tetano
Editor, Senior Moderator
Am J Ophthalmol
. 2021 May 19;S0002-9394(21)00286-5.
doi: 10.1016/j.ajo.2021.05.008. Online ahead of print.
Presence of SARS-CoV-2 Viral RNA in Aqueous Humor of Asymptomatic Individuals
Ellen H Koo[SUP] 1 [/SUP], Allen O Eghrari[SUP] 2 [/SUP], Daliya Dzhaber[SUP] 3 [/SUP], Amar Shah[SUP] 3 [/SUP], Elizabeth Fout[SUP] 4 [/SUP], Sander Dubovy[SUP] 3 [/SUP], Jorge Maestre-Mesa[SUP] 3 [/SUP], Darlene Miller[SUP] 3 [/SUP]
Affiliations
Abstract
Purpose: To determine whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is detectable in the aqueous of asymptomatic individuals presenting for ophthalmic surgery.
Design: Prospective cross-sectional study.
Methods: Setting and Participants, All patients undergoing anterior segment surgery at an Ambulatory Surgical Center (ASC) belonging to a tertiary academic center in South Florida during a 102-day period between June and September 2020 received nasal swab testing for SARS-CoV-2 and underwent a relevant review of symptoms prior to surgery, with negative results required for both in order to proceed with surgery. Main Outcomes and Measures, A small sample of aqueous humor (approximately 0.2cc) was acquired at the beginning of anterior segment surgery in all participants. Aqueous humor was analyzed for SARS-CoV-2 viral ribonucleic acid (RNA) using real-time reverse transcriptase polymerase chain reaction (rRT-PCR). Demographic information was acquired from participants for secondary analyses.
Results: A total of 70 samples were acquired. Of these, 39 were excluded due to insufficient material or inconclusive results. Out of 31 samples that were successfully analyzed, 6 (19.4%) demonstrated detectable SARS-CoV-2 RNA. None of the six individuals (0%) with detectable viral RNA in aqueous humor reported symptoms during the year, compared to 2 of 25 individuals (8%) with negative samples (p=1). Positive samples were distributed throughout the study period, including both the first and the last day of enrollment.
Conclusion: The presence of SARS-CoV-2 viral RNA in aqueous despite negative nasal swab testing confirms its presence beyond the blood-ocular barrier in asymptomatic individuals and raises the possibility that the virus may persist in immunoprivileged spaces despite an absence of symptoms.
Keywords: Aqueous humor, anterior chamber; COVID-19; Cataract surgery; Ocular manifestations; Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
. 2021 May 19;S0002-9394(21)00286-5.
doi: 10.1016/j.ajo.2021.05.008. Online ahead of print.
Presence of SARS-CoV-2 Viral RNA in Aqueous Humor of Asymptomatic Individuals
Ellen H Koo[SUP] 1 [/SUP], Allen O Eghrari[SUP] 2 [/SUP], Daliya Dzhaber[SUP] 3 [/SUP], Amar Shah[SUP] 3 [/SUP], Elizabeth Fout[SUP] 4 [/SUP], Sander Dubovy[SUP] 3 [/SUP], Jorge Maestre-Mesa[SUP] 3 [/SUP], Darlene Miller[SUP] 3 [/SUP]
Affiliations
- PMID: 34022227
- DOI: 10.1016/j.ajo.2021.05.008
Abstract
Purpose: To determine whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is detectable in the aqueous of asymptomatic individuals presenting for ophthalmic surgery.
Design: Prospective cross-sectional study.
Methods: Setting and Participants, All patients undergoing anterior segment surgery at an Ambulatory Surgical Center (ASC) belonging to a tertiary academic center in South Florida during a 102-day period between June and September 2020 received nasal swab testing for SARS-CoV-2 and underwent a relevant review of symptoms prior to surgery, with negative results required for both in order to proceed with surgery. Main Outcomes and Measures, A small sample of aqueous humor (approximately 0.2cc) was acquired at the beginning of anterior segment surgery in all participants. Aqueous humor was analyzed for SARS-CoV-2 viral ribonucleic acid (RNA) using real-time reverse transcriptase polymerase chain reaction (rRT-PCR). Demographic information was acquired from participants for secondary analyses.
Results: A total of 70 samples were acquired. Of these, 39 were excluded due to insufficient material or inconclusive results. Out of 31 samples that were successfully analyzed, 6 (19.4%) demonstrated detectable SARS-CoV-2 RNA. None of the six individuals (0%) with detectable viral RNA in aqueous humor reported symptoms during the year, compared to 2 of 25 individuals (8%) with negative samples (p=1). Positive samples were distributed throughout the study period, including both the first and the last day of enrollment.
Conclusion: The presence of SARS-CoV-2 viral RNA in aqueous despite negative nasal swab testing confirms its presence beyond the blood-ocular barrier in asymptomatic individuals and raises the possibility that the virus may persist in immunoprivileged spaces despite an absence of symptoms.
Keywords: Aqueous humor, anterior chamber; COVID-19; Cataract surgery; Ocular manifestations; Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).