Presence of SARS-CoV-2 Viral RNA in Aqueous Humor of Asymptomatic Individuals.

Journal Article (Journal Article)

PURPOSE: The purpose of this study was to determine whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is detectable in the aqueous of asymptomatic individuals presenting for ophthalmic surgery. DESIGN: Prospective cross-sectional study. METHODS: Setting and participants: all patients undergoing anterior segment surgery at an ambulatory surgical center (ASC) belonging to a tertiary academic center in South Florida during a 102-day period between June and September 2020 received nasal swab testing for SARS-CoV-2 and underwent a relevant review of symptoms prior to surgery, with negative results required for both in order to proceed with surgery. Main outcomes and measurements: a small sample of aqueous humor (approximately 0.2 cc) was acquired at the beginning of anterior segment surgery from all participants. Aqueous humor was analyzed for SARS-CoV-2 viral ribonucleic acid (RNA) using real-time reverse transcriptase polymerase chain reaction. Demographic information was acquired from participants for secondary analyses. RESULTS: A total of 70 samples were acquired. Of those, 39 samples were excluded due to insufficient material or inconclusive results. Of 31 samples that were successfully analyzed, 6 (19.4%) demonstrated detectable SARS-CoV-2 RNA. None of the 6 individuals (0%) with detectable viral RNA in aqueous humor reported symptoms during the year, compared to 2 of 25 individuals (8%) with negative samples (P = 1). Positive samples were distributed throughout the study period, including both the first and the last days of enrollment. CONCLUSIONS: The presence of SARS-CoV-2 viral RNA in aqueous despite negative nasal swab testing confirmed its presence beyond the blood-ocular barrier in asymptomatic individuals and raises the possibility that the virus may persist in immunoprivileged spaces despite an absence of symptoms.

Full Text

Duke Authors

Cited Authors

  • Koo, EH; Eghrari, AO; Dzhaber, D; Shah, A; Fout, E; Dubovy, S; Maestre-Mesa, J; Miller, D

Published Date

  • October 2021

Published In

Volume / Issue

  • 230 /

Start / End Page

  • 151 - 155

PubMed ID

  • 34022227

Pubmed Central ID

  • PMC8132502

Electronic International Standard Serial Number (EISSN)

  • 1879-1891

Digital Object Identifier (DOI)

  • 10.1016/j.ajo.2021.05.008


  • eng

Conference Location

  • United States