Original Article

Conjunctival polymerase chain reactions in COVID-19 patients and its correlation with clinical and paraclinical indexes

Abstract

Background and Objectives: This study aimed to detect SARS-CoV-2 in conjunctival samples of COVID-19 patients to investigate the transmission route of COVID-19 and its correlation with laboratory indexes.
Materials and Methods: In this cross-sectional study, 44 COVID-19 patients were tested for conjunctival PCR in Ayatollah Rouhani hospital of Babol, Iran, in January and February 2021. The conjunctival samples were collected using a conjunctival swab and suspended in a viral transport medium. After RNA extraction and cDNA synthesis, real-time PCR was performed to investigate the SARS-CoV-2 genome in samples. The ocular manifestations and laboratory indexes were evaluated for all patients.
Results: Among 44 COVID-19 patients, 6 samples (13.63%) were positive in terms of conjunctival PCR. The mean ± SD age of conjunctival PCR-positive patients was 76.17 ± 16.61-year-old, while conjunctival PCR-negative COVID-19 patients were aged 57.54 ± 13.61-year-old (p <0.05). D-dimer serum level is significantly higher in conjunctival PCR-positive COVID-19 patients (4001.00 ± 3043.36 µg/ml) compared to normal individuals (496.80 ± 805.92 µg/ml, p <0.01).
Conclusion: Our study showed that the conjunctiva and tear contain the SARS-CoV-2 in COVID-19 patients as a possible transmission route.

1. Jin M, Tong Q. Rhabdomyolysis as potential late complication associated with COVID-19. Emerg Infect Dis 2020;26:1618-1620.
2. Lee IC, Huo TI, Huang YH. Gastrointestinal and liver manifestations in patients with COVID-19. J Chin Med Assoc 2020;83:521-523.
3. Kirwan R, McCullough D, Butler T, Perez de Heredia F, Davies IG, Stewart C. Sarcopenia during COVID-19 lockdown restrictions: long-term health effects of short-term muscle loss. Geroscience 2020;42:1547-1578.
4. Alzamora MC, Paredes T, Caceres D, Webb CM, Valdez LM, La Rosa M. Severe COVID-19 during pregnancy and possible vertical transmission. Am J Perinatol 2020;37:861-865.
5. Ahn JY, Sohn Y, Lee SH, Cho Y, Hyun JH, Baek YJ, et al. Use of convalescent plasma therapy in two COVID-19 patients with acute respiratory distress syndrome in Korea. J Korean Med Sci 2020;35(14):e149.
6. Amesty MA, Alió Del Barrio JL, Alió JL. COVID-19 disease and ophthalmology: An update. Ophthalmol Ther 2020;9:1-12.
7. Wu P, Duan F, Luo C, Liu Q, Qu X, Liang L, et al. Characteristics of ocular findings of patients with coronavirus disease 2019 (COVID-19) in Hubei province, China. JAMA Ophthalmol 2020;138:575-578.
8. Liu X, Liu C, Liu G, Luo W, Xia N. COVID-19: progress in diagnostics, therapy and vaccination. Theranostics 2020;10:7821-7835.
9. Lu H, Stratton CW, Tang YW. Outbreak of pneumonia of unknown etiology in Wuhan, China: The mystery and the miracle. J Med Virol 2020;92:401-402.
10. Atum M, Boz AAE, Çakır B, Karabay O, Köroğlu M, Öğütlü A, et al. Evaluation of conjunctival swab PCR results in patients with SARS-CoV-2 infection. Ocul Immunol Inflamm 2020;28:745-748.
11. Xia J, Tong J, Liu M, Shen Y, Guo D. Evaluation of coronavirus in tears and conjunctival secretions of patients with SARS-CoV-2 infection. J Med Virol 2020;92:589-594.
12. Kaya H, Çalışkan A, Okul M, Sarı T, Akbudak IH. Detection of SARS-CoV-2 in the tears and conjunctival secretions of coronavirus disease 2019 patients. J Infect Dev Ctries 2020;14:977-981.
13. Li X, Chan JF, Li KK, Tso EY, Yip CC, Sridhar S, et al. Detection of SARS-CoV-2 in conjunctival secretions from patients without ocular symptoms. Infection 2021;49:257-265.
14. Güemes-Villahoz N, Burgos-Blasco B, Arribi-Vilela A, Arriola-Villalobos P, Rico-Luna CM, Cuiña-Sardiña R, et al. Detecting SARS-CoV-2 RNA in conjunctival secretions: Is it a valuable diagnostic method of COVID-19? J Med Virol 2021;93:383-388.
15. Kang D, Park J, Na J, Lee H, Baek S. Measurement of Lacrimal Sac Fossa using orbital computed tomography. J Craniofac Surg 2017;28:125-128.
16. Kaur P, Sehgal G, Shailpreet, Singh KD, Singh B. Evaluation and comparison of conjunctival swab polymerase chain reaction results in SARS-CoV-2 patients with and without ocular manifestations. Indian J Ophthalmol 2021;69:2211-2214.
17. Velavan TP, Meyer CG. Mild versus severe COVID-19: Laboratory markers. Int J Infect Dis 2020;95:304-307.
18. Middleton EA, He XY, Denorme F, Campbell RA, Ng D, Salvatore SP, et al. Neutrophil extracellular traps contribute to immunothrombosis in COVID-19 acute respiratory distress syndrome. Blood 2020;136:1169-1179.
Files
IssueVol 13 No 6 (2021) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijm.v13i6.8074
Keywords
Conjunctiva; SARS-CoV-2; Real-time polymerase chain reaction; COVID-19; Eye manifestations

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How to Cite
1.
Farzin M, Rasoulinejad SA, Babaei M, Sadeghi F, Sadeghi-Haddad-Zavareh M, Firouzjahi A, Heidari B. Conjunctival polymerase chain reactions in COVID-19 patients and its correlation with clinical and paraclinical indexes. Iran J Microbiol. 2021;13(6):757-763.