Italy’s first coronavirus patient traveled from Wuhan, China, to Italy in late January and was admitted to the hospital with coronavirus symptoms days later. A recently published report shows that she had detectable traces of the virus in her eyes days after it had cleared from her nose.
The report demonstrates that the novel coronavirus can exist in an infected person’s eye fluids at probable contagious levels, increasing the need for people to be cognizant about their hand hygiene and to keep their hands away from their face, experts say.
The 65-year-old woman, who is not named in the report, arrived in Italy on Jan. 23 after leaving the first hot spot of the virus. By Jan. 29, she was admitted to an isolation unit at an Italian hospital with a dry cough, sore throat, stuffy nose and conjunctivitis, an infection of the lining of the eye commonly known as pinkeye, in both eyes. She tested positive for the virus.
Doctors collected eye swabs from the woman on her third day of admission because of her persistent conjunctivitis, and researchers found she had detectable infectious particles in her eyes.
Her pinkeye cleared up by her 20th day in the hospital, but traces of genetic material from the coronavirus dallied.
The woman’s eye samples tested positive for traces of the virus for up to her 21st day under care, according to the report. For about five days, it wasn’t detected, until it showed up again on Day 27 — days after it was undetectable in her nasal swabs.
Researchers performed additional tests and found that the virus in her eyes had been replicating, meaning that her eyes could be contagious.
The findings indicate that eye secretions of patients with covid-19 could be contagious, along with the importance of practicing good personal hygiene, according to infectious disease experts.
Viral conjunctivitis is extremely contagious, so the report serves as no surprise that the coronavirus could be found in the eyes, said Aaron Glatt, professor and chair of the department of medicine at Mount Sinai South Nassau, a hospital in New York.
Glatt, who is also a spokesperson for the Infectious Diseases Society of America, said the study’s findings could affect public health but noted that more research like it will have to be performed to gauge how widespread the issue is.
The report mentioned that unprotected eye exposure was thought to be a source of infection at a Wuhan fever clinic in January. One covid-19 patient out of 30 with conjunctivitis at a Chinese hospital also had detectable amounts of the virus in the eyes.
“This has ramifications, but you can’t make policy based on one patient,” he said about the study, supporting the paper’s message that more testing should be conducted.
The paper underscores how much scientists are continuing to learn about the virus, he said.
The findings also establish the connection between the nose and the eye that people don’t always remember, said W. David Hardy, an infectious disease specialist and adjunct professor of medicine in the division of infectious diseases at Johns Hopkins University School of Medicine.
Hardy said the nose and the eye act as a drainage system where viruses can travel up the nose and into the eye or the reverse, he said.
While the paper does verify that eye fluid can contain contagious traces of the coronavirus, Hardy highlighted that the virus’s favorite body cells are those that line the throat and the lungs, where it’s known to inflict serious damage on its victims.
“The cells that are inside the eye are similar but not the same,” he said. “When it gets into the eye, it doesn’t cause nearly the same amount of destruction as it does to cells in the respiratory system.”
The general public shouldn’t rush out to purchase face shields because of the study’s finding, but they should continue to practice good hand hygiene, experts say.
“The whole message that is important here is that you don’t touch your face until you get home, wash your hands and make sure your hands are clean before touching your face,” Hardy said. “You have to be extra vigilant and assume that everything out there could’ve been contaminated with fresh covid virus.”
