Tehran University of Medical Sciences Iranian Journal of Microbiology 2008-3289 13 6 2021 12 15 757 763 Maral Farzin Department of Medicine, School of Medicine, Babol University of Medical Sciences, Babol, Iran Seyed Ahmad Rasoulinejad Department of Ophthalmology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran Mansour Babaei Department of Rheumatology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran Farzin Sadeghi Cellular & Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Mahmoud Sadeghi-Haddad-Zavareh Department of Infectious Diseases, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran Alireza Firouzjahi Department of Pathology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran Behzad Heidari Department of Rheumatology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran 2021 06 03 2021 10 28 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. https://ijm.tums.ac.ir/index.php/ijm/article/view/3179 https://ijm.tums.ac.ir/index.php/ijm/article/download/3179/1402