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In-Depth Investigation of Conjunctival Swabs and Tear Fluid of Symptomatic COVID-19 Patients, an Observational Cohort Study
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 observati...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Association for Research in Vision and Ophthalmology
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8543390/ https://www.ncbi.nlm.nih.gov/pubmed/34673905 http://dx.doi.org/10.1167/tvst.10.12.32 |
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author | 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. |
author_facet | 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. |
author_sort | Gijs, Marlies |
collection | PubMed |
description | 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-1β 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. |
format | Online Article Text |
id | pubmed-8543390 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | The Association for Research in Vision and Ophthalmology |
record_format | MEDLINE/PubMed |
spelling | pubmed-85433902021-10-29 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. Transl Vis Sci Technol Article 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-1β 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. The Association for Research in Vision and Ophthalmology 2021-10-21 /pmc/articles/PMC8543390/ /pubmed/34673905 http://dx.doi.org/10.1167/tvst.10.12.32 Text en Copyright 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. |
spellingShingle | Article 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. In-Depth Investigation of Conjunctival Swabs and Tear Fluid of Symptomatic COVID-19 Patients, an Observational Cohort Study |
title | In-Depth Investigation of Conjunctival Swabs and Tear Fluid of Symptomatic COVID-19 Patients, an Observational Cohort Study |
title_full | In-Depth Investigation of Conjunctival Swabs and Tear Fluid of Symptomatic COVID-19 Patients, an Observational Cohort Study |
title_fullStr | In-Depth Investigation of Conjunctival Swabs and Tear Fluid of Symptomatic COVID-19 Patients, an Observational Cohort Study |
title_full_unstemmed | In-Depth Investigation of Conjunctival Swabs and Tear Fluid of Symptomatic COVID-19 Patients, an Observational Cohort Study |
title_short | In-Depth Investigation of Conjunctival Swabs and Tear Fluid of Symptomatic COVID-19 Patients, an Observational Cohort Study |
title_sort | in-depth investigation of conjunctival swabs and tear fluid of symptomatic covid-19 patients, an observational cohort study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8543390/ https://www.ncbi.nlm.nih.gov/pubmed/34673905 http://dx.doi.org/10.1167/tvst.10.12.32 |
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