Positive detection of SARS-CoV-2 combined HSV1 and HHV6B virus nucleic acid in tear and conjunctival secretions of a non-conjunctivitis COVID-19 patient with obstruction of common lacrimal duct
Authors: Yawen Wang
Li Zhang
Shuo Zhao
Hui Liu
Yaguang Hu
Li Li
Fang Wang
Han Xia
Miaomiao Liu
Tianyan Chen
Journal: Acta ophthalmologica (2020)
Discipline: CLINICAL MEDICINE
Keywords: COVID-19; SARS-CoV-2; eye swabs; nasopharyngeal swabs; next-generation sequencing
Affiliations: Department of Ophthalmology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China., Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China., Department of Cardiac Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China., Department of Laboratory Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China., Department of Surgery Intensive Care Unit, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China., Biobank, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China., Faculty of Electronic and Information Engineering, School of Automation Science and Engineering, Xi'an Jiaotong University, Xi'an, China.

Abstract:  Background: The current outbreak of COVID-19 has spread rapidly all over the world. Respiratory droplets and contaction with infected patients are the two major transmission routes. However, the value of tear virus nucleic acid is still not clear. We dynamic detected the SARS-CoV-2 in eye sample of one COVID-19 patient with obstruction of common lacrimal ducts. Methods: Besides the routine examination, nasopharyngeal and eye swab were continuously measured by polymerase chain reaction assay and next-generation sequencing (NGS). Gene detection was performed for drug use guidance, and flow cytometry was performed to analyse the lymphocyte subsets. Results: Nasopharyngeal swabs were positive for 22 days, but eye swabs were still continuously positive for 2 weeks after nasopharyngeal swabs turned negative. The low level of lymphocyte and the high level IL-6 lasted for almost 4 weeks, then became near normal. Next-generation sequencing (NGS) confirmed the existing of SARS-CoV-2, HSV1 and HHV6B virus nucleic acid. The gene detection for drug use guidance showed the genetic locus ABCB1 (3435T&gt;C) rs1045642 belonged to type CC and it mean the efficiency of lopinavir-ritonavir would be significantly decreased. The flow cytometry of lymphocyte subsets showed PD-1+ CD95+ cells was accounting for 94.8% in CD3+ CD8+ T subset and for 94.8% in CD3+ TCRγδ+ T subset. Conclusions: As obstruction of common lacrimal duct, positively detection in one eye for 2 weeks more after nasopharyngeal swab became negative. More eye swabs should be collected from COVID-19 patients, especially from those immunocompromised, those with eye symptoms and those had a history of ocular diseases. 

Retracted: No

PubPeer comments:
 Three papers of N. Sanoj Rejinold, published around the same time, appear to contain figures that look very similar to each other. Let s call them here papers A, B, and C. This post is on Paper C. * Paper A: Carbohydrate polymers 83, no. 2 (2011): 776-786. DOI: 10.1016 j.carbpol.2010.08.052 * Paper B: Journal of colloid and interface science 360, no. 1 (2011): 39-51. DOI: 10.1016 j.jcis.2011.04.006 * Paper C: International journal of biological macromolecules 49, no. 2 (2011): 161-172. DOI: 10.1016 j.ijbiomac.2011.04.008 Figure 5 of paper A, Figure 8 of paper B (this paper), and Figure 5 of paper C appear to show panels that look very similar across the three papers. Yet, each paper is based on a different nano-particle composite. Could the authors please explain? ![file] , 
 Figure 7 of paper A, Figure 11 of paper B, and Figure 7 of paper C also share some similarities, in particular in the control panels. Could the authors please explain if they represent the same experiment? ![file] , 
 Figure 3CD of paper A, Figure 5AB of paper B, and Figure 3FG of paper C also share some similarities. Even though each paper represents a different type of nanoparticle scaffold, the 2 graphs look remarkably similar across the papers. Could the authors please explain if they represent the same experiment? ![file] , 
 Figure 2CD of paper A, Figure 3AB of paper B, and Figure 3AB of paper C also share some similarities. Some of the spectra represent the same compounds, but not in all cases. Could the authors please explain if they represent the same experiment? ![file] , 
 Figure 2AB of paper A, Figure 4AB of paper B, and Figure 3CDE of paper C also share some similarities. The photos of the nanoparticles at different temperatures look very similar, as well as the temperature plots. Could the authors please explain if they represent the same experiment? Each of these 3 papers appears to look at a different type of nanoparticle. ![file] , 
 Figure 14 of paper B and Figure 9 of paper C both show hemolysis experiments, but of different types of nanoparticles. Yet the photos look remarkably similar. Note the smudges of blood in the tube on the far right, and in the caps of some other tubes. ![file] , 
 Figure 2 of paper B and Figure 2 of paper C also show remarkable similarities. The chemical structures are different but the photos appear to look the same. Could the authors please clarify? ![file] , 
 Introducing paper D: * Paper A: Carbohydrate polymers 83, no. 2 (2011): 776-786. DOI: 10.1016 j.carbpol.2010.08.052 * Paper B: Journal of colloid and interface science 360, no. 1 (2011): 39-51. DOI: 10.1016 j.jcis.2011.04.006 * Paper C: International journal of biological macromolecules 49, no. 2 (2011): 161-172. DOI: 10.1016 j.ijbiomac.2011.04.008 * Paper D: ACS applied materials interfaces 3, no. 9 (2011): 3654-3665. DOI: 10.1021 am200844m Figure 10 of paper B, Figure 6 of paper C, and the first 4 bars of Figure 13 in paper D all appear to share unexpected similarities in relative heights and error bars. ![file] , 
 In Figure 8, two sets of panels appear to look similar to each other (shown in shades of blue). Could the authors comment if these are the same experiments? They also look similar to panels in Figure 13 of paper B. ![file] , 
 Corrigendum published, [15 August 2019] . ----------------------------------- In the original manuscript, the Fig. 2A, B were wrongly provided and it has been corrected. The corrected Fig. 2 is shown below. ![] Similarly, Fig. 3E, the LCST transition of chitosan-g-PNIPAAm is incorrect and it has been corrected. Accordingly, the photographic LCST images of Fig. 3C, D is also being corrected. In Fig. 3F and G, DLS data of bare TRC NPs and curcumin loaded TRC NPs is also incorrect. We rectified these mistake and corrected Fig. 3 is presented below. ![] In the original manuscript, Fig. 5A, the fluorescent images of cellular uptake of CRC and CRC loaded TRC NPs was incorrectly provided. To rectify this mistake, we have reperformed the experiment of Fig. 5A. Further, Fig. 5Ba, flowcytometric histograms of control L929 and PC3 cells were incorrectly provided and it has also been corrected. The corrected Fig. 5 is given below. ![] Additionally, in the original manuscript, Fig. 6 A and B, wrong error bar was provided. Especially for control, Media group had no error bars provided. Now we corrected these mistakes and the corrected Fig. 6 is given below. ![] These changes in the figures would not affect the conclusion from the figure nor the overall conclusion of the whole manuscript. The authors would like to apologise for any inconvenience caused. ----------------------------------------  All our results were wrong so we are replacing them. The conclusions remain unchanged. ,