Background

SARS-CoV-2 is found in conjunctival swabs and tears of COVID-19 patients. However, the presence of SARS-CoV-2 has not been detected in the human eye to date. We undertook this study to analyze the prevalence of SARS-CoV-2 in human post-mortem ocular tissues.

Methods

The expression of SARS-CoV-2 RNA was assessed by RT-PCR in corneal and scleral tissues from 33 surgical-intended donors who were eliminated from a surgical use per Eye Bank Association of America (EBAA) donor screening guidelines or medical director review or positive COVID-19 test. Ocular levels of SARS-CoV-2 RNA (RT-PCR), Envelope and Spike proteins (immunohistochemistry) and anti-SARS-CoV-2 IgG and IgM antibodies (ELISA) in blood were evaluated in 10 COVID-19 donors.

Findings

Of 132 ocular tissues from 33 surgical-intended donors, the positivity rate for SARS-CoV-2 RNA was ∼13% (17/132). Of 10 COVID-19 donors, six had PCR positive post-mortem nasopharyngeal swabs whereas eight exhibited positive post-mortem anti-SARS-CoV-2 IgG levels. Among 20 eyes recovered from 10 COVID-19 donors: three conjunctival, one anterior corneal, five posterior corneal, and three vitreous swabs tested positive for SARS-CoV-2 RNA. SARS-CoV-2 spike and envelope proteins were detected in epithelial layer of the corneas that were procured without Povidone-Iodine (PVP–I) disinfection.

Interpretations

Our study showed a small but noteworthy prevalence of SARS-CoV-2 in ocular tissues from COVID-19 donors. These findings underscore the criticality of donor screening guidelines, post-mortem nasopharyngeal PCR testing and PVP-I disinfection protocol to eliminate any tissue harboring SARS-CoV-2 being used for corneal transplantation.

中文翻译：

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人类死后眼组织中 SARS-CoV-2 的患病率

 背景

在 COVID-19 患者的结膜拭子和眼泪中发现了 SARS-CoV-2。然而，迄今为止，尚未在人眼中检测到 SARS-CoV-2 的存在。我们进行这项研究是为了分析人类死后眼组织中 SARS-CoV-2 的流行情况。

 方法

通过 RT-PCR 评估了 33 名拟手术捐献者的角膜和巩膜组织中 SARS-CoV-2 RNA 的表达，这些捐献者根据美国眼库协会 (EBAA) 捐献者筛选指南或医疗主任审查被排除在手术用途之外。 COVID-19 检测呈阳性。对 10 名 COVID-19 捐献者的血液中 SARS-CoV-2 RNA (RT-PCR)、包膜蛋白和刺突蛋白（免疫组织化学）以及抗SARS-CoV-2 IgG 和 IgM 抗体 (ELISA) 的眼部水平进行了评估。

 发现

在来自 33 名手术捐赠者的 132 份眼组织中，SARS-CoV-2 RNA 的阳性率为 ∼13% (17/132)。在 10 名 COVID-19 捐献者中，有 6 名死后鼻咽拭子 PCR 呈阳性，而 8 名死后抗SARS-CoV-2 IgG 水平呈阳性。从 10 名 COVID-19 捐献者身上恢复的 20 只眼睛中：3 只结膜、1 只前角膜、5 只后角膜和 3 只玻璃体拭子检测出 SARS-CoV-2 RNA 呈阳性。在未经聚维酮碘 (PVP-I) 消毒的角膜上皮层中检测到 SARS-CoV-2 刺突蛋白和包膜蛋白。

 解释

我们的研究表明，在 COVID-19 捐赠者的眼组织中，SARS-CoV-2 的患病率虽小，但值得注意。这些发现强调了供体筛选指南、尸检鼻咽 PCR 检测和 PVP-I 消毒方案的重要性，以消除用于角膜移植的任何含有 SARS-CoV-2 的组织。