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. 2020 Sep 1;138(9):990-993.
doi: 10.1001/jamaophthalmol.2020.3154.

Detection of Coronavirus Disease 2019 Viral Material on Environmental Surfaces of an Ophthalmology Examination Room

Hasan Aytogan  1 , Emre Ayintap  2 , Nisel Özkalay Yilmaz  3
Affiliations

Detection of Coronavirus Disease 2019 Viral Material on Environmental Surfaces of an Ophthalmology Examination Room

Hasan Aytogan et al. JAMA Ophthalmol. .

Abstract

Importance: 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.

Objective: 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.

Main outcomes and measures: 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.

Results: 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.

Conclusions and relevance: 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.

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Conflict of interest statement

Conflict of Interest Disclosures: None reported.

Figures

Figure 1.
Figure 1.. Triage System
COVID-19 indicates coronavirus disease 2019.
Figure 2.
Figure 2.. The Examination Room Separated Into 5 Zones
Considering the patient in the center of the circles, each circle was determined to be 1 m distant from the previous circle. Zone 1 included a slitlamp shield, phoropter, and biomicroscope stage; zone 2, a tonometer; zones 3 and 4, a desk; and zone 5, the door handles.
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References

    1. Wu F, Zhao S, Yu B, et al. A new coronavirus associated with human respiratory disease in China. Nature. 2020;579(7798):265-269. doi: 10.1038/s41586-020-2008-3 - DOI - PMC - PubMed
    1. Yezli, S. and Otter, J.A.. Minimum infective dose of the major human respiratory and enteric viruses transmitted through food and the environment. Food Environ Microbiol. 2011; 3: 1–30. doi: 10.1007/s12560-011-9056-7 - DOI - PMC - PubMed
    1. Geller C, Varbanov M, Duval RE. Human coronaviruses: insights into environmental resistance and its influence on the development of new antiseptic strategies. Viruses. 2012;4(11):3044-3068. doi: 10.3390/v4113044 - DOI - PMC - PubMed
    1. van Doremalen N, Bushmaker T, Munster VJ. Stability of Middle East respiratory syndrome coronavirus (MERS-CoV) under different environmental conditions. Euro Surveill. 2013;18(38):19. doi: 10.2807/1560-7917.ES2013.18.38.20590 - DOI - PubMed
    1. Chan KH, Peiris JS, Lam SY, Poon LL, Yuen KY, Seto WH. The effects of temperature and relative humidity on the viability of the SARS coronavirus. Adv Virol. 2011;2011:734690. doi: 10.1155/2011/734690 - DOI - PMC - PubMed