerosols can be generated during ophthalmic procedures in SARS-CoV-2 positive patients [ 24 ]. The detection of viral RNA in the intraocular milieu may also provide a clue to the pathogenesis of ophthalmologic symptoms during COVID-19-related intraocular disease [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

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Detection of SARS-CoV-2-RNA in post-mortem samples of human eyes

Penkava

Muenchhoff

Badell³

et al. 2021

Graefes Arch Clin Exp Ophthalmol

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Purpose To detect SARS-CoV-2 RNA in post-mortem human eyes. Ocular symptoms are common in patients with COVID-19. In some cases, they can occur before the onset of respiratory and other symptoms. Accordingly, SARS-CoV-2 RNA has been detected in conjunctival samples and tear film of patients suffering from COVID-19. However, the detection and clinical relevance of intravitreal SARS-CoV-2 RNA still remain unclear due to so far contradictory reports in the literature. Methods In our study 20 patients with confirmed diagnosis of COVID-19 were evaluated post-mortem to assess the conjunctival and intraocular presence of SARS-CoV-2 RNA using sterile pulmonary and conjunctival swabs as well as intravitreal biopsies (IVB) via needle puncture. SARS-CoV-2 PCR and whole genome sequencing from the samples of the deceased patients were performed. Medical history and comorbidities of all subjects were recorded and analyzed for correlations with viral data. Results SARS-CoV-2 RNA was detected in 10 conjunctival (50%) and 6 vitreal (30%) samples. SARS-CoV-2 whole genome sequencing showed the distribution of cases largely reflecting the frequency of circulating lineages in the Munich area at the time of examination with no preponderance of specific variants. Especially there was no association between the presence of SARS-CoV-2 RNA in IVBs and infection with the variant of concern (VOC) alpha. Viral load in bronchial samples correlated positively with load in conjunctiva but not the vitreous. Conclusion SARS-CoV-2 RNA can be detected post mortem in conjunctival tissues and IVBs. This is relevant to the planning of ophthalmologic surgical procedures in COVID-19 patients, such as pars plana vitrectomy or corneal transplantation. Furthermore, not only during surgery but also in an outpatient setting it is important to emphasize the need for personal protection in order to avoid infection and spreading of SARS-CoV-2. Prospective studies are needed, especially to determine the clinical relevance of conjunctival and intravitreal SARS-CoV-2 detection concerning intraocular affection in active COVID-19 state and in post-COVID syndrome.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Detection of SARS-CoV-2-RNA in post-mortem samples of human eyes

Penkava

Muenchhoff

Badell³

et al. 2021

Graefes Arch Clin Exp Ophthalmol

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“…The comparison of these parameter values between different visits showed no significance, except for ACV. SARS-CoV-2 virus presence has been reported in the anterior chamber and cornea tissue [ 10 – 13 ]. Yan et al reported the presence of nucleocapsid protein antigens on the cells of the conjunctiva, iris, and trabecular meshwork of a patient with a COVID-19 infection, and these antigens were absent on the specimens from the control patient [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…The presence of SARS-CoV-2 RNA and proteins was reported in the anterior chamber and corneal tissue following COVID-19 infection [ 10 – 13 ]. Moreover, some incompatible reports were on the presence of viruses on the ocular surface [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Changes in Anterior Chamber Parameters Measured by Pentacam in Coronavirus Disease 2019 Infection: A Longitudinal Study

Shokoohi-Rad

Abrishami

Bakhtiari

et al. 2022

Journal of Ophthalmology

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Purpose. To evaluate changes in anterior segment parameters measured by imaging in coronavirus disease 2019 (COVID-19) infection. Methods. This longitudinal observational study included patients who recovered from COVID-19. All subjects exhibited a confirmed diagnosis of COVID-19 with a positive result of nasopharyngeal reverse transcription-polymerase chain reaction evaluation. Corneal Pentacam (Oculus, Dutenhofen, Germany) imaging was performed at least two weeks after recovery from systemic COVID-19. Measurements were repeated one and three months later. Results. A total of 20 patients, 11 (55%) of whom were females, with a mean age of 35.5 ± 7.1 years (age range: 25–51 years) recovered from nonhospitalized COVID-19 infection, were enrolled in this study. An increase in the keratometry mean front, keratometry mean back, cornea volume, and anterior chamber depth was observed in the longitudinal evaluation; however, they showed no statistical significance. The anterior chamber volume was statistically increased at three-month follow-up, compared to baseline (baseline: 177.8 ± 36.68 mm3; three months: 182.25 ± 39.58 mm3, P = 0.048 ). Conclusion. COVID-19 infection may affect the cornea and anterior segment.

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