Maria Cristina Savastano1,2, Gloria Gambini1,2, Alfonso Savastano1,2, Benedetto Falsini1,2, Umberto De Vico1,2, Maurizio Sanguinetti3,4, Paola Cattani2,5, Simona Marchetti2,5, Anna Rita Larici2,6, Francesco Franceschi2,7, Angelo Santoliquido2,7, Rossana Moroni8, Andrea Cambieri9, Rocco Bellantone2,10, Francesco Landi2,11, Giovanni Scambia2,12, Stanislao Rizzo1,2,13. 1. Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli IRCCS", Rome, Italy. 2. Catholic University "Sacro Cuore", Rome, Italy. 3. Institute of Microbiology, Catholic University of "Sacro Cuore", Rome, Italy. 4. Department of Laboratory and Infectious Science, "FondazionePoliclinico Universitario A. Gemelli IRCCS", Rome, Lazio, Italy. 5. Department of Diagnostic and Laboratory Medicine, Institute of Microbiology, Catholic University of "Sacro Cuore", Rome, Lazio, Italy. 6. Department of Radiology, "Fondazione Policlinico Universitario A. Gemelli IRCCS", Rome, Lazio, Italy. 7. Emergency Medicine, "Fondazione Policlinico Universitario A. Gemelli IRCCS", Rome, Lazio, Italy. 8. Scientific Direction, "Fondazione Policlinico Universitario A. Gemelli IRCCS", Rome, Lazio, Italy. 9. Hospital Health Management, "Fondazione Policlinico Universitario A. Gemelli IRCCS", Rome, Italy. 10. Division of Endocrine and Metabolic Surgery, "Fondazione Policlinico Universitario A. Gemelli IRCCS", Rome, Lazio, Italy. 11. Department of Geriatrics, "Fondazione Policlinico Universitario A. Gemelli IRCCS", Rome, Lazio, Italy. 12. "Dipartimento scienze della salute della donna e del bambino e di sanità pubblica", "Fondazione Policlinico Universitario A. Gemelli IRCCS", Rome, Lazio, Italy. 13. Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, Pisa, Italy.
Abstract
BACKGROUND: The possible transmission of severe acute respiratory coronavirus 2 (SARS-CoV-2) by tears and conjunctiva is still debated. METHODS: Main outcome was to investigate the agreement between nasopharyngeal swab (NPs) and conjunctival swabs (Cs) in patients with SARS-CoV-2 infection. We divided patients into four groups: (1) NPs and Cs both negative (C-NF-), (2) NPs positive and Cs negative (NFs+Cs-), (3) NPs negative and Cs positive (NFs-Cs+), and (4) NPs and Cs both positive (NFs-Cs+). The secondary outcomes were to correlate Cs results with systemic clinical parameters such as: oxygen saturation (SpO2), dyspnea degree (DP), radiologic pulmonary impairment based on chest radiography (XR) or computed tomography (CT), blood chemistry as D-Dimer (D-Dimer), fibrinogen, ferritin, lactate dehydrogenase (LDH), and C-reactive protein (C-RP). RESULTS: A total of 100 conjunctival swabs in 50 patients with SARS-CoV-2 have been enrolled in this interventional clinical trials. Ocular signs (conjunctivitis) were present in five patients (10%). NPs and Cs highlighted a poor level of agreement (0.025; p = 0.404). Median SpO2 levels are the highest in the NF-C- group (98%) and the lowest (90%) in the group NF+C+ (p = 0.001). Pulmonary impairment was statistically significantly different between NFs and Cs groups (p = 0.019). Pulmonary impairment score increased from NFs-Cs- group (3.8 ± 3.9), to NFs+Cs+ group (6.7 ± 4.1). Intensive care unit patients showed higher COVID-19 Cs positivity in conjunctiva (12.5%) against hospitalized ones (5.8%). CONCLUSIONS: In patients hospitalized for SARS-CoV-2 the virus can be detected in conjunctival swab. Intensive care unit patients may reveal a higher COVID-19 presence in the conjunctiva. The most severe pulmonary impairment can be observed in NFs and Cs positivity. TRIAL REGISTRATION: Clinicaltrials.gov registration. ETHICAL COMMITTEE AUTHORIZATION: ID number: 0013008/20.
BACKGROUND: The possible transmission of severe acute respiratory coronavirus 2 (SARS-CoV-2) by tears and conjunctiva is still debated. METHODS: Main outcome was to investigate the agreement between nasopharyngeal swab (NPs) and conjunctival swabs (Cs) in patients with SARS-CoV-2 infection. We divided patients into four groups: (1) NPs and Cs both negative (C-NF-), (2) NPs positive and Cs negative (NFs+Cs-), (3) NPs negative and Cs positive (NFs-Cs+), and (4) NPs and Cs both positive (NFs-Cs+). The secondary outcomes were to correlate Cs results with systemic clinical parameters such as: oxygen saturation (SpO2), dyspnea degree (DP), radiologic pulmonary impairment based on chest radiography (XR) or computed tomography (CT), blood chemistry as D-Dimer (D-Dimer), fibrinogen, ferritin, lactate dehydrogenase (LDH), and C-reactive protein (C-RP). RESULTS: A total of 100 conjunctival swabs in 50 patients with SARS-CoV-2 have been enrolled in this interventional clinical trials. Ocular signs (conjunctivitis) were present in five patients (10%). NPs and Cs highlighted a poor level of agreement (0.025; p = 0.404). Median SpO2 levels are the highest in the NF-C- group (98%) and the lowest (90%) in the group NF+C+ (p = 0.001). Pulmonary impairment was statistically significantly different between NFs and Cs groups (p = 0.019). Pulmonary impairment score increased from NFs-Cs- group (3.8 ± 3.9), to NFs+Cs+ group (6.7 ± 4.1). Intensive care unit patients showed higher COVID-19 Cs positivity in conjunctiva (12.5%) against hospitalized ones (5.8%). CONCLUSIONS: In patients hospitalized for SARS-CoV-2 the virus can be detected in conjunctival swab. Intensive care unit patients may reveal a higher COVID-19 presence in the conjunctiva. The most severe pulmonary impairment can be observed in NFs and Cs positivity. TRIAL REGISTRATION: Clinicaltrials.gov registration. ETHICAL COMMITTEE AUTHORIZATION: ID number: 0013008/20.
Authors: W-M Chan; D T L Liu; P K S Chan; K K L Chong; K S C Yuen; T Y H Chiu; B S M Tam; J S K Ng; D S C Lam Journal: Eye (Lond) Date: 2006-03 Impact factor: 3.775
Authors: Ivan Yu Jun Seah; Danielle E Anderson; Adrian Eng Zheng Kang; Linfa Wang; Pooja Rao; Barnaby Edward Young; David Chien Lye; Rupesh Agrawal Journal: Ophthalmology Date: 2020-03-24 Impact factor: 12.079