{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:57:03Z","timestamp":1753891023145,"version":"3.41.2"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,8,6]],"date-time":"2021-08-06T00:00:00Z","timestamp":1628208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viruses is mainly transmitted through respiratory droplets. Notably, some coronavirus disease 2019 (COVID-19) patients have ocular manifestations, including conjunctival hyperaemia, chemosis, epiphora, and increased secretions. However, the association between SARS-CoV-2 and ocular surface diseases is poorly described. Between May 2020 and March 2021, a total of 2, 0157 participants from six districts of China were enrolled. Serum samples were tested for immunoglobulin G and M (IgG and IgM) antibodies against the SARS-CoV-2 spike protein and nucleoprotein using magnetic chemiluminescence enzyme immunoassays. Throat swabs were tested for SARS-CoV-2 RNA using RT-PCR assays in a designated virology laboratory. Fisher exact, \u03c7<jats:sup>2<\/jats:sup> test, and logistic regression analysis were performed. Of 2, 0157 serum samples tested, 1, 755 (8.71%) were from ocular surface diseases, 1, 2550 (62.26%) from no-ocular surface diseases (ocular diseases except ocular surface diseases), 5, 852 (29.03%) from no-ocular diseases. SARS-CoV-2 prevalence for the combined measure was 0.90% (182\/2, 0157). Seroprevalence of SARS-CoV-2 was significantly (p&amp;lt;0.05) higher in the population with ocular surface diseases (2.28%, 40\/1755) compared with no-ocular surface diseases (0.70%, 88\/1, 2550), and no-ocular diseases (0.92%, 54\/5, 852). Similar results were also observed with respect to sex, age, time, and districts. Logistic regression analyses revealed that ocular surface diseases [ocular surface diseases <jats:italic>vs.<\/jats:italic> no-ocular diseases (p=0.001, OR =1.467, 95% CI=1.174-1.834); ocular surface diseases <jats:italic>vs.<\/jats:italic> no-ocular surface diseases (p&amp;lt;0.001, OR =2.170, 95% CI=1.434-3.284)] were associated with increased risk of susceptible to SARS-CoV-2 infection. In a word, there was a significant association between ocular surface disease and SARS-CoV-2 infection. Therefore, increasing awareness of eye protection during the pandemic is necessary, especially for individuals with ocular surface diseases.<\/jats:p>","DOI":"10.3389\/fimmu.2021.695428","type":"journal-article","created":{"date-parts":[[2021,8,6]],"date-time":"2021-08-06T08:38:34Z","timestamp":1628239114000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Association of Ocular Surface Diseases With SARS-CoV-2 Infection in Six Districts of China: An Observational Cohort Study"],"prefix":"10.3389","volume":"12","author":[{"given":"Shengjie","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yichao","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Tang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhujian","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenjun","family":"Cao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xingtao","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinghuai","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,8,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1016\/S0140-6736(20)30183-5","article-title":"Clinical Features of Patients Infected With 2019 Novel Coronavirus in Wuhan, China","volume":"395","author":"Huang","year":"2020","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2020.1291","article-title":"Characteristics of Ocular Findings of Patients With Coronavirus Disease 2019 (COVID-19) in Hubei Province, China","volume":"138","author":"Wu","year":"2020","journal-title":"JAMA Ophthalmol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtos.2020.03.010","article-title":"The Evidence of SARS-CoV-2 Infection on Ocular Surface","volume":"18","author":"Zhang","year":"2020","journal-title":"Ocul Surf"},{"key":"B4","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1186\/s40662-020-00189-0","article-title":"SARS-CoV-2 in the Ocular Surface of COVID-19 Patients","volume":"7","author":"Xie","year":"2020","journal-title":"Eye Vis (Lond)"},{"key":"B5","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1016\/j.jtos.2020.05.013","article-title":"Co-Expression of SARS-CoV-2 Entry Genes in the Superficial Adult Human Conjunctival, Limbal and Corneal Epithelium Suggests an Additional Route of Entry via the Ocular Surface","volume":"19","author":"Collin","year":"2020","journal-title":"Ocul Surf"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2020.06.037","article-title":"Ocular Symptoms Among Nonhospitalized Patients Who Underwent COVID-19 Testing","volume":"127","author":"Gangaputra","year":"2020","journal-title":"Ophthalmology"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(21)00026-7","article-title":"Serological Evidence of Human Infection With SARS-CoV-2: A Systematic Review and Meta-Analysis","volume":"9","author":"Chen","year":"2021","journal-title":"Lancet Glob Health"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.immuni.2020.05.002","article-title":"Immunology of COVID-19: Current State of the Science","volume":"52","author":"Vabret","year":"2020","journal-title":"Immunity"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa344","article-title":"Antibody Responses to SARS-CoV-2 in Patients of Novel Coronavirus Disease 2019","volume":"71","author":"Zhao","year":"2020","journal-title":"Clin Infect Dis"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2026116","article-title":"Humoral Immune Response to SARS-CoV-2 in Iceland","volume":"383","author":"Gudbjartsson","year":"2020","journal-title":"N Engl J Med"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-020-0949-6","article-title":"Seroprevalence of Immunoglobulin M and G Antibodies Against SARS-CoV-2 in China","volume":"26","author":"Xu","year":"2020","journal-title":"Nat Med"},{"key":"B12","doi-asserted-by":"publisher","first-page":"e0008975","DOI":"10.1371\/journal.pntd.0008975","article-title":"Seroprevalence and Asymptomatic Carrier Status of SARS-CoV-2 in Wuhan City and Other Places of China","volume":"15","author":"Duan","year":"2021","journal-title":"PloS Negl Trop Dis"},{"key":"B13","doi-asserted-by":"publisher","first-page":"48","DOI":"10.4103\/ijmr.IJMR_3290_20","article-title":"Prevalence of SARS-CoV-2 Infection in India: Findings From the National Serosurvey, May-June 2020","volume":"152","author":"Murhekar","year":"2020","journal-title":"Indian J Med Res"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.14765","article-title":"Prevalence of SARS-CoV-2 Antibodies in Health Care Personnel in the New York City Area","volume":"324","author":"Moscola","year":"2020","journal-title":"JAMA"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2020.4130","article-title":"Seroprevalence of Antibodies to SARS-CoV-2 in 10 Sites in the United States, March 23-May 12, 2020","volume":"180","author":"Havers","year":"2020","journal-title":"JAMA Intern Med"},{"key":"B16","doi-asserted-by":"publisher","first-page":"e39","DOI":"10.1016\/S0140-6736(20)30313-5","article-title":"2019-Ncov Transmission Through the Ocular Surface Must Not Be Ignored","volume":"395","author":"Lu","year":"2020","journal-title":"Lancet"},{"key":"B17","doi-asserted-by":"publisher","first-page":"4400","DOI":"10.1038\/s41467-020-18149-6","article-title":"Ocular Conjunctival Inoculation of SARS-CoV-2 Can Cause Mild COVID-19 in Rhesus Macaques","volume":"11","author":"Deng","year":"2020","journal-title":"Nat Commun"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2020.04.028","article-title":"Ocular Findings and Proportion With Conjunctival SARS-COV-2 in COVID-19 Patients","volume":"127","author":"Zhou","year":"2020","journal-title":"Ophthalmology"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2020.06.026","article-title":"Ocular Signs of COVID-19 Suggested by Internet Search Term Patterns Worldwide","volume":"128","author":"Deiner","year":"2021","journal-title":"Ophthalmology"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtos.2020.06.007","article-title":"ACE2 and TMPRSS2 Are Expressed on the Human Ocular Surface, Suggesting Susceptibility to SARS-CoV-2 Infection","volume":"18","author":"Zhou","year":"2020","journal-title":"Ocul Surf"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtos.2020.09.010","article-title":"SARS-CoV-2 Receptor ACE2 Is Expressed in Human Conjunctival Tissue, Especially in Diseased Conjunctival Tissue","volume":"19","author":"Li","year":"2020","journal-title":"Ocul Surf"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2021.695428\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,6]],"date-time":"2021-08-06T08:38:36Z","timestamp":1628239116000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2021.695428\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,6]]},"references-count":21,"alternative-id":["10.3389\/fimmu.2021.695428"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2021.695428","relation":{},"ISSN":["1664-3224"],"issn-type":[{"type":"electronic","value":"1664-3224"}],"subject":[],"published":{"date-parts":[[2021,8,6]]},"article-number":"695428"}}