SARS-CoV-2 on Ocular Surfaces in a Cohort of Patients With COVID-19 From the Lombardy Region, Italy

Azzolini, Claudio; Donati, Simone; Premi, Elias; Baj, Andreina; Siracusa, Claudia; Genoni, Angelo; Grossi, Paolo; Azzi, Lorenzo; Sessa, Fausto; Dentali, Francesco; Severgnini, Paolo; Minoja, Giulio; Cabrini, Luca; Chiaravalli, Maurizio; Veronesi, Giovanni; Carcano, Giulio; Maffioli, Lorenzo; Tagliabue, Angelo

doi:10.1001/jamaophthalmol.2020.5464

Cited by 59 publications

(55 citation statements)

References 66 publications

(115 reference statements)

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“…SARS-CoV-2 was found on the ocular surface in 52 of 91 patients with COVID-19 (57.1%; 95%CI: 46.3-67.5%) hospitalized in ICU. 18 In the present study, the higher serum levels of neutrophils, C-reactive protein, and D-dimer, laboratorial markers of systemic inflammation, in patients with SARS-CoV-2 detected in tears might suggest higher severity to be associated with a higher percentage of conjunctival positivity. In addition, there was a greater need for mechanical ventilation among these patients.…”

Section: Discussionmentioning

confidence: 44%

Identification of SARS-CoV-2 on the ocular surface in a cohort of COVID-19 patients from Brazil

Gasparini

Santos

Hamade

et al. 2021

Exp Biol Med (Maywood)

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In this cross-sectional study, we investigate the presence of Severe Acute Respiratory Syndrome Coronavirus 2 Ribonucleic Acid (SARS-CoV-2 RNA) in the tears of hospitalized COVID-19 patients. After laboratory confirmation of SARS-CoV-2 infection by reverse transcription polymerase chain reaction (RT-PCR) analysis, tear samples from both eyes of each patient were collected using conjunctival swab for RT-PCR. Detailed demographic profile, systemic and ocular symptoms, comorbidities, clinical, ancillary, and ocular manifestations were evaluated. Of the 83 patients enrolled in the study, 7 (8.43%) had SARS-CoV-2 RNA detected in the tear samples. Neutrophils’ count, C-reactive protein, and D-dimer were higher in patients with SARS-CoV-2 detected in tears than in patients without virus in ocular surface samples. One patient with SARS-CoV-2 in tears showed mild ocular eyelid edema, hyperemia, and chemosis. No relevant ocular manifestations were detected in the other patients. Although the levels of viral RNA on ocular surface samples were low for most patients (5/7), with positivity only for gene N and CT higher than 30, two patients were positive for all viral targets tested ( N, E, and RpRd), with viral load near 1 × 105 ePFU/mL, indicating that the ocular transmission of SARS-CoV-2 is a possibility that needs to be considered, especially in the hospital environment. Further studies need to be conducted to demonstrate whether infective viral particles could be isolated from tears.

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Section: Discussionmentioning

confidence: 44%

Identification of SARS-CoV-2 on the ocular surface in a cohort of COVID-19 patients from Brazil

Gasparini

Santos

Hamade

et al. 2021

Exp Biol Med (Maywood)

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“…showed that the human cornea does not support SARS-CoV-2 infection despite the expression of ACE2 in the human corneal epithelium 45 . However, studies in COVID-19 patients found an increase of the virus in dry eye disease, suggesting a possible consequence of infection 46 , and in a cohort of patients with COVID-19, 63% had a positive viral test in the conjunctiva, but the origin of the infection was undetermined 47 . Nevertheless, the role of lipid mediators in managing the ACE2 upregulation as well as hyper-inflammation, increase in cytokine expression, and senescence programming after tissue damage uncovers mechanistic insights that are also applicable to other tissues.…”

Section: Discussionmentioning

confidence: 95%

ELV-N32 and RvD6 isomer decrease pro-inflammatory cytokines, senescence programming, ACE2 and SARS-CoV-2-spike protein RBD binding in injured cornea

Pham

Kakazu

et al. 2021

Sci Rep

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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection that causes coronavirus disease 2019 (COVID-19) has resulted in a pandemic affecting the most vulnerable in society, triggering a public health crisis and economic collapse around the world. Effective treatments to mitigate this viral infection are needed. Since the eye is a route of virus entrance, we use an in vivo rat model of corneal inflammation as well as human corneal epithelial cells (HCEC) in culture challenged with IFNγ as models of the eye surface to study this issue. We explore ways to block the receptor-binding domain (RBD) of SARS-CoV-2 Spike (S) protein to angiotensin-converting enzyme 2 (ACE2). We found that the lipid mediators, elovanoid (ELV)-N32 or Resolvin D6-isomer (RvD6i) decreased the expression of the ACE2 receptor, furin, and integrins in damaged corneas or IFNγ-stimulated HCEC. There was also a concomitant decrease in the binding of Spike RBD with the lipid treatments. Using RNA-seq analysis, we uncovered that the lipid mediators also attenuated the expression of pro-inflammatoy cytokines participating in hyper-inflammation and senescence programming. Thus, the bioactivity of these lipid mediators will contribute to open therapeutic avenues to counteract virus attachment and entrance to the body.

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“…The study conducted in Italy (Lombardia) SARS-CoV-2 was found in 57.1% of patients on the ocular surface with a variability of viral load from both eyes [22]. The infectivity of the material was not determined but the results suggested that the test can be positive in conjunctival swab and negative in nasopharingeal swab.…”

Section: Transmissionmentioning

confidence: 98%

COVID-19 Conjunctivitis

Konjevoda¹,

Čanović²,

Pavičić³

2021

Infectious Eye Diseases - Recent Advances in Diagnosis and Treatment

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The outbreak of new Cov-2 epidemic was detected in December 2019 in the city of Wuhan, China, caused by Severe Acute Respiratory Syndrome Coronavirus −2 and started its rapid spread througth the world. The World Health Organisation (WHO) declared a public health emergency of international concern (PHEIC) on the 30th of January 2020. -2 infection can present with spectrum of clinical manifestations, primary of upper respiratory tract and in some cases, especially in immunocompromised patients can cause changes in lower respiratory tract such as pneumonia and bronchitis. Conjunctivitis is not a common manifestation of SARS-Cov-2 infection. It should however be kept in mind that patients with ocular manifestations and symptoms can represent the COVID-19 cases. CoVs can produce several ocular manifestations from conjunctivitis, uveitis – anterior and posterior, retinitis and optic neuritis.

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SARS-CoV-2 on Ocular Surfaces in a Cohort of Patients With COVID-19 From the Lombardy Region, Italy

Cited by 59 publications

References 66 publications

Identification of SARS-CoV-2 on the ocular surface in a cohort of COVID-19 patients from Brazil

Identification of SARS-CoV-2 on the ocular surface in a cohort of COVID-19 patients from Brazil

ELV-N32 and RvD6 isomer decrease pro-inflammatory cytokines, senescence programming, ACE2 and SARS-CoV-2-spike protein RBD binding in injured cornea

COVID-19 Conjunctivitis

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