Detection of SARS-CoV-2 in Human Retinal Biopsies of Deceased COVID-19 Patients

Casagrande, Maria; Fitzek, Antonia; Püschel, Klaus; Aleshcheva, Ganna; Schultheiss, Heinz‐Peter; Berneking, Laura; Spitzer, Martin S.; Schultheiß, Maximilian

doi:10.1080/09273948.2020.1770301

Cited by 241 publications

(233 citation statements)

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“…Recently, a study pointed out important findings regarding the novel coronavirus disease 2019 (COVID- 19), which is caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). 1 In this study, Casagrande et al reported, for the first time, the presence of SARS-CoV-2 in the human retina, indicating that this coronavirus can reach retinal tissue and possibly cause damages. 1 However, the mechanisms by which SARS-CoV-2 could infect the retina are still to be properly addressed in the literature.…”

Section: Dear Editormentioning

confidence: 48%

SARS-CoV-2 Targeting the Retina: Host–virus Interaction and Possible Mechanisms of Viral Tropism

Figueiredo

Raony

Giestal-de-Araujo

2020

Ocular Immunology and Inflammation

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Background: Coronavirus disease 2019 (COVID-19) is caused by Severe Acute Respiratory Syndrome Coronavirus 2 10 (SARS-CoV-2). Recent studies demonstrated not only retinal impairments but also detected SARS-CoV-2 in the retina of patients with COVID-19. Purpose: This letter discusses the retinal tropism of SARS-CoV-2, describing possible routes for this coronavirus to reach the retina and cellular mechanisms involved in the retinal cell infection. Conclusions: Determining how SARS-CoV-2 can affect the retinal tissue is essential for the development of new therapeutic strategies and preventive measures, as well as for understanding the possible relationship between COVID-19 damage to the retina and to the brain.

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Section: Dear Editormentioning

confidence: 48%

SARS-CoV-2 Targeting the Retina: Host–virus Interaction and Possible Mechanisms of Viral Tropism

Figueiredo

Raony

Giestal-de-Araujo

2020

Ocular Immunology and Inflammation

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“…We also detected SARS-CoV-2 RNA in two of 20 vitreous swabs. Similarly, a recent study demonstrated 21% (3/14) prevalence rate of SARS-CoV-2 RNA in the retinal biopsies of deceased COVID-19 patients [ 11 ]. Hence, the possibility of infiltration via retinal vasculature could not be eliminated.…”

Section: Discussionmentioning

confidence: 94%

“…In January 2020, an ophthalmologist contracted COVID-19 from an asymptomatic glaucoma patient; the initial indication was that the ocular surface served as a mediator of viral infection [ 3 ]. Studies have shown that SARS-CoV-2 may cause conjunctivitis, and viral RNA has been detected in tears and retinal biopsies of COVID-19 patients [ [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] ]. Conjunctival manifestations have been reported at rates as low as 0.8% [ 6 ] in the largest retrospective study from China, and at rates of 6% [ 9 ], 32% [ 5 ], and as high as 66% [ 10 ] in other studies.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of SARS-CoV-2 in human post-mortem ocular tissues

Sawant¹,

et al. 2021

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Background SARS-CoV-2 is found in conjunctival swabs and tears of COVID-19 patients. However, the presence of SARS-CoV-2 has not been detected in the human eye to date. We undertook this study to analyze the prevalence of SARS-CoV-2 in human post-mortem ocular tissues. Methods The expression of SARS-CoV-2 RNA was assessed by RT-PCR in corneal and scleral tissues from 33 surgical-intended donors who were eliminated from a surgical use per Eye Bank Association of America (EBAA) donor screening guidelines or medical director review or positive COVID-19 test. Ocular levels of SARS-CoV-2 RNA (RT-PCR), Envelope and Spike proteins (immunohistochemistry) and anti -SARS-CoV-2 IgG and IgM antibodies (ELISA) in blood were evaluated in 10 COVID-19 donors. Findings Of 132 ocular tissues from 33 surgical-intended donors, the positivity rate for SARS-CoV-2 RNA was ∼13% (17/132). Of 10 COVID-19 donors, six had PCR positive post-mortem nasopharyngeal swabs whereas eight exhibited positive post-mortem anti -SARS-CoV-2 IgG levels. Among 20 eyes recovered from 10 COVID-19 donors: three conjunctival, one anterior corneal, five posterior corneal, and three vitreous swabs tested positive for SARS-CoV-2 RNA. SARS-CoV-2 spike and envelope proteins were detected in epithelial layer of the corneas that were procured without Povidone-Iodine (PVP–I) disinfection. Interpretations Our study showed a small but noteworthy prevalence of SARS-CoV-2 in ocular tissues from COVID-19 donors. These findings underscore the criticality of donor screening guidelines, post-mortem nasopharyngeal PCR testing and PVP-I disinfection protocol to eliminate any tissue harboring SARS-CoV-2 being used for corneal transplantation.

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“…In klinischen Beobachtungen erschienen wiederkehrend Erkrankte, die an einer Keratokonjunktivitis litten, vereinzelt wurden Netzhautentzündungen (Retinitis) oder Sehnervenentzündungen (Neuritis nervi optici) dokumentiert [23]. Durch postmortale Untersuchungen konnten in einigen Proben via RT-PCR RNA Rückstände von SARS-CoV-2 in der Retina und Kornea nachgewiesen werden [24].…”

Section: Augenunclassified

Obduktionen bei COVID-19

et al. 2020

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ZUSAMMENFASSUNGBei der Erkrankung COVID-19 (coronavirus disease 2019) handelt es sich um eine virale Infektion mit einem Betacoronavirus, bei der die Infizierten an unterschiedlichen klinischen Symptomen leiden. Bei Erkrankten können sich Symptome wie Husten, Fieber sowie schwere respiratorische und organische Funktionseinschränkungen zeigen 1, 2. Pathophysiologisch bindet nach der Aufnahme des Virus über den oberen Respirationstrakt ein viruseigenes Spikeprotein an den membrangebundenen ACE2-Rezeptor (Angiotensin-converting enzyme 2 Rezeptor), welcher vorrangig in Lungen-, Herz- und Nierengewebe exprimiert wird. Da es bei den unterschiedlichen Organgeweben zu heterogenen Expressionsmustern von ACE2-Rezeptoren kommt, sind die Effekte der Infektion variabel. Diese pathologischen Veränderungen werden im Folgenden aus den Erkenntnissen bisheriger Publikationen, in denen postmortale Untersuchungen im Rahmen einer offenen Leichenschau (Obduktion) oder einer postmortalen Bildgebung (PMCT) durchgeführt wurden, zusammenfassend dargestellt. Nicht näher eingegangen wird auf die bereits vielfach dargestellten diversen Vorerkrankungen der meist multimorbiden und hochbetagten Patienten unter den COVID-19-Sterbefällen.

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Detection of SARS-CoV-2 in Human Retinal Biopsies of Deceased COVID-19 Patients

Cited by 241 publications

References 22 publications

SARS-CoV-2 Targeting the Retina: Host–virus Interaction and Possible Mechanisms of Viral Tropism

SARS-CoV-2 Targeting the Retina: Host–virus Interaction and Possible Mechanisms of Viral Tropism

Prevalence of SARS-CoV-2 in human post-mortem ocular tissues

Obduktionen bei COVID-19

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