Prevalence of SARS-CoV-2 in human post-mortem ocular tissues.

Abstract

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 additional 10 research-intent COVID-19 positive 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.

• Authors: Onkar B Sawant, Sneha Singh, Robert Emery Wright 3rd, Kayla M Jones, Michael S Titus, Eugene Dennis, Eric Hicks, Parag A Majmudar, Ashok Kumar, Shahzad I Mian
• Journal: The ocular surface (Ocul Surf) Vol. 19 Pg. 322-329 (01 2021) ISSN: 1937-5913 [Electronic] United States
• PMID: 33176215 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
• Copyright: Copyright © 2020 Elsevier Inc. All rights reserved.

Chemical References

• RNA, Viral

Topics

• Aged
• Autopsy
• COVID-19
• Conjunctiva (virology)
• Cornea (virology)
• Female
• Humans
• Male
• Middle Aged
• Prevalence
• RNA, Viral (isolation & purification)
• SARS-CoV-2 (isolation & purification)
• Vitreous Body (virology)