COVID-19 sufferers’ eyes and tears may be contaminated with SARS-CoV-2

The extreme acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is current in respiratory droplets. Transmission of SARS-CoV-2 by way of droplets can infect folks, thus inflicting coronavirus illness 2019 (COVID-19). A brand new examine revealed within the journal Imaginative and prescient investigates the presence of SARS-CoV-2 in tears and eye secretions and describes the ocular signs in sufferers with COVID-19.

Research: SARS-CoV-2 in Conjunctiva and Tears and Ocular Signs of Sufferers with COVID-19. Picture Credit score: goffkein.professional /

COVID-19 signs

Sufferers with COVID-19 typically current with fever, cough, shortness of breath, muscle weak point and ache, in addition to numerous gastrointestinal signs. Sufferers with extreme COVID-19 can also develop bilateral pneumonia and hypoxemia. When extreme COVID-19 results in cytokine storms, a number of organs can get affected.

SARS-CoV-2 has been detected in tears and conjunctival secretions, principally in sufferers with extreme COVID-19. These sufferers additionally reveal ocular manifestations of the illness.

A cross-sectional examine

Within the present cross-sectional cohort examine, scientists enrolled 56 hospitalized sufferers. This was a single-site examine carried out on the College Hospital of Santiago de Compostela in Spain.

Sufferers have been eligible to take part within the present examine if they’d reverse-transcriptase polymerase chain response (RT-PCR)-confirmed SARS-CoV-2 an infection from a nasopharyngeal swab and have been inside the first 20 days from the onset of signs. Sufferers from the intensive care unit or with a poor common situation have been excluded from this examine.

Conjunctival secretions and tears have been collected utilizing flocked swabs and Schirmer strips for performing RT-PCR. The scientists assessed the ocular floor manifestations by way of an Ocular Floor Illness Index (OSDI) questionnaire.

Prevalence of SARS-CoV-2 in conjunctival samples

Of the 56 sufferers enrolled on this examine, 32 have been male and 24 have been feminine. The imply age of the sufferers was 69 years, starting from 27 to 89 years. The illness severity was delicate in 5 sufferers, reasonable in 30 sufferers, and extreme in 21 sufferers.

Sufferers had been admitted to the hospital for a mean of two.4 days earlier than ocular testing. The imply time from the onset of common signs till the gathering of ocular samples was 7.1 days.

The next proportion of sufferers had systemic comorbidity: hypertension, 48.2%; diabetes, 28.6%; most cancers, 23.2%; coronary heart illness, 21.4%; weight problems, 17.9%; and power lung illness, 16%. Nineteen sufferers (33.9%) had reported earlier ocular circumstances, together with cataract surgical procedure (16.1%), glaucoma (5.4%), retinal vein occlusion (3.6%), strabismus (3.6%), uveitis (1.8%), refractive surgical procedure (1.8%), and diabetic retinopathy (1.8%).

4 (7.1%) of the 56 conjunctival swabs samples and 4 (3.6%) of 112 Schirmer strips examined constructive for SARS-CoV-2. Within the 4 sufferers with constructive conjunctival swab samples, Schirmer strip samples have been adverse in each eyes in a single affected person, constructive solely within the left eye in two sufferers, and constructive in each eyes in a single affected person. Not one of the sufferers had each a adverse conjunctival swab and a constructive Schirmer strip pattern.

There was no affiliation noticed between the RT-PCR check from ocular samples and ocular signs. Twenty-nine % of sufferers with a adverse RT-PCR and 25% of sufferers with constructive ocular RT-PCR had ocular signs. Three of the sufferers had a reasonable sickness and one introduced a extreme course of the illness. General, 17 (30%) sufferers introduced ocular signs.

The scientists concluded that the viral load was low on the ocular floor as a result of the cycle threshold (Ct) values have been excessive in ocular samples. The affected person with constructive conjunctival and tear samples in each eyes had a better viral load within the eyes when in comparison with the opposite sufferers. Just one affected person had a excessive viral load within the eyes than within the nasopharynx. Curiously, this affected person demonstrated extra extreme systemic illness.

Limitations of the examine

A few of the limitations of the present examine embrace a small pattern measurement, in addition to the truth that the nasopharyngeal and ocular samples have been taken throughout completely different levels of the illness. This will have an effect on the homogeneity of the outcomes.

Moreover, the scientists couldn’t carry out slit lamp examinations or biomicroscopy to look at the eyes of the sufferers for any abnormalities or issues.


The present examine reveals that SARS-CoV-2 may be detected within the conjunctiva and tears of sufferers with COVID-19. The 7.1% prevalence of SARS-CoV-2 in conjunctival samples discovered on this examine is akin to beforehand reported charges.

The outcomes from this examine and former research point out that the ocular floor can act as an entry level and reservoir for the transmission of SAR-CoV-2. Contact with the ocular floor might transmit the virus; subsequently, business ocular antiseptics might assist with avoiding transmission and stopping ocular signs throughout COVID-19 an infection.

Well being care professionals, significantly eye care suppliers, ought to pay attention to ocular transmission and comply with strict disinfection protocols.

Journal reference:

  • Rodríguez-Ares, T., Lamas-Francis, D., Treviño, M., et al. (2021) SARS-CoV-2 in Conjunctiva and Tears and Ocular Signs of Sufferers with COVID-19. Imaginative and prescient 5(4):51. doi:10.3390/vision5040051

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