Presence of viral RNA of SARS-CoV-2 in conjunctival swab specimens of COVID-19 patients

Kumar, Kiran; Prakash, Akshata A; Gangasagara, Suresh Babu; Rathod, Sujatha B L; Ravi, K; Rangaiah, Ambica; Shankar, Sathyanarayan Muthur; Basawarajappa, Shantala Gowdara; Bhushan, Shashi; Neeraja, T; Khandenahalli, Srinivas; Swetha, M.; Gupta, Priyam; Sampritha, U C; Prasad, Guru N S; Jayanthi, C.

doi:10.4103/ijo.ijo_1287_20

Cited by 73 publications

(84 citation statements)

References 12 publications

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“…One of the major conclusions which one can make from this systematic review is that the prevalence of ocular symptoms and signs is low and that conjunctivitis is a relatively rare occurrence. In this review, this prevalence ranges from 0 to 31.58% [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. This is in keeping with a previous large study from China which reported that nine patients (0.82%) out of 1099 laboratory-confirmed COVID-19 patients experienced conjunctival congestion [23].…”

Section: Resultssupporting

confidence: 86%

“…In this systematic review, apart from conjunctivitis, there were also descriptions of the development of pseudomembranous haemorrhagic conjunctivitis [13] and keratoconjunctivitis [15] in the patients. It was also suggested that ocular symptoms and signs commonly appear in patients with severe pneumonia [6]. The timing of the onset of ocular manifestations varied among the studies.…”

Section: Resultsmentioning

confidence: 99%

“…To this end, different research teams have performed reverse transcription polymerase chain reaction (RT-PCR) on ocular samples of tears and conjunctival secretions, and viral cultures. What has been reported is that COVID-19 can be accompanied by conjunctivitis with its attendant symptoms of conjunctival infection, epiphora, itch, discharge, etc., but this remains a relatively rare occurrence compared with the classic respiratory symptoms [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. It is questionable whether the eye is truly a portal of transmission.…”

Section: Introductionmentioning

confidence: 99%

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Systematic Review of Ocular Involvement of SARS-CoV-2 in Coronavirus Disease 2019

Cheong

2020

Curr Ophthalmol Rep

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Purpose of Review Studies have reported ocular involvement in the coronavirus disease 2019 (COVID-19), with SARS-CoV-2 having been detected in ocular swab samples. This has implicated the eye as a portal of transmission. The aim of this systemic review is to summarise and discuss the current literature regarding ocular involvement of SARS-CoV-2 in COVID-19. Recent Findings In this systematic review, the prevalence of ocular symptoms and signs was low (from 0 to 31.58%) and conjunctivitis was a relatively rare occurrence. The rate of detection of SARS-CoV-2 in the ocular swab samples was low as well and this ranged from 0 to 11.11%. The development of ocular symptoms and signs was not always accompanied by the detection of SARS-CoV-2 in the ocular swab samples. The opposite was described as well. This may reflect issues related to the characteristics of SARS-CoV-2 and of the study design. Nonetheless, the nature of research in a pandemic is that conclusions can change as more information is obtained. Summary Whilst the eye is unlikely to be a main transmission route, we need to consider the possibilities of conjunctivitis as a presenting complaint and of the eye playing a role in the transmission of SARS-CoV-2. Furthermore, we need to take the appropriate precautions in our practice. Further studies are needed to evaluate the viral tropism of SARS-CoV-2 and its role in the eyes.

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Section: Resultssupporting

confidence: 86%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Systematic Review of Ocular Involvement of SARS-CoV-2 in Coronavirus Disease 2019

Cheong

2020

Curr Ophthalmol Rep

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“…[ 10 ] Also, reports suggesting red eye as the first feature of COVID-19 may have provoked patients to seek ophthalmologists' advise. [ 11 12 ]…”

Section: Discussionmentioning

confidence: 99%

To evaluate the effect of COVID-19 pandemic and national lockdown on patient care at a tertiary-care ophthalmology institute

Babu

Kohli

Mishra

et al. 2020

Indian J Ophthalmol

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Purpose: To evaluate the effect of COVID-19 pandemic and national lockdown on patient care at a tertiary-care ophthalmology institute. Methods: Records of all the patients who presented from March 25 th to May 3 rd , 2020 were scanned to evaluate the details regarding the presenting complaints, diagnosis, advised treatment and surgical interventions. Results: The number of outpatient department visits, retinal laser procedures, intravitreal injections and cataract surgeries during this lockdown decreased by 96.5%, 96.5%, 98.7% and 99.7% respectively compared from the corresponding time last year. Around 38.8% patients could be triaged as non-emergency cases based on history alone while 59.5% patients could be triaged as non-emergency cases after examination. Only eighty-four patients opted for video-consultation from April 15 th to May 3 rd , 2020. Nine patients presented with perforated corneal ulcer, but could not undergo penetrating keratoplasty due to the lack to available donor corneal tissue. One of these patients had to undergo evisceration due to disease progression. Two patients with open globe injury presented late after trauma and had to undergo enucleation. Around 9% patients could not undergo the advised urgent procedure due to logistical issues related to the lockdown. Conclusion: A significant number of patients could not get adequate treatment during the lockdown period. Hospitals need to build capacity to cater to the expected patient surge post-COVID-19-era, especially those requiring immediate in-person attention. A large number of patients can be classified as non-emergency cases. These patients need to be encouraged to follow-up via video-consultation to carve adequate in-person time for the high-risk patients.

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“…SARS-CoV-2 has been detected in different bodily fluids, including respiratory secretions, blood, and feces [8,9]. SARS-CoV-2 RNA has been detected by reverse transcription-polymerase chain reaction (RT-PCR) in the conjunctival secretions in a number of patients, and by viral culture in one patient in Rome [10][11][12][13][14][15][16][17][18][19][20][21]. Conjunctival secretions may, therefore, be a potential source of transmission of SARS-CoV-2.…”

Section: Introductionmentioning

confidence: 99%

Detection of SARS-CoV-2 in conjunctival secretions from patients without ocular symptoms

Chan

et al. 2020

Infection

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Purpose To evaluate the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in conjunctival secretions from patients without ocular symptoms. Methods Conjunctival swabs were prospectively collected from laboratory-confirmed Coronavirus disease 2019 (COVID-19) patients without ocular symptoms for reverse transcription-polymerase chain reaction (RT-PCR) and viral culture. Results A total of 158 conjunctival swabs were obtained from 49 laboratory-confirmed COVID-19 patients. The median duration of illness when the first conjunctival swab was obtained was 10 days (range 2-27 days). Four conjunctival swabs from four different patients (4/49, 8.2%) were positive for SARS-CoV-2 RNA by RT-PCR. The Ct values ranged from 32.7 to 37.7 (mean 35.4). Viral cultures were negative for all four RT-PCR-positive conjunctival swabs. Conclusion Conjunctival secretions of a minority of COVID-19 patients without ocular symptoms may contain relatively low levels of SARS-CoV-2 RNA, but their infectiousness remains undetermined. Appropriate infection control measures should be implemented during ophthalmological assessment of COVID-19 patients to prevent potential nosocomial transmission of SARS-CoV-2.

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Presence of viral RNA of SARS-CoV-2 in conjunctival swab specimens of COVID-19 patients

Cited by 73 publications

References 12 publications

Systematic Review of Ocular Involvement of SARS-CoV-2 in Coronavirus Disease 2019

Systematic Review of Ocular Involvement of SARS-CoV-2 in Coronavirus Disease 2019

To evaluate the effect of COVID-19 pandemic and national lockdown on patient care at a tertiary-care ophthalmology institute

Detection of SARS-CoV-2 in conjunctival secretions from patients without ocular symptoms

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