Journal-based CME Course: Presumed SARS-CoV-2 Viral Particles in the Human Retina of Patients With COVID-19

Activity ID

8049

Expires

August 4, 2024

Format Type

Journal-based

CME Credit

1

Fee

$30

CME Provider: JAMA Ophthalmology

Description of CME Course

Importance  The presence of the SARS-CoV-2 virus in the retina of deceased patients with COVID-19 has been suggested through real-time reverse polymerase chain reaction and immunological methods to detect its main proteins. The eye has shown abnormalities associated with COVID-19 infection, and retinal changes were presumed to be associated with secondary microvascular and immunological changes.

Objective  To demonstrate the presence of presumed SARS-CoV-2 viral particles and its relevant proteins in the eyes of patients with COVID-19.

Design, Setting, and Participants  The retina from enucleated eyes of patients with confirmed COVID-19 infection were submitted to immunofluorescence and transmission electron microscopy processing at a hospital in São Paulo, Brazil, from June 23 to July 2, 2020. After obtaining written consent from the patients’ families, enucleation was performed in patients deceased with confirmed SARS-CoV-2 infection. All patients were in the intensive care unit, received mechanical ventilation, and had severe pulmonary involvement by COVID-19.

Main Outcomes and Measures  Presence of presumed SARS-CoV-2 viral particles by immunofluorescence and transmission electron microscopy processing.

Results  Three patients who died of COVID-19 were analyzed. Two patients were men, and 1 was a woman. The age at death ranged from 69 to 78 years. Presumed S and N COVID-19 proteins were seen by immunofluorescence microscopy within endothelial cells close to the capillary flame and cells of the inner and the outer nuclear layers. At the perinuclear region of these cells, it was possible to observe by transmission electron microscopy double-membrane vacuoles that are consistent with the virus, presumably containing COVID-19 viral particles.

Conclusions and Relevance  The present observations show presumed SARS-CoV-2 viral particles in various layers of the human retina, suggesting that they may be involved in some of the infection’s ocular clinical manifestations.

Disclaimers

1. This activity is accredited by the American Medical Association.
2. This activity is free to AMA members.

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