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University of Nebraska Medical Center

COVID-19 virus detected in tears of patients with, without ocular symptoms

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  • Of five patients who tested positive for SARS-CoV-2 in their tear sample, only one exhibited ocular signs of disease.
  • Ocular manifestations included dry eye symptoms, conjunctivitis and lid edema.

SARS-CoV-2 may be transmissible through ocular routes, highlighting the importance of taking precautions during ocular examinations of patients diagnosed with COVID-19, according to a study.

“It is worth noting that the viral load in conjunctival samples is generally lower when compared to nasopharyngeal secretions,” Kanishk Singh, MBBS, MD, from All India Institute of Medical Sciences, and colleagues wrote in Cureus. “Despite this disparity, concerns persist regarding the potential transmission of the disease through tear samples, even when obvious ocular signs and symptoms are absent.”

In a prospective, cross-sectional study from February to June 2021, researchers included 40 patients who tested positive for COVID-19, based on nasopharyngeal, real-time reverse transcription-polymerase chain reaction (RT-PCR) assay. In addition to conducting a full ocular examination, researchers collected tear samples within 48 hours of collecting naso-oropharyngeal samples and submitted them for analysis via RT-PCR.

The researchers reported that 65% of participants had moderate COVID-19, 15% had severe COVID-19 and the rest had mild COVID-19. Five patients tested positive for SARS-CoV-2 in their tear sample, but only one had ocular manifestations of disease. However, of seven patients who exhibited ocular signs such as dry eye symptoms, conjunctivitis and lid edema, only one tested positive for SARS-CoV-2 in their tears.

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