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In-Depth Investigation of Conjunctival Swabs and Tear Fluid of Symptomatic COVID-19 Patients, an Observational Cohort Study.
Gijs, Marlies; Veugen, Judith M J; Wolffs, Petra F G; Savelkoul, Paul H M; Tas, Jeanette; van Bussel, Bas C T; de Kruif, Martijn D; Henry, Ronald M A; Webers, Carroll A B; Dickman, Mor M; Nuijts, Rudy M M A.
  • Gijs M; University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands.
  • Veugen JMJ; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands.
  • Wolffs PFG; University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands.
  • Savelkoul PHM; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands.
  • Tas J; Department of Medical Microbiology, Maastricht University Medical Center, Maastricht, the Netherlands.
  • van Bussel BCT; Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.
  • de Kruif MD; Department of Medical Microbiology, Maastricht University Medical Center, Maastricht, the Netherlands.
  • Henry RMA; Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.
  • Webers CAB; Department of Medical Microbiology, Maastricht University Medical Center, Maastricht, the Netherlands.
  • Dickman MM; Department of Medical Microbiology and Infection Control, Amsterdam Infection and Immunity Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
  • Nuijts RMMA; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands.
Transl Vis Sci Technol ; 10(12): 32, 2021 10 04.
Article in English | MEDLINE | ID: covidwho-1484163
ABSTRACT

Purpose:

The putative presence of SARS-CoV-2 in ocular specimen puts healthcare workers at risk. We thoroughly examined conjunctival swabs and tear fluid in a large cohort of COVID-19 patients.

Methods:

A total of 243 symptomatic laboratory-confirmed COVID-19 patients were included in this observational multicenter study. Conjunctival swabs were analyzed by reverse transcription polymerase chain reaction for detection of SARS-CoV-2 RNA. Next-generation sequencing and phylogenetic analysis were performed to identify viral strains and to determine tissue tropism. Schirmer tear samples from 43 hospitalized COVID-19 patients and 25 healthy controls were analyzed by multiplex cytokine immunoassays.

Results:

Viral SARS-CoV-2 RNA was detected in conjunctival swabs from 17 (7.0%) of 243 COVID-19 patients. Conjunctival samples were positive for viral SARS-CoV-2 RNA as long as 12 days after disease onset. Cycle threshold (Ct) values for conjunctival swabs (mean 34.5 ± 5.1) were significantly higher than nasopharyngeal swabs (mean 16.7 ± 3.6). No correlation between Ct values of conjunctival and nasopharyngeal swabs was observed. The majority of positive conjunctival samples were detected only once and primarily during the first visit. Next-generation sequencing analysis revealed that the virus strain found in the conjunctiva was most often identical to the one found in the nasopharynx. Tear cytokine levels IL-1ß and IL-6 were elevated in COVID-19 patients compared to healthy controls.

Conclusions:

Conjunctival samples that were positive for SARS-CoV-2 RNA contained the same viral strain as the nasopharynx. Translational Relevance The presence of SARS-CoV-2 viral RNA and elevated cytokines in tear fluid confirm the involvement of the ocular surface in COVID-19 disease.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: RNA, Viral / COVID-19 Type of study: Controlled clinical trial / Diagnostic study / Etiology study / Incidence study / Observational study / Prognostic study / Risk factors Topics: Long Covid Limits: Humans Language: English Journal: Transl Vis Sci Technol Year: 2021 Document Type: Article Affiliation country: Tvst.10.12.32

Full text: Available Collection: International databases Database: MEDLINE Main subject: RNA, Viral / COVID-19 Type of study: Controlled clinical trial / Diagnostic study / Etiology study / Incidence study / Observational study / Prognostic study / Risk factors Topics: Long Covid Limits: Humans Language: English Journal: Transl Vis Sci Technol Year: 2021 Document Type: Article Affiliation country: Tvst.10.12.32