Journal
OCULAR SURFACE
Volume 19, Issue -, Pages 322-329Publisher
ELSEVIER
DOI: 10.1016/j.jtos.2020.11.002
Keywords
SARS-CoV-2; COVID-19; Cornea; Corneal transplantation
Categories
Funding
- Eye Bank Association of America (USA)
- National Eye Institute (USA) [EY027381, EY026964]
- National Institute of Allergy and Infectious Diseases (USA) [AI135583, AI140033]
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This study found a small but noteworthy prevalence of SARS-CoV-2 in ocular tissues from COVID-19 donors, highlighting the importance of stringent donor screening and disinfection protocols to prevent any tissue carrying SARS-CoV-2 from being used for corneal transplantation.
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 similar to 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.
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