Italy’s first coronavirus patient had detectable levels of virus genetic material in her eyes long after it had cleared from her nose, according to a newly released report that highlights how the eyes could possibly assist in the spread of the disease.
The woman, 65, traveled from Wuhan, China – the original epicenter of the virus – to Italy on Jan. 23. She was admitted to a hospital there on Jan. 29, a day after she first experienced symptoms of the novel virus, which in her case included cough, sore throat, coryza and conjunctivitis, or pink eye.
She later developed a fever, which was accompanied by nausea and vomiting, according to the report published in the April 17 journal Annals of Internal Medicine.
On the third day of the woman’s hospitalization, doctors took a swab of her eyes, which detected the virus’ RNA, or its genetic material. Her eyes were continually swabbed throughout the duration of her hospital stay.
By day 20, the woman’s conjunctivitis had cleared, but the virus’ genetic material was still found in her eyes up to day 21, “suggesting sustained replication in conjunctiva.” In other words, the virus was replicating in her eyes, indicating they may be contagious, the researchers said.
After initially clearing in both her eyes and nose, the virus’ genetic material was detected once more on day 27.
“SARS-CoV-2 RNA was detected in ocular swabs days after it was undetectable in nasal swabs,” they wrote in the report.
The researchers concluded that the woman’s case serves as a good example of how the eyes could be a possible source of infection.
“We found that ocular fluids from SARS-CoV-2-infected patients may contain infectious virus, and hence may be a potential source of infection. These findings highlight the importance of control measures, such as avoiding touching the nose, mouth, and eyes and frequent hand washing,” they wrote, noting the case is a reminder of the importance of “appropriate use of personal protective equipment for ophthalmologists during clinical examination, because ocular mucosa may be not only a site of virus entry but also a source of contagion.”
“Furthermore, we observed that ocular involvement of SARS-CoV-2 may occur early in the COVID-19 course, suggesting that measures to prevent transmission via this route must be implemented as early as possible,” they added.