{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T15:48:48Z","timestamp":1790178528765,"version":"4.1.0"},"reference-count":20,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2020,12,23]],"date-time":"2020-12-23T00:00:00Z","timestamp":1608681600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Ophthalmology"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The possible transmission of severe acute respiratory coronavirus 2 (SARS-CoV-2) by tears and conjunctiva is still debated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Main outcome was to investigate the agreement between nasopharyngeal swab (NPs) and conjunctival swabs (Cs) in patients with SARS-CoV-2 infection. We divided patients into four groups: (1) NPs and Cs both negative (C\u2212NF\u2212), (2) NPs positive and Cs negative (NFs+Cs\u2212), (3) NPs negative and Cs positive (NFs\u2212Cs+), and (4) NPs and Cs both positive (NFs\u2212Cs+). The secondary outcomes were to correlate Cs results with systemic clinical parameters such as: oxygen saturation (SpO\n                      <jats:sub>2<\/jats:sub>\n                      ), dyspnea degree (DP), radiologic pulmonary impairment based on chest radiography (XR) or computed tomography (CT), blood chemistry as D-Dimer (D-Dimer), fibrinogen, ferritin, lactate dehydrogenase (LDH), and C-reactive protein (C-RP).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 100 conjunctival swabs in 50 patients with SARS-CoV-2 have been enrolled in this interventional clinical trials. Ocular signs (conjunctivitis) were present in five patients (10%). NPs and Cs highlighted a poor level of agreement (0.025; p\u2009=\u20090.404). Median SpO\n                      <jats:sub>2<\/jats:sub>\n                      levels are the highest in the NF\u2212C\u2212 group (98%) and the lowest (90%) in the group NF+C+ ( p\u2009=\u20090.001). Pulmonary impairment was statistically significantly different between NFs and Cs groups ( p\u2009=\u20090.019). Pulmonary impairment score increased from NFs\u2212Cs\u2212 group (3.8\u2009\u00b1\u20093.9), to NFs+Cs+ group (6.7\u2009\u00b1\u20094.1). Intensive care unit patients showed higher COVID-19 Cs positivity in conjunctiva (12.5%) against hospitalized ones (5.8%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In patients hospitalized for SARS-CoV-2 the virus can be detected in conjunctival swab. Intensive care unit patients may reveal a higher COVID-19 presence in the conjunctiva. The most severe pulmonary impairment can be observed in NFs and Cs positivity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration:<\/jats:title>\n                    <jats:p>Clinicaltrials.gov registration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethical committee authorization:<\/jats:title>\n                    <jats:p>ID number: 0013008\/20<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1120672120976548","type":"journal-article","created":{"date-parts":[[2020,12,24]],"date-time":"2020-12-24T03:14:10Z","timestamp":1608779650000},"page":"2886-2893","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Evidence-based of conjunctival COVID-19 positivity: An Italian experience: Gemelli Against COVID Group"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1397-4333","authenticated-orcid":false,"given":"Maria Cristina","family":"Savastano","sequence":"first","affiliation":[{"name":"Ophthalmology Unit, \u201cFondazione Policlinico Universitario A. Gemelli IRCCS\u201d, Rome, Italy"},{"name":"Catholic University \u201cSacro Cuore\u201d, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"Gambini","sequence":"additional","affiliation":[{"name":"Ophthalmology Unit, \u201cFondazione Policlinico Universitario A. Gemelli IRCCS\u201d, Rome, Italy"},{"name":"Catholic University \u201cSacro Cuore\u201d, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1575-6567","authenticated-orcid":false,"given":"Alfonso","family":"Savastano","sequence":"additional","affiliation":[{"name":"Ophthalmology Unit, \u201cFondazione Policlinico Universitario A. Gemelli IRCCS\u201d, Rome, Italy"},{"name":"Catholic University \u201cSacro Cuore\u201d, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedetto","family":"Falsini","sequence":"additional","affiliation":[{"name":"Ophthalmology Unit, \u201cFondazione Policlinico Universitario A. Gemelli IRCCS\u201d, Rome, Italy"},{"name":"Catholic University \u201cSacro Cuore\u201d, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umberto","family":"De Vico","sequence":"additional","affiliation":[{"name":"Ophthalmology Unit, \u201cFondazione Policlinico Universitario A. Gemelli IRCCS\u201d, Rome, Italy"},{"name":"Catholic University \u201cSacro Cuore\u201d, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Sanguinetti","sequence":"additional","affiliation":[{"name":"Institute of Microbiology, Catholic University of \u201cSacro Cuore\u201d, Rome, Italy"},{"name":"Department of Laboratory and Infectious Science, \u201cFondazionePoliclinico Universitario A. Gemelli IRCCS\u201d, Rome, Lazio, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Cattani","sequence":"additional","affiliation":[{"name":"Catholic University \u201cSacro Cuore\u201d, Rome, Italy"},{"name":"Department of Diagnostic and Laboratory Medicine, Institute of Microbiology, Catholic University of \u201cSacro Cuore\u201d, Rome, Lazio, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Marchetti","sequence":"additional","affiliation":[{"name":"Catholic University \u201cSacro Cuore\u201d, Rome, Italy"},{"name":"Department of Diagnostic and Laboratory Medicine, Institute of Microbiology, Catholic University of \u201cSacro Cuore\u201d, Rome, Lazio, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Rita","family":"Larici","sequence":"additional","affiliation":[{"name":"Catholic University \u201cSacro Cuore\u201d, Rome, Italy"},{"name":"Department of Radiology, \u201cFondazione Policlinico Universitario A. Gemelli IRCCS\u201d, Rome, Lazio, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Franceschi","sequence":"additional","affiliation":[{"name":"Catholic University \u201cSacro Cuore\u201d, Rome, Italy"},{"name":"Emergency Medicine, \u201cFondazione Policlinico Universitario A. Gemelli IRCCS\u201d, Rome, Lazio, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Santoliquido","sequence":"additional","affiliation":[{"name":"Catholic University \u201cSacro Cuore\u201d, Rome, Italy"},{"name":"Emergency Medicine, \u201cFondazione Policlinico Universitario A. Gemelli IRCCS\u201d, Rome, Lazio, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossana","family":"Moroni","sequence":"additional","affiliation":[{"name":"Scientific Direction, \u201cFondazione Policlinico Universitario A. 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