COVID-19 positivity rate in corneal tissue donors – A cause for concern!

Abstract

Purpose: To determine the postmortem positivity for COVID-19 among voluntary eye donors who had been certified to have died of non-COVID-19 causes. Methods: All donors who donated their corneas (from March 2021 onward) were assessed for COVID-19 positivity tested by nasopharyngeal swab reverse transcription-polymerase chain reaction (RT-PCR) test. Relevant screening history was taken prior to collection. Strict precautions were taken during the retrieval as per the guidelines issued by the National Program for Control of Blindness and Visual Impairment and the Eye Bank Association of India, and the tissues were handled as per standard operating protocol. Results: 85 eye calls were attended during this period, of which 56 were home-based and 29 were from a hospital setting. Samples from 12 of the former group of donors were found to be positive for COVID-19 (14%). Conclusion: This study highlights the possibility of postmortem RT-PCR positivity in voluntary corneal tissue donors without a prior history of symptoms, signs, or diagnosis of illness suggestive of COVID-19. It is recommended that postmortem testing of donors should be done by RT-PCR for retrievals made during the pandemic.

SARS-CoV-2 infection status in corneal preservation solution and COVID-19 prevalence after corneal transplantation

“…Even if the donor is already infected with SARS-CoV-2, RNA may not be detected in corneal preservation solution. An RT-PCR of nasopharyngeal swab fluid from corneal donors without symptoms revealed that 12 of 85 samples were positive for COVID-19 36 . In addition, RNA of SARS-CoV-2 was detected in 2 (0.3%) corneal specimens from 588 donors with no medical or epidemiological relevance for COVID-19, and RNA was also detected in their corneal preservative fluid 37 .…”

SARS-CoV-2 infection status in corneal preservation solution and COVID-19 prevalence after corneal transplantation

“…Even if the donor is already infected with SARS-CoV-2, RNA may not be detected in corneal preservation solution. An RT-PCR of nasopharyngeal swab uid from corneal donors without symptoms revealed that 12 of 85 samples were positive for COVID-19 (30) . In addition, RNA of SARS-CoV-2 was detected in 2 (0.3%) corneal specimens from 588 donors with no medical or epidemiological relevance for COVID-19, and RNA was also detected in their corneal preservative uid (31) .…”

Dilemma of donor testing before corneal retrieval in the COVID-19 era

“…Recent studies have reported a significant RT-PCR positivity rate of nasopharyngeal swabs obtained from presumed COVID-19-negative potential donors, ranging from 4.8% to as high as 18.64%. [ 1 15 16 ] Arora et al . [ 15 ] also reported a high viral load (Ct < 25) in 54.54% of the positive cases, suggestive of high risk of disease transmission to the health personnel handling the tissue.…”