Conjunctival Swabs Reveal Higher Detection Rate Compared to Schirmer Strips for SARS-CoV-2 RNA Detection in Tears of Hospitalized COVID-19 Patients
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Tear Sample Collection
2.3. SARS-CoV-2 Viral Genome Detection by Quantitative Real-Time Polymerase Chain Reaction (qRT-PCR)
2.4. Statistical Analysis
2.5. Ethical Aspects
3. Results
3.1. Patients’ Demographics
3.2. SARS-CoV-2 Was Better Detected in Tear Samples Collected by Conjunctival Swab Compared to These by Schirmer Strips
3.3. Patients Who Had SARS-CoV-2 Positive Tear Samples Reported Significantly More Subjective Ocular Symptoms, However Objective Measurements Did Not Differ
3.4. Patients with SARS-CoV-2 Positive Tears Had Worse Prognosis
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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COVID-19 | Non-COVID-19 | |||
---|---|---|---|---|
Total | SARS-CoV-2 Detection in Tears | No SARS-CoV-2 Detection in Tears | Total | |
Number of Patients | 33 | 6 | 27 | 28 |
Sex | ||||
Male | 57.6% (19) | 33.3% (2) | 62.9% (17) | 42.9% (12) |
Female | 42.4% (14) | 66.7% (4) | 37.1% (10) | 57.1% (16) |
Mean age (range) | 58.6 (23–87) | 68.7 (56–82) | 56.3 (23–87) | 59.4 (24–86) |
Mean CCI (range) | 62.6% (0.0–98.0%) | 34.0% (0.0–77.0%) | 67.6% (0.0–98.0%) | 55.0% (0.0–98.0%) |
SAH | 48.5% (16) | 83.3% (5) | 40.7% (11) | 39.3% (11) |
DM2 | 24.2% (8) | 50.0% (3) | 18.5% (5) | 17.8% (5) |
Obesity | 24.2% (8) | 33.3% (2) | 22.2% (6) | 25.0% (7) |
Dyslipidemia | 12.1% (4) | 16.7% (1) | 11.1% (3) | 3.6% (1) |
Vaccine | ||||
CoronaVac 3rd dose | 6.6% (2) | 33.3% (2) | 0.0% (0) | 0.0% * (0) |
CoronaVac 2nd dose | 36.4% (12) | 50.0% (3) | 33.3% (9) | 42.9% * (6) |
CoronaVac 1st dose | 9.1% (3) | 0.0% (0) | 11.1% (3) | 0.0% * (0) |
Oxford’s AZD1222 2nd dose | 0.0% (0) | 0.0% (0) | 0.0% (0) | 7.1% * (1) |
Oxford’s AZD1222 1st dose | 9.1% (3) | 0.0% (0) | 11.1% (3) | 14.3% * (2) |
No vaccine | 38.8% (13) | 16.7% (1) | 44.5% (12) | 35.7% * (5) |
Unknown | 0 | 0 | 0 | 14 |
SARS-CoV-2 testing in tears (conjunctival swab and Schirmer strips) | 100.0% (33) | 100.0% (6) | 100.0% (27) | 50.0% (14) |
Total (33) | SARS-CoV-2 Tear Samples | χ2 | ||
---|---|---|---|---|
Positive (6) | Negative (27) | |||
Reported ocular symptoms | 48.5% (16) | 50.0% (3) | 48.1% (13) | ns |
Foreign body sensation | 30.3% (10) | 16.6% (1) | 33.3% (9) | ns |
Tearing | 9.1% (3) | 33.3% (2) | 6.9% (1) | 0.022 |
Red eye | 12.1% (4) | 16.6% (1) | 11.1% (3) | ns |
Pain | 12.1% (4) | 0.0% (0) | 14.8% (4) | ns |
Previous eye surgery | 21.2% (7) | 16.6% (1) | 22.2% (6) | ns |
Use of eye drops | 0.0% (0) | 0.0% (0) | 0.0% (0) | ns |
Use of O2 (nasal cannula) | 72.7% (24) | 100.0% (6) | 66.6% (18) | ns |
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Sabage, L.E.; Sun, Y.J.; Wolf, J.; Sabage, J.; Mazzo, A.; Santos, C.F.; Mahajan, V.B.; Manzoni Lourençone, L.F. Conjunctival Swabs Reveal Higher Detection Rate Compared to Schirmer Strips for SARS-CoV-2 RNA Detection in Tears of Hospitalized COVID-19 Patients. J. Clin. Med. 2022, 11, 6929. https://doi.org/10.3390/jcm11236929
Sabage LE, Sun YJ, Wolf J, Sabage J, Mazzo A, Santos CF, Mahajan VB, Manzoni Lourençone LF. Conjunctival Swabs Reveal Higher Detection Rate Compared to Schirmer Strips for SARS-CoV-2 RNA Detection in Tears of Hospitalized COVID-19 Patients. Journal of Clinical Medicine. 2022; 11(23):6929. https://doi.org/10.3390/jcm11236929
Chicago/Turabian StyleSabage, Luís Expedito, Young Joo Sun, Julian Wolf, Josmar Sabage, Alessandra Mazzo, Carlos Ferreira Santos, Vinit B. Mahajan, and Luiz Fernando Manzoni Lourençone. 2022. "Conjunctival Swabs Reveal Higher Detection Rate Compared to Schirmer Strips for SARS-CoV-2 RNA Detection in Tears of Hospitalized COVID-19 Patients" Journal of Clinical Medicine 11, no. 23: 6929. https://doi.org/10.3390/jcm11236929
APA StyleSabage, L. E., Sun, Y. J., Wolf, J., Sabage, J., Mazzo, A., Santos, C. F., Mahajan, V. B., & Manzoni Lourençone, L. F. (2022). Conjunctival Swabs Reveal Higher Detection Rate Compared to Schirmer Strips for SARS-CoV-2 RNA Detection in Tears of Hospitalized COVID-19 Patients. Journal of Clinical Medicine, 11(23), 6929. https://doi.org/10.3390/jcm11236929