Detection of SARS-CoV-2 virus on the ocular surface of an asymptomatic health-care professional / Detecção do vírus SARS-CoV-2 na superfície ocular de um professional de saúde assintomático

ABSTRACT Coronavirus disease (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Its main form of transmission is through respiratory droplets. Case reports have described the presence of this virus in biological materials such as blood, feces, urine, and tears, which generate hypotheses about other means thereby the disease is transmitted. In this report, we describe a case of SARS-CoV-2 identified on the eye surface of an asymptomatic health-care professional. The nasopharyngeal reverse transcription polymerase chain reaction test, using a sample collected on the same day, and the serological test, performed 3 months later, did not reveal any evidence of SARS-CoV-2 infection. These results alert on the possibility of a false-positive reverse transcription polymerase chain reaction result for the ocular surface or the presence of the virus in the conjunctival mucosa in individuals without infection.

RESUMO A COVID-19 é uma doença infeciosa causada pelo SARS-CoV-2, sendo sua principal forma de transmissão através de gotículas respiratórias. Já existem relatos de caso descrevendo a presença desse vírus em materiais biológicos como sangue, fezes, urina e lágrima, o que gera hipóteses sobre outros meios de transmissão da doença. Neste estudo, descrevemos um caso de identificação do vírus SARS-CoV-2 na superfície ocular de um profissional de saúde assintomático. A transcrição inversa da reação em cadeia da polimerase da nasofaringe, coletada no mesmo dia, e o teste sorológico, realizado três meses após, não detectaram qualquer evidência de infecção pelo SARS-CoV-2. Esses dados alertam para a possibilidade de resultado falso positivo da transcrição inversa da reação em cadeia da polimerase da superfície ocular ou a presença do vírus na mucosa conjuntival sem infecção.

Detection of SARS-CoV-2 virus on the ocular surface of an asymptomatic health-care professional.

Coronavirus disease (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Its main form of transmission is through respiratory droplets. Case reports have described the presence of this virus in biological materials such as blood, feces, urine, and tears, which generate hypotheses about other means thereby the disease is transmitted. In this report, we describe a case of SARS-CoV-2 identified on the eye surface of an asymptomatic health-care professional. The nasopharyngeal reverse transcription polymerase chain reaction test, using a sample collected on the same day, and the serological test, performed 3 months later, did not reveal any evidence of SARS-CoV-2 infection. These results alert on the possibility of a false-positive reverse transcription polymerase chain reaction result for the ocular surface or the presence of the virus in the conjunctival mucosa in individuals without infection.

Identification of SARS-CoV-2 on the ocular surface in a cohort of COVID-19 patients from Brazil.

In this cross-sectional study, we investigate the presence of Severe Acute Respiratory Syndrome Coronavirus 2 Ribonucleic Acid (SARS-CoV-2 RNA) in the tears of hospitalized COVID-19 patients. After laboratory confirmation of SARS-CoV-2 infection by reverse transcription polymerase chain reaction (RT-PCR) analysis, tear samples from both eyes of each patient were collected using conjunctival swab for RT-PCR. Detailed demographic profile, systemic and ocular symptoms, comorbidities, clinical, ancillary, and ocular manifestations were evaluated. Of the 83 patients enrolled in the study, 7 (8.43%) had SARS-CoV-2 RNA detected in the tear samples. Neutrophils' count, C-reactive protein, and D-dimer were higher in patients with SARS-CoV-2 detected in tears than in patients without virus in ocular surface samples. One patient with SARS-CoV-2 in tears showed mild ocular eyelid edema, hyperemia, and chemosis. No relevant ocular manifestations were detected in the other patients. Although the levels of viral RNA on ocular surface samples were low for most patients (5/7), with positivity only for gene N and CT higher than 30, two patients were positive for all viral targets tested (N, E, and RpRd), with viral load near 1 × 105 ePFU/mL, indicating that the ocular transmission of SARS-CoV-2 is a possibility that needs to be considered, especially in the hospital environment. Further studies need to be conducted to demonstrate whether infective viral particles could be isolated from tears.

Talk the talk and walk the walk! Association between Weekly Exercise Load and Knowledge about Recommendations for Fighting Innactivity

The World Health Organization (WHO) recommends as a weekly "target dose" of exercise 150 minutes of moderate exercise or 75 minutes of intense exercise. Public health policies have prioritized the practice of exercise as a strategy for disease prevention and health promotion, with health professionals as their main promoters. Objective: To assess the interaction between the amount of exercise per week and the knowledge about recommendations for fighting a sedentary lifestyle among health care professionals attending a congress of cardiology. Methods: Participants of the 2017 Rio de Janeiro Society of Cardiology Congress were interviewed. Knowledge about the World Health Organization (WHO) recommendations for fighting a sedentary lifestyle was assessed by asking participants the question: "How much weekly exercise is recommended by the WHO?" Responders were stratified by the weekly exercise load reported. A multivariate logistic model was created to determine independent predictors of knowledge. Results: A total of 426 participants were interviewed (45.5% men, median age 31 years, 37.8% physicians, 65.8% of the physicians were cardiologists). The overall knowledge level was 44.6%; 38.1%, 52.7% and 56.6% among non-physicians, non-cardiologists and cardiologists, respectively (p = 0.002). Of all participants, 21.8% were inactive, 15% were lightly active, 34.7% moderately active and 28.4% highly active, and the percentage of individuals who gave a correct answer to the question on exercise recommendations was 30.1%, 42%, 48% and 52.9% respectively (p < 0.0001). In the multivariate analysis, being highly active (OR = 2.25, IC95%, 1.238 - 4.089), moderately active (OR = 1.93, IC 95% 1.105 - 3.39) and being a cardiologist (OR = 2.01, IC 95% 1.243 - 3,267) were predictors of knowledge. Conclusions: There was a linear association between exercise level and knowledge about the WHO recommendations on exercise. Policies to stimulate the practice of exercise among health professionals can positively impact campaigns for reducing sedentary lifestyle in the general population