• Ophthalmologe · Jul 2020

    Review

    [What is the importance of the conjunctiva as a potential transmission pathway for SARS-CoV-2 infections?]

    • Clemens Lange, Julian Wolf, Claudia Auw-Haedrich, Anja Schlecht, Stefaniya Boneva, Thabo Lapp, Hansjürgen Agostini, Gottfried Martin, Thomas Reinhard, and Günther Schlunck.
    • Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland. clemens.lange@uniklinik-freiburg.de.
    • Ophthalmologe. 2020 Jul 1; 117 (7): 626-630.

    AbstractRecent studies have described conjunctivitis in approximately 1% of COVID-19 patients and speculated that SARS-CoV‑2 can be transmitted via the conjunctiva. In this article we recapitulate the molecular mechanisms of host cell entry of SARS-CoV‑2 and discuss the current evidence for a potential conjunctival transmission of SARS-CoV‑2. The current body of evidence indicates that SARS-CoV‑2 requires the membrane-bound angiotensin-converting enzyme 2 (ACE2) and the membrane-bound serine protease TMPRSS2 to enter cells. Recent studies suggest that COVID-19 patients rarely exhibit viral RNA in tear film and conjunctival smears and that, ACE2 and TMPRSS2 are only expressed in very small amounts in the conjunctiva, making conjunctival infection with SARS-CoV‑2 via these mediators unlikely. Nevertheless, we consider the current evidence to be still too limited to provide a conclusive statement and recommend appropriate protective measures for healthcare personnel who are in close contact with suspected and confirmed COVID-19 patients.

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