• Users Online: 2859
  • Home
  • Print this page
  • Email this page

   Table of Contents      
ORIGINAL ARTICLE
Year : 2020  |  Volume : 68  |  Issue : 6  |  Page : 1015-1017

Presence of viral RNA of SARS-CoV-2 in conjunctival swab specimens of COVID-19 patients


1 Department of Ophthalmology, Minto Ophthalmic Hospital, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
2 Department of Medicine, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
3 Department of Microbiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
4 Department of Pulmonary Medicine, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
5 Department of Pharmacology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India

Date of Submission05-May-2020
Date of Acceptance16-May-2020
Date of Web Publication25-May-2020

Correspondence Address:
Dr. Kiran Kumar
Cataract, Cornea and Refractive Services, Minto Regional Institute of Ophthalmology, Bangalore Medical College and Research Institute, Bengaluru - 560 002, Karnataka
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1287_20

Rights and Permissions
  Abstract 


Purpose: To detect the presence of viral RNA of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in conjunctival swab specimens of coronavirus disease-19 (COVID-19) patients. Methods: Forty-five COVID-19 patients positive for real-time reverse transcription-polymerase chain reaction (RT-PCR) for SARS-CoV-2 in nasopharyngeal swab with or without ocular manifestations were included in the study. The conjunctival swab of each patient was collected by an ophthalmologist posted for COVID duty. Results: Out of 45 patients, 35 (77.77%) were males and the rest were females. The mean age was 31.26 ± 12.81 years. None of the patients had any ocular manifestations. One (2.23%) out of 45 patients was positive for RT-PCR SARS-CoV-2 in the conjunctival swab. Conclusion: This study shows that SARS-CoV-2 can be detected in conjunctival swabs of confirmed cases of COVID-19 patients. Though the positivity rate of detecting SARS-CoV-2 in conjunctival swabs is very less, care should be exercised during the ocular examination of patients of COVID-19.

Keywords: Conjunctival swab, coronavirus disease-19, nasopharyngeal swab, SARS-CoV-2


How to cite this article:
Kumar K, Prakash AA, Gangasagara SB, Rathod SB, Ravi K, Rangaiah A, Shankar SM, Basawarajappa SG, Bhushan S, Neeraja T G, Khandenahalli S, Swetha M, Gupta P, Sampritha U C, Prasad GN, Jayanthi CR. Presence of viral RNA of SARS-CoV-2 in conjunctival swab specimens of COVID-19 patients. Indian J Ophthalmol 2020;68:1015-7

How to cite this URL:
Kumar K, Prakash AA, Gangasagara SB, Rathod SB, Ravi K, Rangaiah A, Shankar SM, Basawarajappa SG, Bhushan S, Neeraja T G, Khandenahalli S, Swetha M, Gupta P, Sampritha U C, Prasad GN, Jayanthi CR. Presence of viral RNA of SARS-CoV-2 in conjunctival swab specimens of COVID-19 patients. Indian J Ophthalmol [serial online] 2020 [cited 2022 Jul 3];68:1015-7. Available from: https://www.ijo.in/text.asp?2020/68/6/1015/284769



Since December 2019, there have been cases of coronavirus disease 2019 (COVID-19) reported in China, which soon spread to other parts of the world. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the causative pathogen which is a member of the Coronaviridae family. A few researchers have reported keratoconjunctivitis as an ocular abnormality of SARS-CoV-2.[1] Signs and symptoms of COVID-19 have been described as fever, cough, myalgia, fatigue, sputum production, headache, hemoptysis, diarrhea, and conjunctivitis.[2] Since the diagnosis of COVID-19 patients cannot be only based on symptoms, reverse transcription-polymerase chain reaction (RT-PCR) is a simple and reliable molecular test on respiratory samples (throat swab/nasopharyngeal swab/sputum/endotracheal aspirates, and bronchoalveolar lavage).[3]

Close examination of patients by ophthalmologists and physical contact with patients' eyes is inevitable. This could be a potential source of the spread of SARS-CoV-2. Other viruses like adenovirus and influenza viruses are known for ocular tropism.[4] Therefore, this study was designed to understand whether SARS-CoV-2 can be detected in the conjunctival swab of patients of COVID-19.


  Methods Top


A prospective interventional study was conducted at a dedicated tertiary COVID-19 hospital in south India in April 2020. Institute ethical clearance was obtained prior to the onset of the study. Confirmed positive cases of COVID-19 by nasopharyngeal swab according to WHO standards with or without ocular symptoms were included in the study.[5] Suspect and probable cases and those patients who were critically ill were excluded. Signed consent was obtained for each sample collection from patients. The conjunctival swab was collected by an ophthalmologist posted for COVID duty. Eyelids were everted and samples were obtained by sweeping the inferior fornices of either of the two eyes with sterile nylon flocked swabs without topical anesthesia. The tips of the swab sticks were broken off and placed into a viral transport medium—Hi media (HiMedia Laboratories Pvt. Ltd, Nashik, India. Catalog No: 0000431084). Personal protection equipment was used and necessary precautions were used to minimize the risk of spread of infection from one patient to another. Samples were transported to the specified lab facility maintaining the recommended cold chain. In the laboratory, samples were extracted using the magnetic bead extraction method (Thermo scientific viral isolation kit—5X MagMAX, Thermo Fischer scientific Baltics UAB, Vilnius, Lithuania) in Biomek 4000 platform as per the manufacturer's instructions. In eight-strip PCR tubes, 22.5 μL of the mixed reaction solution or master mix (SARS CoV-2 Detection kit; fortitude 2.0) was loaded. To this, 2.5 μL of the extracted nucleic acid was added to each well, covered and the PCR was performed using the CFX96 real-time PCR (Bio-Rad). After the completion of the PCR run, the amplification curves were judged to decide if the results were negative or positive. A cutoff cycle threshold (Ct) value of 40 was considered as positive as per the manufacturer's instructions.


  Results Top


Out of 45 patients, 35 (77.77%) were males and the rest were females. Patients with a minimum age of 6 years and a maximum age of 75 years were present in the study. For our convenience, patients were divided into four age groups: less than 20 years (6); 21–40 years (29); 41–60 years (9), and more than 60 years (1). The mean age (±SD) was 31.26 ± 12.81 years. None of the patients in our study had any ocular symptoms.

Only one (2.23%) out of 45 patients was positive with the Ct value of 33, for real-time RT-PCR SARS-CoV-2 in conjunctival swab as shown in [Table 1].
Table 1: Demography, clinical symptoms, nasopharyngeal swab, and conjunctival swab reports of coronavirus disease-19-positive patients

Click here to view



  Discussion Top


No reports were suggesting ocular transmission of COVID-19 initially. Xia et al. evaluated the conjunctival secretions of 30 confirmed cases of COVID-19.[6] In one of these patients, both tear and conjunctival secretions tested positive for the virus by RT-PCR. There are numerous anecdotal reports suggesting conjunctivitis as the initial symptom before the onset of pneumonia, including that of Guangfa Wang, a national expert on the panel for pneumonia during the early investigations in Wuhan, China.[7]

Some studies reported the presence of SARS-CoV or Middle-East respiratory syndrome (MERS-CoV) in tears or conjunctival sac.[8] Another study by Chen et al. detected SARS-CoV-2 in the conjunctival sac of only three COVID-19 patients out of 67 positive cases. But these three patients did not have any ocular symptoms.[9] Sun et al. found that among 72 patients confirmed by laboratory diagnosis with SARS-CoV-2 RT-PCR assay, SARS-CoV-2 RNA fragments were found in ocular discharges belonging to one patient.[10] The above studies show that SARS-CoV-2 can be detected in conjunctival sac, in only a small percentage of COVID-19 positive patients. Also, the risk of infection of SARS-CoV-2 through eye secretions remains uncertain.

Our study showed that only one (2.23%) out of 45 patients had detectable levels of SARS-CoV-2 in conjunctival swabs of COVID-19-positive patients using RT-PCR. Low level of viral detection can be due to various factors like the time for maximum replication of the virus, the timing of performing of sampling, time of presentation of the patient to the hospital and possibly less secretion of the virus through conjunctival secretion, and also low sensitivity of RT-PCR.[11] In a study done by Ziad and colleagues, tracheal aspirates yielded a higher SARS-CoV-2 load than a nasopharyngeal swab.[12] This suggests that viral concentration differs in different sites and secretions. A study was done by de Wit et al. in the rhesus macaque model with MERS-CoV, which is another type of coronavirus.[13] They found out that MERS-CoV RNA could be detected in the conjunctiva well within 6 days of infection beyond which, it failed to detect the virus. Since the majority of people infected with the SARS-CoV-2 virus are asymptomatic, it is difficult to determine the peak of virus load unless multiple samplings are done at varied intervals.

There are several limitations to this study which include relatively small sample size, absence of detailed ocular examinations, sampling done only once from the eyes of each patient, which can increase the prevalence of false-negatives.


  Conclusion Top


This study shows that SARS-CoV-2 can be detected in conjunctival swabs of confirmed cases of COVID-19 patients. Though the positivity rate of detecting SARS-CoV-2 in conjunctival swabs is very less, care should be exercised during the ocular examination of patients of COVID-19.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: Implications for virus origins and receptor binding. Lancet 2020;395:565-74.  Back to cited text no. 1
    
2.
Huang C, Wang Y, Li X. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506.  Back to cited text no. 2
    
3.
Shen M, Zhou Y, Ye J, Abdullah AL-maskri AA, Kang Y, Zeng S, et al. Recent advances and perspectives of nucleic acid detection for coronavirus. J Pharm Anal 2020;10:97-101.  Back to cited text no. 3
    
4.
Nilsson EC, Storm RJ, Bauer J, Johansson SM, Lookene A, Šngström J, et al. The GD1a glycan is a cellular receptor for adenoviruses causing epidemic keratoconjunctivitis. Nat Med 2011;17:105-9.  Back to cited text no. 4
    
5.
World Health Organization. Case definitions for surveillance of severe acute respiratory syndrome (SARS).  Back to cited text no. 5
    
6.
Xia J, Tong J, Liu M, Shen Y, Guo D. Evaluation of coronavirus in tears and conjunctival secretions of patients with SARS-CoV-2 infection. J Med Virol 2020. doi: 10.1002/jmv. 25725. [Epub ahead of print].  Back to cited text no. 6
    
7.
Lu CW, Liu XF, Jia ZF. 2019-nCoV transmission through the ocular surface must not be ignored. Lancet 2020;395(10224):e39.  Back to cited text no. 7
    
8.
Loon SC, Teoh SC, Oon LL, Se-Thoe SY, Ling AE, Leo YS, et al. The severe acute respiratory syndrome coronavirus in tears. Br J Ophthalmol 2004;88:861-3.  Back to cited text no. 8
    
9.
Yunyun Zhou, Yuyang Zeng, Yongqing Tong, ChangZheng Chen. Ophthalmologic evidence against the interpersonal transmission of 2019 novel coronavirus through conjunctiva. med Rxiv 2020. doi: https://doi.org/10.1101/2020.02.11.20021956. (Preprint)  Back to cited text no. 9
    
10.
Zhang X, Chen X, Chen L, Deng C, Zou X, Liu W, et al. The evidence of SARS-CoV-2 infection on ocular surface. Ocul Surf. 2020 Apr 11. pii: S1542-0124(20)30065-3. doi: 10.1016/j.jtos.2020.03.010. [Epub ahead of print].  Back to cited text no. 10
    
11.
Yang Y, Yang M, Shen C, Wang F, Yuan J, Li J, et al. Laboratory diagnosis and monitoring the viral shedding of 2019-nCoVinfections. medRxiv preprint. doi: 10.1101/2020.02.11.20021493. (Preprint).  Back to cited text no. 11
    
12.
Memish ZA, Al-Tawfiq JA, Makhdoom HQ, Assiri A, Alhakeem RF, Albarrak A, et al. Respiratory tract samples, viral load, and genome fraction yield in patients with Middle East respiratory syndrome. J Infect Dis 2014;210:1590-4.  Back to cited text no. 12
    
13.
de Wit E, Rasmussen AL, Falzarano D, Bushmaker T, Feldmann F, Brining DL, et al. Middle East respiratory syndrome coronavirus (MERS-CoV) causes transient lower respiratory tract infection in rhesus macaques. Proc Natl Acad Sci U S A 2013;110:16598-603.  Back to cited text no. 13
    



 
 
    Tables

  [Table 1]


This article has been cited by
1 SARS-COV-2 viral load in tears of patients with COVID-19 in the early symptomatic stages: comparison of two different tear sampling methods
A. Sonmez, S. Aydin Kurna, F. G. Aslan, F. B. Kaplan, B. AÁikalin, P. Eker
International Ophthalmology. 2022;
[Pubmed] | [DOI]
2 COVID-19 and the eye: alternative facts The 2022 Bowman Club, David L. Easty lecture
Lawson Ung, James Chodosh
BMJ Open Ophthalmology. 2022; 7(1): e001042
[Pubmed] | [DOI]
3 SARS-CoV-2 RNA Detected in Vitreous Samples Obtained at Autopsy
Marisa Tieger, Upasana Das Adhikari, Shizuo Mukai, Mara Farcasnu, James R. Stone, Dean Eliott, Leo A. Kim, Douglas S. Kwon, Elizabeth J. Rossin
Journal of VitreoRetinal Diseases. 2022; : 2474126422
[Pubmed] | [DOI]
4 Ocular manifestations of COVID-19
Mashael Al-Namaeh
Therapeutic Advances in Ophthalmology. 2022; 14: 2515841422
[Pubmed] | [DOI]
5 Analysis of ophthalmic emergency visits during COVID-19 Lockdown in a tertiary eye care center in South India
SohamSubodhchandra Pal, MdShahid Alam, SarangMurlidharrao Giratkar, Bipasha Mukherjee
TNOA Journal of Ophthalmic Science and Research. 2022; 60(1): 2
[Pubmed] | [DOI]
6 Ocular Manifestations in Children with COVID-19: Systematic Review and Meta-Analysis
Naser Nasiri, Hamid Sharifi, Tahereh Rahimi, Ghodsieh Sharif, Ali Sharifi
Journal of Medical Microbiology and Infectious Diseases. 2022; 10(2): 58
[Pubmed] | [DOI]
7 Detection of coronavirus-2 by real-time reverse transcription polymerase chain reaction in conjunctival swabs from patients with severe form of Coronavirus disease 2019 in S„o Paulo, Brazil
Mariana Akemi Matsura Misawa, Tatiana Tanaka, TomŠs Minelli, Pedro Gomes Oliveira Braga, Juliana Mika Kato, Michele Soares Gomes GouvÍa, Jo„o Renato Rebello Pinho, Joyce Hisae Yamamoto
Clinics. 2021; 76
[Pubmed] | [DOI]
8 Fundus evaluation in COVID-19 positives with non-severe disease
Ravi Bypareddy, BL Sujatha Rathod, YD Shilpa, HR Hithashree, KalpanaBadami Nagaraj, BC Hemalatha, Jessica Basumatary, Deeksha Bekal, R Niranjan, PG Anusha
Indian Journal of Ophthalmology. 2021; 69(5): 1271
[Pubmed] | [DOI]
9 Vitreoretinal abnormalities in corona virus disease 2019 patients: What we know so far
Nathania Sutandi, Felix Lee
Taiwan Journal of Ophthalmology. 2021; 0(0): 0
[Pubmed] | [DOI]
10 Investigation of SARS-CoV-2 in tear and conjunctival secretions of hospitalized patients with clinically-confirmed COVID-19 pneumonia
Yunus Karabela, Semsi Nur Karabela, Mehmet Ozbas, Havva Kasikci, Kadriye Kart Yasar
BMC Infectious Diseases. 2021; 21(1)
[Pubmed] | [DOI]
11 Prevalence of SARS-CoV-2 amongst ophthalmologists throughout the first and second waves of the pandemic
Matteo Sacchi, Rosario Alfio Umberto Lizzio, Edoardo Villani, Elena Tagliabue, Gianluca Monsellato, Giorgio Pajardi, Saverio Luccarelli, Paolo Nucci
Medicine. 2021; 100(50): e28192
[Pubmed] | [DOI]
12 Response to comments on: Clinical profile and prevalence of conjunctivitis in mild COVID-19 patients in a tertiary care COVID-19 hospital: A retrospective cross-sectional study
K Sindhuja, Neiwete Lomi, MohamedI Asif, Radhika Tandon
Indian Journal of Ophthalmology. 2021; 69(1): 166
[Pubmed] | [DOI]
13 Propensity of aerosol and droplet creation during oculoplastic procedures: A risk assessment with high-speed imaging amidst COVID-19 pandemic
Roshmi Gupta, Khushboo Pandey, Rwituja Thomas, Saptarshi Basu, Bhujang Shetty, Rohit Shetty, AbhijitSinha Roy
Indian Journal of Ophthalmology. 2021; 69(3): 734
[Pubmed] | [DOI]
14 Bilateral neurorethinovasculitis associated with COVID-19 infection in a girl 17 years old
Ekaterina Denisova, E. N Demchenko, Elizaveta A. Geraskina, Mariia A. Khrabrova, Anna Y. Panova
Russian Pediatric Ophthalmology. 2021; 16(2): 41
[Pubmed] | [DOI]
15 A Year of Living Dangerously: Challenges and Recommendations for Safely Performing Ophthalmic Surgery During the COVID-19 Pandemic, from Start to Finish
Juan Pablo Salica, Constanza Potilinski, Marcia Querci, Ignacio Navarro, Juan SebastiŠn Rivero, Pablo Daponte, Roberto Pineda ll, Juan E Gallo
Clinical Ophthalmology. 2021; Volume 15: 261
[Pubmed] | [DOI]
16 Evidence of SARS-CoV-2 Transmission Through the Ocular Route
Jing-Yu Qu, Hua-Tao Xie, Ming-Chang Zhang
Clinical Ophthalmology. 2021; Volume 15: 687
[Pubmed] | [DOI]
17 Testing the Sensitivity of Conjunctival Swabs from Confirmed COVID-19 Patients
Manal Hadrawi, Mohammad Malak, Faeeqah Almahmoudi, Ahmed Mogharbel, Omar Rozy, Somaya Hanafi, Batool Ali, Sanaa Nabeel, Fatimah Fagieha, khaled Alzahrani
Clinical Ophthalmology. 2021; Volume 15: 2489
[Pubmed] | [DOI]
18 Wuhan to World: The COVID-19 Pandemic
Ashok Kumar, Rita Singh, Jaskaran Kaur, Sweta Pandey, Vinita Sharma, Lovnish Thakur, Sangeeta Sati, Shailendra Mani, Shailendra Asthana, Tarun Kumar Sharma, Susmita Chaudhuri, Sankar Bhattacharyya, Niraj Kumar
Frontiers in Cellular and Infection Microbiology. 2021; 11
[Pubmed] | [DOI]
19 Do Ocular Fluids Represent a Transmission Route of SARS-CoV-2 Infection?
Giulio Petronio Petronio, Roberto Di Marco, Ciro Costagliola
Frontiers in Medicine. 2021; 7
[Pubmed] | [DOI]
20 Exposure of Ophthalmologists to Patients' Exhaled Droplets in Clinical Practice: A Numerical Simulation of SARS-CoV-2 Exposure Risk
Yanchao Fan, Li Liu, Hui Zhang, Yingping Deng, Yi Wang, Mengjie Duan, Huan Wang, Lixiang Wang, Leifeng Han, Yalin Liu
Frontiers in Public Health. 2021; 9
[Pubmed] | [DOI]
21 Transmission of SARS-CoV-2 Indoor and Outdoor Environments
Xueli Xu, Jing Zhang, Liting Zhu, Qiansheng Huang
Atmosphere. 2021; 12(12): 1640
[Pubmed] | [DOI]
22 Manifestations and Virus Detection in the Ocular Surface of Adult COVID-19 Patients: A Meta-Analysis
Yu-Yen Chen, Yung-Feng Yen, Li-Ying Huang, Pesus Chou, Yedi Zhou
Journal of Ophthalmology. 2021; 2021: 1
[Pubmed] | [DOI]
23 Risk Assessment of Aerosol Generation During Vitreoretinal Surgery Using High Speed Imaging Amidst the COVID-19 Pandemic
Chaitra Jayadev, Thirumalesh Mochi Basavaraj, Khushboo Pandey, Roven Pinto, Shashi Prabha Pandey, Saptarshi Basu, Abhijit Sinha Roy, Rohit Shetty
Translational Vision Science & Technology. 2021; 10(12): 17
[Pubmed] | [DOI]
24 The impact of COVID-19 related national lockdown on ophthalmic emergency in Italy: A multicenter study
Maria L Salvetat, Carlo Salati, Patrizia Busatto, Marco Zeppieri
European Journal of Ophthalmology. 2021; : 1120672121
[Pubmed] | [DOI]
25 Ophthalmology-focused publications and findings on COVID-19: A systematic review
Ya-Ping Jin, Graham E Trope, Sherif El-Defrawy, Elin Y Liu, Yvonne M Buys
European Journal of Ophthalmology. 2021; 31(4): 1677
[Pubmed] | [DOI]
26 Detection of SARS-CoV-2 in conjunctival secretions from patients without ocular symptoms
Xin Li, Jasper Fuk-Woo Chan, Kenneth Kai-Wang Li, Eugene Yuk-Keung Tso, Cyril Chik-Yan Yip, Siddharth Sridhar, Tom Wai-Hin Chung, Kelvin Hei-Yeung Chiu, Derek Ling-Lung Hung, Alan Ka-Lun Wu, Sandy Ka-Yee Chau, Raymond Liu, Kwok-Cheung Lung, Anthony Raymond Tam, Vincent Chi-Chung Cheng, Kelvin Kai-Wang To, Kwok-Hung Chan, Ivan Fan-Ngai Hung, Kwok-Yung Yuen
Infection. 2021; 49(2): 257
[Pubmed] | [DOI]
27 Comparison of the simultaneous conjunctiva and oropharynxĖnasopharynx swab results in patients applying to the SARS-CoV-2 outpatient clinic for the first time
Ayten Gunduz, Murat Firat, Gamze Turkoglu
Journal of Medical Virology. 2021; 93(7): 4516
[Pubmed] | [DOI]
28 Evaluation of SARS-CoV-2 in Tears of Patients with Moderate to Severe COVID-19
Ritu Arora, Ruchi Goel, Sumit Kumar, Mohit Chhabra, Sonal Saxena, Vikas Manchanda, Palak Pumma
Ophthalmology. 2021; 128(4): 494
[Pubmed] | [DOI]
29 Ocular manifestations in COVID-19 patients: A systematic review and meta-analysis
Yueyang Zhong, Kai Wang, Yanan Zhu, Danni Lyu, Yinhui Yu, Su Li, Ke Yao
Travel Medicine and Infectious Disease. 2021; 44: 102191
[Pubmed] | [DOI]
30 Detection of three pandemic causing coronaviruses from non-respiratory samples: systematic review and meta-analysis
Chandan Mishra, Suneeta Meena, Jitendra Kumar Meena, Suman Tiwari, Purva Mathur
Scientific Reports. 2021; 11(1)
[Pubmed] | [DOI]
31 Evaluation of Nasopharyngeal and Conjunctival Swab Samples of Hospitalised Patients with Confirmed COVID-19
÷zkan Kocamis, Kemal ÷rnek, Nazife Asikgarip, Lokman Hizmali, Fikriye Milletli Sezgin, Yahya Sahin
Ocular Immunology and Inflammation. 2021; 29(4): 634
[Pubmed] | [DOI]
32 The Presence of SARS-CoV-2 in Conjunctival Secretions of COVID-19 Patients
Emine Ciloglu, Nese Cetin Dogan, Emre Ozdemir, Hatice Kaya, Pelin Duru Cetinkaya
Ocular Immunology and Inflammation. 2021; 29(4): 652
[Pubmed] | [DOI]
33 Comparative Evaluation of Tears and Nasopharyngeal Swab for SARS-CoV-2 in COVID-19 Dedicated Intensive Care Unit Patients
Ritu Arora, Ruchi Goel, Sonal Saxena, Vikas Manchanda, Mohammad Ahmad, Gaurav Gupta, Mohit Chhabra, Sumit Kumar, Tran Minh Nhu Nguyen, Payden, Palak Pumma, Kirti Saxena
Ocular Immunology and Inflammation. 2021; 29(4): 690
[Pubmed] | [DOI]
34 Glaucoma care during the coronavirus disease 2019 pandemic
Kateki Vinod, Paul A. Sidoti
Current Opinion in Ophthalmology. 2021; 32(2): 75
[Pubmed] | [DOI]
35 Propensity and quantification of aerosol and droplet creation during phacoemulsification with high-speed shadowgraphy amid COVID-19 pandemic
Naren Shetty, Luci Kaweri, Pooja Khamar, Nikhil Balakrishnan, Abdur Rasheed, Prasenjit Kabi, Saptarshi Basu, Rohit Shetty, Rudy M.M.A. Nuijts, Abhijit Sinha Roy
Journal of Cataract and Refractive Surgery. 2020; 46(9): 1297
[Pubmed] | [DOI]
36 Quantitative shadowgraphy of aerosol and droplet creation during oscillatory motion of the microkeratome amid COVID-19 and other infectious diseases
Pooja Khamar, Rohit Shetty, Nikhil Balakrishnan, Prasenjit Kabi, Durbar Roy, Saptarshi Basu, Abhijit Sinha Roy
Journal of Cataract and Refractive Surgery. 2020; 46(10): 1416
[Pubmed] | [DOI]
37 Coronavirus global pandemic: An overview of current findings among pediatric patients
Evanthia Perikleous, Aggelos Tsalkidis, Andrew Bush, Emmanouil Paraskakis
Pediatric Pulmonology. 2020; 55(12): 3252
[Pubmed] | [DOI]
38 Systematic Review of Ocular Involvement of SARS-CoV-2 in Coronavirus Disease 2019
Kai Xiong Cheong
Current Ophthalmology Reports. 2020; 8(4): 185
[Pubmed] | [DOI]
39 Commentary: Exploring the transmission of COVID-19 through the ocular surface
Joveeta Joseph
Indian Journal of Ophthalmology. 2020; 68(6): 1018
[Pubmed] | [DOI]
40 To evaluate the effect of COVID-19 pandemic and national lockdown on patient care at a tertiary-care ophthalmology institute
Naresh Babu, Piyush Kohli, Chitaranjan Mishra, Sagnik Sen, Dhipak Arthur, Deepesh Chhablani, Girish Baliga, Kim Ramasamy
Indian Journal of Ophthalmology. 2020; 68(8): 1540
[Pubmed] | [DOI]
41 Non-contact tonometer use during the COVID-19 pandemic
Dinesh Talwar, Harsh Kumar, Mithun Thulasidas
Indian Journal of Ophthalmology. 2020; 68(7): 1492
[Pubmed] | [DOI]
42 The SARS-CoV-2, tears, and ocular surface debate: What we know and what we need to know
MohammadJaved Ali
Indian Journal of Ophthalmology. 2020; 68(7): 1245
[Pubmed] | [DOI]
43 Nosocomial COVID-19 transmission in routine ophthalmic practiceóIs there new evidence?
SantoshG Honavar
Indian Journal of Ophthalmology. 2020; 68(10): 2059
[Pubmed] | [DOI]
44 Phacoemulsification andCOVID-19 risk
Michael Goggin, Brendan Vote
Clinical & Experimental Ophthalmology. 2020; 48(9): 1131
[Pubmed] | [DOI]
45 Are eyes the windows to COVID-19? Systematic review and meta-analysis
Rina La Distia Nora, Ikhwanuliman Putera, Dhiya Farah Khalisha, Indah Septiana, Asri Salima Ridwan, Ratna Sitompul
BMJ Open Ophthalmology. 2020; 5(1): e000563
[Pubmed] | [DOI]
46 On the whereabouts of SARS-CoV-2 in the human body: A systematic review
Wim Trypsteen, Jolien Van Cleemput, Willem van Snippenberg, Sarah Gerlo, Linos Vandekerckhove, Craig B. Wilen
PLOS Pathogens. 2020; 16(10): e1009037
[Pubmed] | [DOI]
47 Fundus Lesions in Patients Hospitalized With COVID-19 Infection in Mumbai, India: A Retrospective Review
Salil Mehta, Prahlad Prabhudesai
Cureus. 2020;
[Pubmed] | [DOI]



 

Top
 
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
Abstract
Methods
Results
Discussion
Conclusion
References
Article Tables

 Article Access Statistics
    Viewed5200    
    Printed20    
    Emailed0    
    PDF Downloaded887    
    Comments [Add]    
    Cited by others 47    

Recommend this journal