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Lancet:2019新型冠状病毒(2019-nCoV)通过眼表的传播不容忽视

  Lancet:2019新型冠状病毒(2019-nCoV)通过眼睛的传播不容忽视。近期报道了在中国武汉2019年新型冠状病毒(2019-nCoV)感染的患者的流行病学,症状和治疗方法。但是,2019-nCoV是否会通过其他途径传播,不是很清楚。 2020年2月6日,吉林大学附属第一医院眼科陆成伟团队在国际顶级医学期刊Lancet在线发表题为“2019-nCoV transmission through the ocular surface must not be ignored”的通讯论文,认为2019-nCoV通过眼睛的传播被忽略了。因此,呼吸道可能不是2019-nCoV的唯一传播途径,所有检查可疑病例的眼科医生都应戴防护眼镜。

  近期报道了在中国武汉2019年新型冠状病毒(2019-nCoV)感染的患者的流行病学,症状和治疗方法。作为眼科医生,我们认为2019-nCoV通过眼睛的传播被忽略了。

  1月22日,全国肺炎专家小组成员王广发报告说,他在武汉检查期间被2019-nCoV感染。他戴着N95口罩,但没有戴任何保护眼睛的东西。肺炎发作前几天,王广发眼睛发红。武汉发热门诊未经保护的医生可能经过眼睛暴露于2019-nCoV,进而使该病毒感染了人体。

  传染性飞沫和体液很容易污染人结膜上皮。呼吸道病毒能够在感染的患者中引起眼部并发症,进而导致呼吸道感染。严重的急性呼吸综合征冠状病毒(SARS-CoV)主要通过直接或间接传播(眼睛,嘴或鼻子的粘膜间接接触)。粘膜裸露和不受保护的眼睛会增加SARS-CoV传播的风险,这表明未保护的眼睛,暴露于2019-nCoV可能会引起急性呼吸道感染。

  因此,呼吸道可能不是2019-nCoV的唯一传播途径,所有检查可疑病例的眼科医生都应戴防护眼镜。

  我们声明没有利益冲突。

2019-nCoV transmission through the ocular surface must not be ignored

  Chaolin Huang and colleagues1 reported the epidemiology, symptoms, and treatment of patients infected by the 2019 novel coronavirus (2019-nCoV) in Wuhan, China. As ophthalmologists, we believe that transmission of 2019-nCoV through the eyes was ignored.

  On Jan 22, Guangfa Wang, a member of the national expert panel on pneumonia, reported that he was infected by 2019-nCoV during the inspection in Wuhan.2 He wore an N95 mask but did not wear anything to protect his eyes. Several days before the onset of pneumonia, Wang complained of redness of the eyes. Unprotected exposure of the eyes to 2019-nCoV in the Wuhan Fever Clinic might have allowed the virus to infect the body.2

  Infectious droplets and body fluids can easily contaminate the human conjunctival epithelium.3 Respiratory viruses are capable of inducing ocular complications in infected patients, which then leads to respiratory infection.4 Severe acute respiratory syndrome coronavirus (SARS-CoV) is predominantly transmitted through direct or indirect contact with mucous membranes in the eyes, mouth, or nose.5 The fact that exposed mucous membranes and unprotected eyes increased the risk of SARS-CoV transmission4 suggests that exposure of unprotected eyes to 2019-nCoV could cause acute respiratory infection.

  Thus, Huang and colleagues1 should have analysed conjunctival scrapings from both confirmed and suspected 2019-nCoV cases during the onset of symptoms. The respiratory tract is probably not the only transmission route for 2019-nCoV, and all ophthalmologists examining suspected cases should wear protective eyewear.

  We declare no competing interests.

  参考文献

  1 Huang C, Wang YM, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; published online Jan 24. https://doi. org/10.1016/S0140-6736(20)30183-5.

  2 Dai X. Peking University Hospital Wang Guangfa disclosed treatment status on Weibo and suspected infection without wearing goggles. Jan 22, 2020. http://www.bjnews. com.cn/news/2020/01/23/678189.html (accessed Jan 24, 2020).

  3 Olofsson S, Kumlin U, Dimock K, Arnberg N. Avian influenza and sialic acid receptors: more than meets the eye? Lancet Infect Dis 2005; 5: 184–88.

  4 Belser JA, Rota PA, Tumpey TM. Ocular tropism of respiratory viruses. Microbiol Mol Biol Rev 2013; 77: 144–56. 5 Peiris JS, Yuen KY, Osterhaus AD, Stohr K. The severe acute respiratory syndrome.

  DOI:https://doi.org/10.1016/S0140-6736(20)30313-5
  译文参考自iNature公众号

来源:Lancet,2020.02 Cheng-wei Lu,et al.
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