Department of Ophthalmology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany.
Laboratory of Experimental Immunology, Institute of Virology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Graefes Arch Clin Exp Ophthalmol. 2021 Jun;259(6):1605-1608. doi: 10.1007/s00417-021-05086-3. Epub 2021 Jan 29.
The aims of this study were to evaluate the isolated prevalence of real-time reverse transcriptase-polymerase chain reaction (RT-PCR)-confirmed SARS-CoV-2 on the ocular surface without systemic infection in hospitalized asymptomatic patients and to determine the risk for ophthalmologists and medical staff to be infected by prescreened asymptomatic patients in a tertiary eye care center.
In this prospective, observational study, bilateral swaps of the conjunctiva in the lower fornices as well as nasopharyngeal swaps were collected in 1145 hospitalized asymptomatic patients of a tertiary eye care center. Real-time reverse transcriptase-polymerase chain reaction (RT-PCR) analysis was performed for each swap to evaluate the prevalence of SARS-CoV-2. Demographic data and potential risk factors for an isolated infection of the ocular surface were noted.
Two thousand two hundred eighty-eight (99.9%) of all 2290 tested eyes had negative results in the RT-PCR analysis of the conjunctival swabs. One patient had bilateral false-positive results in the conjunctival swabs. None of the 1145 patients had any positive RT-PCR-confirmed result in the nasopharyngeal swabs.
The risk for an isolated conjunctival viral activity in patients with a negative nasopharyngeal swab-based RT-PCR seems to be absent or extremely low, suggesting no need to perform additional conjunctival swabs in patients with negative nasopharyngeal swabs. Furthermore, the risk of a work-related SARS-CoV-2 infection due to direct contact with preselected asymptomatic patients in an eye care center is very low, especially when additional hygiene standards and safe distances are respected carefully. This might reassure medical staff and reduce the fear of SARS-CoV-2 infection.
本研究旨在评估住院无症状患者中无全身感染的实时逆转录聚合酶链反应（RT-PCR）确认的 SARS-CoV-2 对眼表的单独流行情况，并确定眼科医生和医务人员在三级眼科护理中心对预先筛选的无症状患者感染的风险。
在这项前瞻性观察研究中，对 1145 名三级眼科护理中心的住院无症状患者的下穹窿双侧结膜以及鼻咽拭子进行了双侧交换。对每个交换物进行实时逆转录聚合酶链反应（RT-PCR）分析，以评估 SARS-CoV-2 的流行情况。记录了人口统计学数据和眼表孤立感染的潜在危险因素。
2290 份检测眼的 2288 份（99.9%）结膜拭子 RT-PCR 分析结果均为阴性。一名患者的结膜拭子出现双侧假阳性结果。1145 名患者的鼻咽拭子均无 RT-PCR 确认的阳性结果。
对于鼻咽拭子 RT-PCR 阴性的患者，眼表发生孤立性病毒活动的风险似乎不存在或极低，这表明对于鼻咽拭子阴性的患者无需进行额外的结膜拭子检测。此外，在眼科中心与预先筛选的无症状患者直接接触而导致 SARS-CoV-2 工作相关感染的风险非常低，特别是当遵守额外的卫生标准和安全距离时。这可能会使医务人员放心，并减少对 SARS-CoV-2 感染的恐惧。
