DOI: 10.5061/dryad.rn8pk0pdp
title: Detection of SARS-CoV-2 in conjunctival secretion and tears in patients with COVID-19 in a tertiary care centre, South India

description: Aims and objectives: The purpose of this study is to detect the presence
 of SAR-CoV-2 viral RNA in conjunctival secretions of COVID-19 patients and
 to compare the RT-PCR positivity rate for SARS-CoV-2 in conjunctival and
 nasopharyngeal swabs. Materials and method: Eighty hospitalised COVID-19
 patients whose nasopharyngeal swab tested positive for SARS-CoV-2 by
 RT-PCR were included in the study. Conjunctival swab was collected from
 the eyes of these patients and sent for detection of SARS-CoV-2 by RT-PCR
 method. Results: Among the eighty patients, 51 (63.7%) were males and 29
 (36.3%) were females. The mean age of the patients was 55.93 ± 16.59. Six
 patients had ocular manifestations. Eleven (13.75%) patients tested
 positive on conjunctival swab for SARS-CoV-2 viral RNA, and only one of
 them had ocular manifestations out of the eleven. Conclusion: In our
 study, the presence of SARS-CoV-2 in conjunctival secretions of COVID-19
 patients was detected and this was not dependent on the presence of ocular
 manifestations or duration of disease. Though the conjunctival positivity
 is lower compared to the nasopharyngeal swab sampling, ocular surface and
 secretions can be a potential route of viral transmission.
description: <strong>Study</strong>
 <strong>participants</strong>: Patients admitted with a
 positive nasopharyngeal swab for SARS-CoV-2 within a duration of 1 week,
 and age of more than 18 years. Patients with COVID-19-like symptoms but
 whose RT-PCR was negative for COVID-19 were excluded. Critically ill
 patients who couldn’t give consent were also excluded.
 Patients presenting complaints were noted along with any ocular
 complaints. The patient’s co-morbidities were recorded and clinical
 parameters on presentation like body temperature and oxygen saturation
 (SpO2) were also taken from the patient’s medical record. The day of
 nasopharyngeal swab collection was recorded, and days between the
 nasopharyngeal swab collection and conjunctival swab collection were
 calculated for every patient. Written informed consent was obtained from
 patients before sample collection.
 <strong>Sample</strong>
 <strong>collection</strong>: A bedside ophthalmologist
 examination was done, and the patient’s eyelids, adnexa, conjunctiva, and
 cornea were examined before collection of samples. The sample was
 collected under aseptic conditions by the same ophthalmologist who donned
 personal protective equipment. Samples were collected by using
 nylon-flocked swabs by sweeping movement over the inferior fornix from the
 medial to the lateral direction. Sample from both eyes was collected for
 each patient using separate swab sticks without the use of any topical
 anaesthetic drops. Both swab sticks were then dipped into a single viral
 transport medium and transferred to the institutional microbiology lab,
 maintaining a proper cold chain at all times. The  RTPCR was performed on
 the samples using the kit protocol and the results were recorded
 . <strong>Statistical analysis</strong>:
 All the data was entered into an Excel sheet and analyzed using IBM SPSS
 version 25. The continuous and categorical variables have been represented
 as mean ± standard deviation and frequency percentages respectively. The
 association between conjunctival swab positivity and variables like the
 severity of COVID, presence of symptoms such as fever, breathlessness,
 cough, fatigue, myalgia, diarrhea, and ocular symptoms was analyzed using
 the chi-square test. Correlation between the duration of days after which
 the conjunctival swab tested positive from the day of nasopharyngeal swab
 positivity, and oxygen saturation was done using Pearson’s correlation and
 p &lt;0.05 was considered significant.
description: Excel and README files