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

Infection. 2021 Apr;49(2):257-265. doi: 10.1007/s15010-020-01524-2. Epub 2020 Sep 17.

Abstract

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.

Keywords: Asymptomatic; Conjunctiva; RT-PCR; SARS-CoV-2; Shedding.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Animals
  • COVID-19 / diagnosis
  • COVID-19 / virology*
  • COVID-19 Nucleic Acid Testing
  • Chlorocebus aethiops
  • Conjunctiva / virology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • RNA, Viral / genetics
  • RNA, Viral / isolation & purification
  • SARS-CoV-2 / genetics
  • SARS-CoV-2 / growth & development
  • SARS-CoV-2 / isolation & purification*
  • Vero Cells
  • Virus Shedding
  • Young Adult

Substances

  • RNA, Viral