• Comprehensive Ophthalmology, Cornea/External Disease

    Review of: Evaluation of SARS-CoV-2 in tears of patients with moderate to severe COVID-19

    Ung C, Yonekawa Y, Waljee J, et al. Ophthalmology, April 2021

    Researchers used conjunctival swabs to collect tears from eyes within 48 hours of confirmation of SARS-CoV-2 RNA in patients with moderate to severe COVID-19 and found evidence of a higher possibility of viral transmission.

    Study design

    In this cross-sectional study, tears from both eyes were collected within 48 hours of laboratory confirmation of SARS-CoV-2 RNA in patients with moderate to severe COVID-19. Conjunctival swab was used for tear collection.

    Outcomes

    A significantly higher possibility of viral transmission exists through tears in patients with moderate to severe COVID-19. Of the 78 patients in the study, 24% showed presence of SARS-CoV-2 RNA in their tears.

    Limitations

    Limitations included the noninclusion of patients with mild and asymptomatic COVID-19, the small sample size, and the 1-time sampling.

    Clinical significance

    Conjunctival swab is a satisfactory method of tear collection for assessment of SARS- CoV-2 by RT-PCR. The respiratory tract is not the only transmission route, and considerable viral shedding occurs in the precorneal tear film in patients with moderate to severe COVID-19, thus implying that besides N95 respirators, use of goggles and face shields by healthcare workers should be mandatory when interacting with patients with moderate to severe COVID-19 to reduce the transmission of disease.