Department of Ophthalmology, İzmir Tepecik Training and Research Hospital, İzmir, Turkey.
Department of Ophthalmology, Turkish Republic Health Sciences University, Tepecik Training and Research Hospital, İzmir, Turkey.
JAMA Ophthalmol. 2020 Sep 1;138(9):990-993. doi: 10.1001/jamaophthalmol.2020.3154.
The new coronavirus disease 2019 (COVID-19) pandemic poses a particular threat to health care professionals; however, there appear to be no objective data that demonstrate the risks of encountering individuals carrying the virus asymptomatically in the case of maintained elective examinations.
To investigate the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on the environmental surfaces of an ophthalmology examination room after visits by patients who were asymptomatic and had passed COVID-19 triage.
DESIGN, SETTING, AND PARTICIPANTS: This is a quality improvement study conducted 1 week after the first officially confirmed COVID-19 case in İzmir Tepecik Training and Research Hospital, İzmir, Turkey, on March 20, 2020. A triage system was used to determine the risk of COVID-19 from patients who were asymptomatic and presented for examination in an ophthalmology clinic. Real-time polymerase chain reaction testing was used to detect the presence of viral RNA material in samples from the biomicroscope stage, slitlamp breath shield, phoropter, tonometer, and door handles. The first group of samples was taken before the beginning of the examinations, and the second group of the samples was taken after the last patient had left the room.
The main outcome was the presence of viral material on surfaces in 5 circular zones with a diameter of 1 m each around where the patients sat.
Thirty-one persons visited the room, of whom 22 underwent ophthalmic examination and 9 were companions. The mean (SD) examination time was 9 (4) minutes (range, 5-13 minutes). Seven samples were taken before examinations and 7 after examinations. Two samples that were taken after examinations were found to be positive for COVID-19, 1 from the slitlamp breath shield and 1 from the phoropter.
This study showed the presence of COVID-19 viral material in a circle 1 m in diameter around where the patients sat. However, real-time polymerase chain reaction could only detect viral material, not the infectivity of these virus samples.
新出现的 2019 年冠状病毒病（COVID-19）大流行对医疗保健专业人员构成了特别威胁；然而，似乎没有客观数据表明，在维持选择性检查的情况下，遇到无症状携带病毒的个体的风险。
调查在伊兹密尔 Tepecik 培训和研究医院，伊兹密尔，土耳其，2020 年 3 月 20 日确诊首例 COVID-19 病例后，对接受无症状且已通过 COVID-19 分诊的患者进行眼科检查后，环境表面上是否存在严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）。
设计、设置和参与者：这是一项质量改进研究，于 2020 年 3 月 20 日在土耳其伊兹密尔 Tepecik 培训和研究医院确诊首例 COVID-19 病例后一周进行。使用分诊系统来确定无症状并在眼科诊所就诊的患者的 COVID-19 风险。使用实时聚合酶链反应测试从生物显微镜检查台、裂隙灯呼吸罩、检眼镜、眼压计和门把手的样本中检测病毒 RNA 物质的存在。第一组样本在检查开始前采集，第二组样本在最后一位患者离开房间后采集。
主要结果是在每个直径为 1 米的 5 个圆形区域中，患者所坐位置周围的表面上存在病毒物质。
共有 31 人访问了该房间，其中 22 人接受了眼科检查，9 人是陪同人员。平均（SD）检查时间为 9（4）分钟（范围，5-13 分钟）。检查前采集了 7 份样本，检查后采集了 7 份样本。检查后采集的 2 份样本对 COVID-19 呈阳性，1 份来自裂隙灯呼吸罩，1 份来自检眼镜。
本研究表明，在患者所坐位置周围 1 米的圆形区域内存在 COVID-19 病毒物质。然而，实时聚合酶链反应只能检测到病毒物质，而不能检测到这些病毒样本的传染性。
