Instituto Nacional de Ciência e Tecnologia em Biologia Estrutural e Bioimagens-INBEB, Rio de Janeiro, Brazil.
Laboratório de Ultraestrutura Celular Hertha Meyer, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
JAMA Ophthalmol. 2021 Sep 1;139(9):1015-1021. doi: 10.1001/jamaophthalmol.2021.2795.
The presence of the SARS-CoV-2 virus in the retina of deceased patients with COVID-19 has been suggested through real-time reverse polymerase chain reaction and immunological methods to detect its main proteins. The eye has shown abnormalities associated with COVID-19 infection, and retinal changes were presumed to be associated with secondary microvascular and immunological changes.
To demonstrate the presence of presumed SARS-CoV-2 viral particles and its relevant proteins in the eyes of patients with COVID-19.
DESIGN, SETTING, AND PARTICIPANTS: The retina from enucleated eyes of patients with confirmed COVID-19 infection were submitted to immunofluorescence and transmission electron microscopy processing at a hospital in São Paulo, Brazil, from June 23 to July 2, 2020. After obtaining written consent from the patients' families, enucleation was performed in patients deceased with confirmed SARS-CoV-2 infection. All patients were in the intensive care unit, received mechanical ventilation, and had severe pulmonary involvement by COVID-19.
Presence of presumed SARS-CoV-2 viral particles by immunofluorescence and transmission electron microscopy processing.
Three patients who died of COVID-19 were analyzed. Two patients were men, and 1 was a woman. The age at death ranged from 69 to 78 years. Presumed S and N COVID-19 proteins were seen by immunofluorescence microscopy within endothelial cells close to the capillary flame and cells of the inner and the outer nuclear layers. At the perinuclear region of these cells, it was possible to observe by transmission electron microscopy double-membrane vacuoles that are consistent with the virus, presumably containing COVID-19 viral particles.
The present observations show presumed SARS-CoV-2 viral particles in various layers of the human retina, suggesting that they may be involved in some of the infection's ocular clinical manifestations.
通过实时逆转录聚合酶链反应和免疫方法检测其主要蛋白，已经有研究表明，SARS-CoV-2 病毒存在于 COVID-19 已故患者的视网膜中。眼睛已经显示出与 COVID-19 感染相关的异常，并且推测视网膜变化与继发性微血管和免疫变化有关。
证明 COVID-19 患者眼中存在假定的 SARS-CoV-2 病毒颗粒及其相关蛋白。
设计、地点和参与者：2020 年 6 月 23 日至 7 月 2 日，巴西圣保罗的一家医院对确诊 COVID-19 感染的眼球进行了免疫荧光和透射电子显微镜处理，从眼球中取出的视网膜来自于已去世并确诊 SARS-CoV-2 感染的患者。在获得患者家属的书面同意后，对这些患者进行眼球摘除。所有患者均在重症监护病房，接受机械通气，并患有严重的 COVID-19 肺部受累。
通过免疫荧光和透射电子显微镜处理检测假定的 SARS-CoV-2 病毒颗粒的存在。
分析了 3 名死于 COVID-19 的患者。2 名患者为男性，1 名患者为女性。死亡时的年龄在 69 至 78 岁之间。免疫荧光显微镜观察到假定的 S 和 N COVID-19 蛋白存在于靠近毛细血管火焰的内皮细胞内，以及内、外核层的细胞内。在这些细胞的核周区，可以通过透射电子显微镜观察到双层膜空泡，这与病毒一致，推测其中含有 COVID-19 病毒颗粒。
目前的观察结果表明，假定的 SARS-CoV-2 病毒颗粒存在于人视网膜的各个层中，这表明它们可能与某些眼部感染的临床表现有关。
