Ophthalmic Research Centre, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Ophthalmology, Torfeh Medical Centre, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Eye (Lond). 2020 Jul;34(7):1220-1223. doi: 10.1038/s41433-020-0965-2. Epub 2020 May 18.
Since there are few reports on the ocular involvement of coronavirus disease 2019 (COVID-19) patients, this study aimed to assess the presence of severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) in the tears of patients with COVID-19.
In this prospective case series, nasopharyngeal and tear sampling of 43 patients with severe COVID-19 were performed. The quantitative reverse transcription polymerase chain reaction (RT-PCR) was conducted to detect SARS-CoV-2. Ocular and systemic signs and symptoms were recorded from their medical history.
The mean age of patients was 56 ± 13 years. The average disease time from initiation of symptoms was 3.27 days, range: 1-7 days. Forty-one patients (95.3%) had fever at the time of sampling. Only one patient had conjunctivitis. Thirty (69.8%) nasopharyngeal and three (7%) tear samples were positive for SARS-CoV-2. The result of tear sample was positive in the patient with conjunctivitis. All patients with positive tear RT-PCR results had positive nasopharyngeal RT-PCR results.
Ocular manifestation was rare in this series of severe COVID-19 patients, however, 7% of the patients had viral RNA in their conjunctival secretions. Therefore, possibility of ocular transmission should be considered even in the absence of ocular manifestations.
由于关于 2019 年冠状病毒病（COVID-19）患者眼部受累的报道较少，本研究旨在评估 COVID-19 患者的泪液中是否存在严重急性呼吸综合征冠状病毒-2（SARS-CoV-2）。
在这项前瞻性病例系列研究中，对 43 例重症 COVID-19 患者进行了鼻咽和泪液采样。采用实时逆转录聚合酶链反应（RT-PCR）检测 SARS-CoV-2。从他们的病史中记录眼部和全身症状和体征。
患者的平均年龄为 56±13 岁。症状开始后的平均发病时间为 3.27 天，范围为 1-7 天。41 名患者（95.3%）在采样时发热。仅有 1 名患者患有结膜炎。30 名（69.8%）鼻咽和 3 名（7%）泪液样本 SARS-CoV-2 阳性。结膜炎患者的泪液样本结果为阳性。所有 SARS-CoV-2 阳性的患者的鼻咽 RT-PCR 结果均为阳性。
在这一系列重症 COVID-19 患者中，眼部表现罕见，但 7%的患者眼部分泌物中存在病毒 RNA。因此，即使没有眼部表现，也应考虑可能存在眼部传播。
