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SARS-CoV-2 and the ocular surface: test accuracy and viral load.
Santoro, Dalton de Freitas; Hirai, Flavio Eduardo; Tochetto, Lucas Baldissera; Conte, Danielle Dias; Lima, Ana Luísa Hofling; Sousa, Luciene Barbosa de; Bellei, Nancy Cristina Junqueira; Freitas, Denise; Oliveira, Lauro Augusto de.
Afiliação
  • Santoro DF; Department of Ophthalmology and Visual Science, Escola Paulista de Medicina, Hospital São Paulo, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
  • Hirai FE; Department of Ophthalmology and Visual Science, Escola Paulista de Medicina, Hospital São Paulo, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
  • Tochetto LB; Department of Ophthalmology and Visual Science, Escola Paulista de Medicina, Hospital São Paulo, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
  • Conte DD; Department of Medicine, Discipline of Infectious and Parasitic Diseases, Escola Paulista de Medicina, Hospital São Paulo, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
  • Lima ALH; Department of Ophthalmology and Visual Science, Escola Paulista de Medicina, Hospital São Paulo, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
  • Sousa LB; Department of Ophthalmology and Visual Science, Escola Paulista de Medicina, Hospital São Paulo, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
  • Bellei NCJ; Department of Medicine, Discipline of Infectious and Parasitic Diseases, Escola Paulista de Medicina, Hospital São Paulo, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
  • Freitas D; Department of Ophthalmology and Visual Science, Escola Paulista de Medicina, Hospital São Paulo, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
  • Oliveira LA; Department of Ophthalmology and Visual Science, Escola Paulista de Medicina, Hospital São Paulo, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Arq Bras Oftalmol ; 87(5): e20220172, 2023.
Article em En | MEDLINE | ID: mdl-39298730
ABSTRACT

PURPOSE:

This study aimed to evaluate the pre-sence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in the ocular surface of individuals clinically suspected of coronavirus disease 2019 (COVID-19) and determine the accuracy of different approaches of molecular testing on the ocular surface based on the nasopharyngeal positivity status for COVID-19.

METHODS:

A total of 152 individuals with suspected COVID-19 symptoms who simultaneously underwent nasopharyngeal and two different tear film collection techniques for quantitative reverse-transcriptase polymerase chain reaction (RT-qPCR) were included. Tears were collected and randomized one eye had the filter strip for the Schirmer test and the contralateral eye had conjunctival swab/cytology in the inferior fornix. All patients underwent slit lamp biomicroscopy. The accuracy of various ocular surface collection techniques used for the detection of SARS-CoV-2 RNA was determined.

RESULTS:

Of the 152 patients enrolled in the study, 86 (56.6%) had COVID-19 confirmed by nasopharyngeal PCR. Both tear film collection techniques detected viral particles the Schirmer test was positive in 16.3% (14/86) and the conjunctival swab/cytology in 17.4% (15/86), with no statistically significant differences. No positive ocular tests were found among those with negative nasopharyngeal PCR tests. The overall agreement of the ocular tests was 92.7%, and in combination, the sensitivity would increase to 23.2%. The mean cycle threshold values in the nasopharyngeal, Schirmer, and conjunctival swab/cytology tests were 18.2 ± 5.3, 35.6 ± 1.4, and 36.4 ± 3.9, respectively. Compared with the nasopharyngeal test, the Schirmer (p=0.001) and conjunctival swab/cytology (p<0.001) tests had significantly different Ct values.

CONCLUSION:

The Schirmer (16.3%) and conjunctival swab (17.4%) tests were comparably capable of detecting SARS-CoV-2 RNA in the ocular surface by RT-PCR accurately based on nasopharyngeal status and demonstrated indistinct sensitivity and specificity. Simultaneous specimen sampling and processing from the nasopharyngeal, Schirmer, and conjunctival swab/cytology tests demonstrated significantly lower viral load in both ocular surface approaches than in the nasopharyngeal test. Ocular manifestations detected by slit lamp biomicroscopy were not associated with ocular RT-PCR positivity.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Lágrimas / RNA Viral / Nasofaringe / Túnica Conjuntiva / Carga Viral / SARS-CoV-2 / COVID-19 Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Arq Bras Oftalmol Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Lágrimas / RNA Viral / Nasofaringe / Túnica Conjuntiva / Carga Viral / SARS-CoV-2 / COVID-19 Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Arq Bras Oftalmol Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil