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. 2021 Apr;49(2):257-265.
doi: 10.1007/s15010-020-01524-2. Epub 2020 Sep 17.

Detection of SARS-CoV-2 in conjunctival secretions from patients without ocular symptoms

Xin Li #  1 , Jasper Fuk-Woo Chan #  2   3   4   5 , Kenneth Kai-Wang Li #  6 , Eugene Yuk-Keung Tso  7 , Cyril Chik-Yan Yip  1 , Siddharth Sridhar  2   3   4 , Tom Wai-Hin Chung  1 , Kelvin Hei-Yeung Chiu  1 , Derek Ling-Lung Hung  1 , Alan Ka-Lun Wu  8 , Sandy Ka-Yee Chau  9 , Raymond Liu  10 , Kwok-Cheung Lung  11 , Anthony Raymond Tam  12 , Vincent Chi-Chung Cheng  1 , Kelvin Kai-Wang To  2   3   4 , Kwok-Hung Chan  2   3   4 , Ivan Fan-Ngai Hung  13   14   15 , Kwok-Yung Yuen  2   3   4   5
Affiliations

Detection of SARS-CoV-2 in conjunctival secretions from patients without ocular symptoms

Xin Li et al. Infection. 2021 Apr.

Abstract

Purpose: To evaluate the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in conjunctival secretions from patients without ocular symptoms.

Methods: Conjunctival swabs were prospectively collected from laboratory-confirmed Coronavirus disease 2019 (COVID-19) patients without ocular symptoms for reverse transcription-polymerase chain reaction (RT-PCR) and viral culture.

Results: A total of 158 conjunctival swabs were obtained from 49 laboratory-confirmed COVID-19 patients. The median duration of illness when the first conjunctival swab was obtained was 10 days (range 2-27 days). Four conjunctival swabs from four different patients (4/49, 8.2%) were positive for SARS-CoV-2 RNA by RT-PCR. The Ct values ranged from 32.7 to 37.7 (mean 35.4). Viral cultures were negative for all four RT-PCR-positive conjunctival swabs.

Conclusion: Conjunctival secretions of a minority of COVID-19 patients without ocular symptoms may contain relatively low levels of SARS-CoV-2 RNA, but their infectiousness remains undetermined. Appropriate infection control measures should be implemented during ophthalmological assessment of COVID-19 patients to prevent potential nosocomial transmission of SARS-CoV-2.

Keywords: Asymptomatic; Conjunctiva; RT-PCR; SARS-CoV-2; Shedding.

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Conflict of interest statement

JF-WC has received travel Grants from Pfizer Corporation Hong Kong and Astellas Pharma Hong Kong Corporation Limited, and was an invited speaker for Gilead Sciences Hong Kong Limited and Luminex Corporation. SS has received speaker’s honoraria from Abbott Laboratories Limited. The other authors declared no conflict of interests. The funding sources had no role in study design, data collection, analysis or interpretation or writing of the report. The corresponding authors had full access to all the data in the study and had final responsibility for the decision to submit for publication.

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