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Xiao Y, Wang L, Li SX, Fang SS, Luo F, Chen SL, Zou X, Ye L, Hou W. Conditional reprogrammed human limbal epithelial cell model for anti-SARS-CoV-2 drug screening. Heliyon 2024; 10:e30044. [PMID: 38698981 PMCID: PMC11064458 DOI: 10.1016/j.heliyon.2024.e30044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/15/2024] [Accepted: 04/18/2024] [Indexed: 05/05/2024] Open
Abstract
To minimize the global pandemic COVID-19 spread, understanding the possible transmission routes of SARS-CoV-2 and discovery of novel antiviral drugs are necessary. We describe here that the virus can infect ocular surface limbal epithelial, but not other regions. Limbal supports wild type and mutant SARS-CoV-2 entry and replication depending on ACE2, TMPRSS2 and possibly other receptors, resulting in slight CPE and arising IL-6 secretion, which symbolizes conjunctivitis in clinical symptoms. With this limbal model, we have screened two natural product libraries and discovered several unreported drugs. Our data reveal important commonalities between COVID-19 and ocular infection with SARS-CoV-2, and establish an ideal cell model for drug screening and mechanism research.
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Affiliation(s)
- Yu Xiao
- Shenzhen Research Institute, Wuhan University, Shenzhen 518057, Guangdong Province, China
- Department of Clinical Laboratory, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, 518107, China
| | - Ling Wang
- Shenzhen Eye Hospital, Shenzhen 518040, Guangdong Province, China
| | - Shi-xu Li
- Shenzhen Eye Hospital, Shenzhen 518040, Guangdong Province, China
| | - Shi-song Fang
- Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, Guangdong Province, China
| | - Fan Luo
- State Key Laboratory of Virology/Institute of Medical Virology, School of Basic Medical Sciences, Wuhan University, Wuhan 430071, Hubei Province, China
| | - Shu-liang Chen
- State Key Laboratory of Virology/Institute of Medical Virology, School of Basic Medical Sciences, Wuhan University, Wuhan 430071, Hubei Province, China
| | - Xuan Zou
- Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, Guangdong Province, China
| | - Lin Ye
- Shenzhen Eye Hospital, Shenzhen 518040, Guangdong Province, China
| | - Wei Hou
- Shenzhen Research Institute, Wuhan University, Shenzhen 518057, Guangdong Province, China
- State Key Laboratory of Virology/Institute of Medical Virology, School of Basic Medical Sciences, Wuhan University, Wuhan 430071, Hubei Province, China
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La Distia Nora R, Zahra SS, Riasanti M, Fatimah A, Ningtias RD, Ibrahim F, Bela B, Handayani RD, Yasmon A, Susiyanti M, Edwar L, Aziza Y, Sitompul R. Dry eye symptoms are prevalent in moderate-severe COVID-19, while SARS-COV-2 presence is higher in mild COVID-19: Possible ocular transmission risk of COVID-19. Heliyon 2024; 10:e28649. [PMID: 38586378 PMCID: PMC10998079 DOI: 10.1016/j.heliyon.2024.e28649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 03/17/2024] [Accepted: 03/21/2024] [Indexed: 04/09/2024] Open
Abstract
Purpose To evaluate the correlation between dry eye symptoms and coronavirus disease 2019 (COVID-19) infection and to assess the real-time reverse transcription-polymerase chain reaction (RT‒PCR) of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) from the conjunctival swab. Methods A prospective observational case series study was conducted of all suspected and confirmed COVID-19 patients from Dr. Cipto Mangunkusumo Hospital (RSCM) and the Universitas Indonesia Hospital (RSUI). On the first day of the visit (day 0), systemic clinical symptoms and naso-oropharyngeal (NO) RT‒PCR results will classify all subjects as non-, suspected, or confirmed (mild, moderate, and severe) COVID-19. In all patients, we determined the dry eye symptoms based on the Ocular Surface Disease Index (OSDI) and followed up 7(day 7) and 14 days (day 14) after the first visit. When it was technically possible, we also examined the objective dry eye measurements: tear meniscus height (TMH), noninvasive Keratograph® break-up time (NIKBUT), and ocular redness. Additionally, we took conjunctival swab samples for SARS-CoV-2 RT-PCR in all patients. Results The OSDI scores for 157 patients decreased across days 0, 7, and 14 (median (interquartile range): 2.3 (0-8), 0 (0-3), and 0 (0-0), p value < 0.0001 (D0 vs D14). The moderate-severe COVID-19 group had a higher OSDI score than the other groups at median D0 (15.6 vs 0-2.3), p value < 0.0001 and this pattern was consistently seen at follow-up D7 and D14. However, dry eye complaints were not correlated with the three objective dry eye measurements in mild-moderate COVID-19 patients. NO RT‒PCR results were positive in 32 (20.4%) patients, namely, 13 and 19 moderate-severe and mild COVID-19 patients, respectively. Positive RT‒PCR results were observed in 7/157 (4.5%) conjunctival swab samples from 1 in non-COVID-19 group and 6 in mild group. Conclusion In the early phase of infection, COVID-19 patients experience dry eye symptoms, which have no correlation with objective dry eye measurements. SARS-CoV-2 in conjunctival swab samples can be detected in patients with normal-to-mild COVID-19, which shows the risk of ocular transmission.
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Affiliation(s)
- Rina La Distia Nora
- Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia – Cipto Mangunkusumo Kirana Eye Hospital, Jakarta, Indonesia
- Universitas Indonesia Hospital (RSUI), Depok, West Java, Indonesia
- Wisma Atlet COVID-19 Emergency Hospital, North Jakarta, Jakarta, Indonesia
| | | | - Mei Riasanti
- Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia – Cipto Mangunkusumo Kirana Eye Hospital, Jakarta, Indonesia
| | - Aliya Fatimah
- Wisma Atlet COVID-19 Emergency Hospital, North Jakarta, Jakarta, Indonesia
| | - Rani Dwi Ningtias
- Wisma Atlet COVID-19 Emergency Hospital, North Jakarta, Jakarta, Indonesia
| | - Fera Ibrahim
- Universitas Indonesia Hospital (RSUI), Depok, West Java, Indonesia
- Department of Microbiology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia – Cipto Mangunkusumo, Jakarta, Indonesia
| | - Budiman Bela
- Universitas Indonesia Hospital (RSUI), Depok, West Java, Indonesia
- Department of Microbiology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia – Cipto Mangunkusumo, Jakarta, Indonesia
| | - R.R. Diah Handayani
- Universitas Indonesia Hospital (RSUI), Depok, West Java, Indonesia
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia - Persahabatan Hospital, Jakarta, Indonesia
| | - Andi Yasmon
- Department of Microbiology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia – Cipto Mangunkusumo, Jakarta, Indonesia
| | - Made Susiyanti
- Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia – Cipto Mangunkusumo Kirana Eye Hospital, Jakarta, Indonesia
| | - Lukman Edwar
- Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia – Cipto Mangunkusumo Kirana Eye Hospital, Jakarta, Indonesia
| | - Yulia Aziza
- Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia – Cipto Mangunkusumo Kirana Eye Hospital, Jakarta, Indonesia
| | - Ratna Sitompul
- Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia – Cipto Mangunkusumo Kirana Eye Hospital, Jakarta, Indonesia
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Hutsaliuk K, Skalska N, Ulianova N. Retinal Changes in Patients With Covid-19 and Different Expressiveness of Metabolic Changes. CESKA A SLOVENSKA OFTALMOLOGIE : CASOPIS CESKE OFTALMOLOGICKE SPOLECNOSTI A SLOVENSKE OFTALMOLOGICKE SPOLECNOSTI 2024; 80:156-166. [PMID: 38527912 DOI: 10.31348/2024/12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
AIMS To study the relationship between the severity of COVID-induced metabolic changes and the structure and frequency of retinal changes, according to funduscopy data in patients with different clinical courses of COVID-19. MATERIALS AND METHODS 117 patients with COVID-19 were examined. While examining patients, severity of the course of COVID-19, the expressiveness of changes in the metabolic status were determined; fundus image registration was performed with portable fundus cameras Pictor Plus Fundus Camera and VistaView (Volk Optical). RESULTS As a result of the research, retinal changes were found in 49 (41.9 %) patients with COVID-19. In 8 (16.3 %) cases, clinically significant (vitreous hemorrhage, prethrombosis of the central retinal vein or branches of the central retinal vein, thrombosis of the central retinal vein or branches of the central retinal vein) COVID-induced retinal and ophthalmological changes were observed, which caused a decrease in visual acuity. In 41 (83.7 %) cases, clinically insignificant changes (cotton wool spots, narrowed retinal vessels, intraretinal and petechial hemorrhages, tortuosity and dilatation of retinal venules) COVID-induced retinal changes were observed. Clinically significant retinal changes occur in patients with a statistically significantly higher level of D-dimer and a greater percentage of lung parenchyma lesion than in the group of patients with clinically insignificant retinal changes (p < 0.05). CONCLUSIONS The structure of retinal changes in patients with COVID-19 correlates with the severity of the clinical course of the disease and changes in the metabolic status of patients. Metabolic changes are correlated with retinal changes and can be predictive for preventing general vascular complications in COVID-19.
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Gronbeck C, Grzybowski A, Grant-Kels JM. COVID-19 and the eye. Clin Dermatol 2024; 42:17-24. [PMID: 37865278 DOI: 10.1016/j.clindermatol.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2023]
Abstract
There is growing literature describing the ocular manifestations of COVID-19. We have assessed published reviews, cross-sectional analyses, and clinical reports to summarize the ocular manifestations of the disease and available vaccines, identify the potential role of ocular transmission, and offer basic clinical guidance to health care providers. Ultimately, self-limiting conjunctivitis and conjunctival hyperemia are the most frequently reported ocular findings; several rarer entities may warrant targeted topical therapies. COVID-19 vaccines have been infrequently associated with the development of rare but significant side effects that may warrant ophthalmologist referral as well as specific treatments. Despite the overall low risk of ocular transmission, eye protection is advisable for health care providers in high-risk scenarios. This review should help to guide the assessment of patients with eye complaints in the setting of COVID-19 to promote appropriate diagnosis, treatment, monitoring, and referral.
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Affiliation(s)
- Christian Gronbeck
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland; Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Poznan, Poland
| | - Jane M Grant-Kels
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut, USA; Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA.
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Mehringer W, Stoeve M, Krauss D, Ring M, Steussloff F, Güttes M, Zott J, Hohberger B, Michelson G, Eskofier B. Virtual reality for assessing stereopsis performance and eye characteristics in Post-COVID. Sci Rep 2023; 13:13167. [PMID: 37574496 PMCID: PMC10423723 DOI: 10.1038/s41598-023-40263-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/08/2023] [Indexed: 08/15/2023] Open
Abstract
In 2019, we faced a pandemic due to the coronavirus disease (COVID-19), with millions of confirmed cases and reported deaths. Even in recovered patients, symptoms can be persistent over weeks, termed Post-COVID. In addition to common symptoms of fatigue, muscle weakness, and cognitive impairments, visual impairments have been reported. Automatic classification of COVID and Post-COVID is researched based on blood samples and radiation-based procedures, among others. However, a symptom-oriented assessment for visual impairments is still missing. Thus, we propose a Virtual Reality environment in which stereoscopic stimuli are displayed to test the patient's stereopsis performance. While performing the visual tasks, the eyes' gaze and pupil diameter are recorded. We collected data from 15 controls and 20 Post-COVID patients in a study. Therefrom, we extracted features of three main data groups, stereopsis performance, pupil diameter, and gaze behavior, and trained various classifiers. The Random Forest classifier achieved the best result with 71% accuracy. The recorded data support the classification result showing worse stereopsis performance and eye movement alterations in Post-COVID. There are limitations in the study design, comprising a small sample size and the use of an eye tracking system.
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Affiliation(s)
- Wolfgang Mehringer
- Machine Learning and Data Analytics Lab (MaD Lab), Department Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91052, Erlangen, Bavaria, Germany.
| | - Maike Stoeve
- Machine Learning and Data Analytics Lab (MaD Lab), Department Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91052, Erlangen, Bavaria, Germany
| | - Daniel Krauss
- Machine Learning and Data Analytics Lab (MaD Lab), Department Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91052, Erlangen, Bavaria, Germany
| | - Matthias Ring
- Machine Learning and Data Analytics Lab (MaD Lab), Department Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91052, Erlangen, Bavaria, Germany
| | - Fritz Steussloff
- Department of Ophthalmology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054, Erlangen, Germany
| | - Moritz Güttes
- Department of Ophthalmology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054, Erlangen, Germany
| | - Julia Zott
- Department of Ophthalmology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054, Erlangen, Germany
| | - Bettina Hohberger
- Department of Ophthalmology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054, Erlangen, Germany
| | - Georg Michelson
- Department of Ophthalmology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054, Erlangen, Germany
- Talkingeyes & More GmbH, 91052, Erlangen, Bavaria, Germany
| | - Bjoern Eskofier
- Machine Learning and Data Analytics Lab (MaD Lab), Department Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91052, Erlangen, Bavaria, Germany
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Premi E, Acampora R, Salmi D, Ilie IA, Pagnoncelli N, Germano F, Gandolfi G, Sanicas M, Seed A, Michael BD, Donati S, Azzolini C, Lanfranchi F. Clinical and Diagnostic Findings of Acute Macular Neuroretinopathy and Paracentral Acute Middle Maculopathy in the COVID-19 Era. Ophthalmologica 2023; 246:181-191. [PMID: 37573773 PMCID: PMC10614461 DOI: 10.1159/000533530] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 08/03/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND Growing evidence suggests an association between the infection from the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and eye disorders. The aim of this review was to analyze the clinical presentation and diagnostic features of acute macular neuroretinopathy (AMN) and paracentral acute middle maculopathy (PAMM) associated with COVID-19 infection. The features are then compared with previous reports regarding these retinal disorders, to recognize possible specific characteristics and to assess the role of multimodal ophthalmic imaging. SUMMARY A literature search was performed by consulting PubMed, Scopus, and Embase. The following terms were searched: "(COVID-19 OR SARS-CoV-2 OR coronavirus) AND ([acute macular neuroretinopathy] OR [paracentral acute middle maculopathy])." Inclusion criteria were as follows: (1) publication date from January 31, 2020 to January 31, 2022; (2) English language; (3) original research or case report; (4) free full-text availability.Optical coherence tomography (OCT) findings in AMN patients were hyper-reflectivity (HR) of the outer plexiform layer, of the outer nuclear layer, and ellipsoid or interdigitation zones (EZ and IZ, respectively) disruption. In most cases, the presence of HR and EZ/IZ abnormalities resulted combined. When performed, OCT angiography (OCTA) identified attenuation of signal of the deep capillary plexus (DCP). The most common OCT finding in PAMM was an alteration of the inner nuclear layer, associated with other areas of HR, while no signs of EZ/IZ disruption were detected. When performed, OCTA showed the attenuation of signal of both the DCP and the superficial capillary plexus. KEY MESSAGES In this review, we reported a case series of AMN and PAMM in patients with a previous or concomitant infection from SARS-CoV-2. The microvascular changes in these cases are highlighted by the OCTA scans. Even if we are far from the determination of a direct link between COVID-19 and these retinal disorders, we could hypothesize that the vascular alterations associated with SARS-CoV-2 infection could be a possible risk factor for both AMN and PAMM.
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Affiliation(s)
- Elias Premi
- Ophthalmology Unit, ASST Sette Laghi, Circolo Hospital and Macchi Foundation, Varese, Italy
- Department of Biotechnologies and Life Sciences, University of Insubria, Varese, Italy
| | - Roberto Acampora
- Milan Center for Neuroscience (NeuroMI), Milan, Italy
- Neurology and Stroke-Unit, Hospital Ospedale del Mare, Naples, Italy
| | - Davide Salmi
- Anesthesia and Intensive Care Unit, Biotechnology and Life Sciences Department, University of Insubria, Varese, Italy
| | - Ingrid Andrea Ilie
- Department of Life Sciences and Biotechnology, School of Biology, University of Ferrara, Ferrara, Italy
| | - Nadia Pagnoncelli
- Psychiatry Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Francesco Germano
- Neurology Unit, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Greta Gandolfi
- Anesthesia and Intensive Care Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Melvin Sanicas
- Clinical – Vaccines, Clover Biopharmaceuticals, Zurich, Switzerland
| | - Adam Seed
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
- Clinical Infection Microbiology and Neuroimmunology, Institute of Infection, Veterinary and Ecological Science, Liverpool, UK
- The NIHR Health Protection Research Unit for Emerging and Zoonotic Infection, Liverpool, UK
| | - Benedict Daniel Michael
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
- Clinical Infection Microbiology and Neuroimmunology, Institute of Infection, Veterinary and Ecological Science, Liverpool, UK
- The NIHR Health Protection Research Unit for Emerging and Zoonotic Infection, Liverpool, UK
| | - Simone Donati
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Claudio Azzolini
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Francesco Lanfranchi
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Genoa, Italy
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Ding Q, Zhao H. Long-term effects of SARS-CoV-2 infection on human brain and memory. Cell Death Discov 2023; 9:196. [PMID: 37380640 DOI: 10.1038/s41420-023-01512-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/05/2023] [Accepted: 06/20/2023] [Indexed: 06/30/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants have caused several waves of outbreaks. From the ancestral strain to Omicron variant, SARS-CoV-2 has evolved with the high transmissibility and increased immune escape against vaccines. Because of the multiple basic amino acids in the S1-S2 junction of spike protein, the widespread distribution of angiotensin-converting enzyme 2 (ACE2) receptor in human body and the high transmissibility, SARS-CoV-2 can infect multiple organs and has led to over 0.7 billion infectious cases. Studies showed that SARS-CoV-2 infection can cause more than 10% patients with the Long-COVID syndrome, including pathological changes in brains. This review mainly provides the molecular foundations for understanding the mechanism of SARS-CoV-2 invading human brain and the molecular basis of SARS-CoV-2 infection interfering with human brain and memory, which are associated with the immune dysfunction, syncytia-induced cell death, the persistence of SARS-CoV-2 infection, microclots and biopsychosocial aspects. We also discuss the strategies for reducing the Long-COVID syndrome. Further studies and analysis of shared researches will allow for further clarity regarding the long-term health consequences.
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Affiliation(s)
- Qiulu Ding
- School of Finance and Business, Shanghai Normal University, Shanghai, China
- School of Education, Shanghai Normal University, Shanghai, China
| | - HanJun Zhao
- Department of Microbiology, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China.
- Centre for Virology, Vaccinology and Therapeutics, Science Park, Hong Kong Special Administrative Region, China.
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Susiyanti M, Daniel H, Faridah D, Devona DA, Pramitha P, Bela B, Haryanto B, Barliana JD, Estu D, Victor AA, Putri ND, Candra J, Sutandi N, Sitorus RS. Incidence and clinical characteristic of ocular surface manifestation: an evaluation of conjunctival swab results in Corona Virus 2019 (COVID-19) patients in Jakarta, Indonesia. J Ophthalmic Inflamm Infect 2023; 13:20. [PMID: 37097586 PMCID: PMC10127182 DOI: 10.1186/s12348-023-00343-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 04/07/2023] [Indexed: 04/26/2023] Open
Abstract
OBJECTIVES This study aimed to investigate the spectrum of ocular characteristics and viral presence in the conjunctival swab of patients with COVID-19. METHODS In this cross-sectional study, fifty-three patients were recruited from two COVID-19 referral hospitals in Jakarta (Cipto Mangunkusumo Hospital and Persahabatan Hospital) from July 2020 to March 2021. The inclusion criteria were patients who were suspected of or confirmed cases of COVID-19 with or without ocular symptoms. Demographic data, history of COVID-19 exposure, underlying medical condition, systemic symptoms, ocular symptoms, supporting laboratory results, reverse-transcriptase polymerase chain reaction (RT-PCR) of naso-oropharyngeal (NOP) swab and conjunctival swab were collected. RESULTS Fifty-three patients who were suspected, probable or confirmed cases of Covid-19 were included. Forty-six out of 53 patients (86.79%) tested positive for either Covid-19 antibody rapid test or naso-oropharyngeal (NOP) swab. Forty-two patients tested positive for NOP swab. Fourteen out of 42 patients (33.33%) experienced symptoms of ocular infection including red eye, epiphora, itchy eyes, and eye discharge. None of these patients were tested positive for conjunctival swab. Two out of 42 patients (4.76%), who were tested positive for conjunctival swab, did not experience any ocular symptoms. CONCLUSIONS Establishing the relationship between Covid-19 infection, ocular symptoms, and presence of SARS-CoV-2 virus on the ocular surface proves to be challenging. In Covid-19 patients, ocular symptoms did not warrant a positive conjunctival swab result. On the contrary, a patient without ocular symptoms can also have detectable presence of SARS-CoV-2 virus on the ocular surface.
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Affiliation(s)
- Made Susiyanti
- Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jalan Kimia No. 8-10, Jakarta, 10320, Indonesia
| | - Hisar Daniel
- Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jalan Kimia No. 8-10, Jakarta, 10320, Indonesia
| | - Diah Faridah
- Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Persahabatan Hospital, Jakarta, Indonesia
| | - Dinda Arken Devona
- Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Persahabatan Hospital, Jakarta, Indonesia
| | - Pradnya Pramitha
- Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Persahabatan Hospital, Jakarta, Indonesia
| | - Budiman Bela
- Department of Clinical Microbiology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
| | - Budi Haryanto
- Department of Clinical Microbiology, Faculty of Medicine Universitas Indonesia, Persahabatan Hospital, Jakarta, Indonesia
| | - Julie Dewi Barliana
- Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jalan Kimia No. 8-10, Jakarta, 10320, Indonesia
| | - Dian Estu
- Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jalan Kimia No. 8-10, Jakarta, 10320, Indonesia
| | - Andi Arus Victor
- Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jalan Kimia No. 8-10, Jakarta, 10320, Indonesia
| | - Nina Dwi Putri
- Department of Child Health, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
| | - Julius Candra
- Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jalan Kimia No. 8-10, Jakarta, 10320, Indonesia
| | - Nathania Sutandi
- Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jalan Kimia No. 8-10, Jakarta, 10320, Indonesia
| | - Rita S Sitorus
- Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jalan Kimia No. 8-10, Jakarta, 10320, Indonesia.
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Brechbühl J, Ferreira F, Lopes AC, Corset E, Gilliand N, Broillet MC. Ocular Symptoms Associated with COVID-19 Are Correlated with the Expression Profile of Mouse SARS-CoV-2 Binding Sites. Viruses 2023; 15:354. [PMID: 36851565 PMCID: PMC9961464 DOI: 10.3390/v15020354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/19/2023] [Accepted: 01/24/2023] [Indexed: 01/28/2023] Open
Abstract
The COVID-19 pandemic has engendered significant scientific efforts in the understanding of its infectious agent SARS-CoV-2 and of its associated symptoms. A peculiar characteristic of this virus lies in its ability to challenge our senses, as its infection can lead to anosmia and ageusia. While ocular symptoms, such as conjunctivitis, optic neuritis or dry eyes, are also reported after viral infection, they have lower frequencies and severities, and their functional development is still elusive. Here, using combined technical approaches based on histological and gene profiling methods, we characterized the expression of SARS-CoV-2 binding sites (Ace2/Tmprss2) in the mouse eye. We found that ACE2 was ectopically expressed in subtissular ocular regions, such as in the optic nerve and in the Harderian/intraorbital lacrimal glands. Moreover, we observed an important variation of Ace2/Tmprss2 expression that is not only dependent on the age and sex of the animal, but also highly heterogenous between individuals. Our results thus give new insight into the expression of SARS-CoV-2 binding sites in the mouse eye and propose an interpretation of the human ocular-associated symptoms linked to SARS-CoV-2.
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Affiliation(s)
- Julien Brechbühl
- Department of Biomedical Sciences, Faculty of Biology and Medicine, University of Lausanne, Bugnon 27, CH-1011 Lausanne, Switzerland
| | | | | | | | | | - Marie-Christine Broillet
- Department of Biomedical Sciences, Faculty of Biology and Medicine, University of Lausanne, Bugnon 27, CH-1011 Lausanne, Switzerland
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Zhu R, Yu ZY, Han L. Insights on the possibility of SARS-CoV-2 transmission through the eyes. Int J Ophthalmol 2022; 15:1857-1863. [PMID: 36404966 PMCID: PMC9631193 DOI: 10.18240/ijo.2022.11.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 08/26/2022] [Indexed: 12/12/2022] Open
Abstract
A novel coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or 2019-nCOV), causing coronavirus disease 2019 (COVID-19), has rapidly spread to most countries and regions worldwide since it broke out at the end of 2019. Epidemic of the virus produces a tremendous pressure on the global health systems. With progressive insight into SARS-CoV-2, the role of eye tissue has attracted wide attention in the spread of COVID-19. Whether SARS-CoV-2 can enter the human body through eyes and cause infection? The fact that unprotected exposure of the eyes to 2019-nCoV might have allowed the virus to infect the body implies that 2019-nCOV can invade eye tissue and set foot in organism. Facing the severe challenge of preventing spread of the COVID-19, combined with the high-risk environment of ophthalmology, it is crucial to investigate ocular tropism of coronavirus. This paper explores the possibility of coronavirus transmission through the eye from aspects of probable mechanisms, clinical cases, detection of coronavirus; and puts forward precautions for ophthalmologists and nurses. Consequently, this review reveals our understanding of ocular tropism of coronavirus and contributes to determining risk of ocular transmission, raising awareness of necessary eye protection among medical workers and reducing further prevalence of SARS-CoV-2.
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Affiliation(s)
- Rui Zhu
- Department of Ophthalmology, the Fourth Affiliated Hospital of China Medical University, Shenyang 110005, Liaoning Province, China
- Eye Hospital of China Medical University, Shenyang 110005, Liaoning Province, China
- Key Lens Research Laboratory of Liaoning Province, Shenyang 110005, Liaoning Province, China
- China Medical University, Shenyang 110122, Liaoning Province, China
| | - Zi-Yan Yu
- Department of Ophthalmology, the Fourth Affiliated Hospital of China Medical University, Shenyang 110005, Liaoning Province, China
- Eye Hospital of China Medical University, Shenyang 110005, Liaoning Province, China
- Key Lens Research Laboratory of Liaoning Province, Shenyang 110005, Liaoning Province, China
| | - Lin Han
- Department of Ophthalmology, the Fourth Affiliated Hospital of China Medical University, Shenyang 110005, Liaoning Province, China
- Eye Hospital of China Medical University, Shenyang 110005, Liaoning Province, China
- Key Lens Research Laboratory of Liaoning Province, Shenyang 110005, Liaoning Province, China
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Zauli G, AlHilali S, Al-Swailem S, Secchiero P, Voltan R. Therapeutic potential of the MDM2 inhibitor Nutlin-3 in counteracting SARS-CoV-2 infection of the eye through p53 activation. Front Med (Lausanne) 2022; 9:902713. [PMID: 35911386 PMCID: PMC9329687 DOI: 10.3389/fmed.2022.902713] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 06/27/2022] [Indexed: 01/08/2023] Open
Abstract
Starting from the beginning of the severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) global pandemic, most of the published data has concentrated on the respiratory signs and symptoms of Covid-19 infection, underestimating the presence and importance of ocular manifestations, such as conjunctivitis, usually reported in SARS-CoV-2 infected patients. With the present review we intend to resume the ocular involvement in SARS-CoV-2 infection and the recent discoveries about the different cell types and tissues of the eye that can be directly infected by SARS-CoV-2 and propagate the infection. Moreover, reviewing literature data about p53 expression in normal and diseased eye tissues, we hypothesize that the pleiotropic protein p53 present at high levels in cornea, conjunctiva and tear film might play a protective role against SARS-CoV-2 infection. Since p53 can be easily up-regulated by using small molecule non-genotoxic inhibitors of MDM2, we propose that topical use of Nutlin-3, the prototype member of MDM2 inhibitors, might protect the anterior surface of the eye from SARS-CoV-2 infection, reducing the spreading of the virus.
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Affiliation(s)
- Giorgio Zauli
- Research Department, King Khaled Eye Specialistic Hospital, Riyadh, Saudi Arabia
- *Correspondence: Giorgio Zauli
| | - Sara AlHilali
- Research Department, King Khaled Eye Specialistic Hospital, Riyadh, Saudi Arabia
| | - Samar Al-Swailem
- Research Department, King Khaled Eye Specialistic Hospital, Riyadh, Saudi Arabia
| | - Paola Secchiero
- Department of Translational Medicine and LTTA Centre, University of Ferrara, Ferrara, Italy
| | - Rebecca Voltan
- Department of Environmental and Prevention Sciences and LTTA Centre, University of Ferrara, Ferrara, Italy
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Roles and Mechanisms of Regulated Necrosis in Corneal Diseases: Progress and Perspectives. J Ophthalmol 2022; 2022:2695212. [PMID: 35655803 PMCID: PMC9152437 DOI: 10.1155/2022/2695212] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/24/2022] [Accepted: 05/09/2022] [Indexed: 11/21/2022] Open
Abstract
Regulated necrosis is defined as cell death characterized by loss of the cell membrane integrity and release of the cytoplasmic content. It contributes to the development and progression of some diseases, including ischemic stroke injury, liver diseases, hypertension, and cancer. Various forms of regulated necrosis, particularly pyroptosis, necroptosis, and ferroptosis, have been implicated in the pathogenesis of corneal disease. Regulated necrosis of corneal cells enhances inflammatory reactions in the adjacent corneal tissues, leading to recurrence and aggravation of corneal disease. In this review, we summarize the molecular mechanisms of pyroptosis, necroptosis, and ferroptosis in corneal diseases and discuss the roles of regulated necrosis in inflammation regulation, tissue repair, and corneal disease outcomes.
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