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András VéghSemmelweis University, Department of Ophthalmology, Budapest, Hungary

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Anita CsorbaSemmelweis University, Department of Ophthalmology, Budapest, Hungary

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Ákos KollerSemmelweis University, Translational Medicine Institute, Budapest, Hungary
Hungarian University of Sports Sciences, Research Center for Sports Physiology, Budapest, Hungary

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Behnam MohammadpourSemmelweis University, Department of Ophthalmology, Budapest, Hungary

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Petra KillikSemmelweis University, Department of Ophthalmology, Budapest, Hungary

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Lilla IstvánSemmelweis University, Department of Ophthalmology, Budapest, Hungary

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Márton MagyarSemmelweis University, Department of Ophthalmology, Budapest, Hungary

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Teréz FenesiSemmelweis University, Department of Ophthalmology, Budapest, Hungary

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Zoltán Zsolt NagySemmelweis University, Department of Ophthalmology, Budapest, Hungary

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Open access

Abstract

Introduction

Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) resulted in a worldwide pandemic, due to its great capacity to invade the human body. Previous studies have shown that the primary route of invasion of this virus is the human respiratory tract via the co-expression of ACE2 receptor and TMPRSS2, a serine protease on the cellular surface. Interestingly, this condition is present not only on the respiratory epithelium but on the conjunctival mucosa, as well. Thus, we hypothesized that SARS-CoV-2 is present on the conjunctival mucosa.

Aim

To prove that SARS-CoV-2 can be detected in the conjunctiva.

Methods

Previously nasopharyngeal swab-sample based real-time polymerase chain reaction (PCR) positive COVID-19 infected patients were selected at the COVID Care Centers of Semmelweis University, Budapest, Hungary. The study was approved by the ethical committee of Semmelweis University. During their recovery, both nasopharyngeal and conjunctival swab-samples were taken and PCR method was used to detect the presence of SARS-CoV-2 RNA. Appropriate statistical analysis was performed.

Results

The study population consisted of 97 patients, 49 females (50.5%) and 48 males (49.5%), with a mean age of 67.2 ± 11.9 years. During recovery, with nasopharyngeal swabs, the PCR test was positive in 55 cases (56.70%), whereas with conjunctival swabs it was positive in 8 cases (8.25%). Both tests were positive in 5 cases (5.15%). In some patients, ocular symptoms were observed as well. The rest of the patients (29 cases) had negative nasopharyngeal PCR tests during recovery.

Conclusions

Although only in few cases, the data of the present study provides a proof of concept that SARS-CoV-2 can be present on the conjunctival mucosa even in nasopharyngeal negative patients, a finding, which can have clinical importance. Also, on the basis of these findings one can hypothesize that - in addition to the respiratory tract – the conjunctiva can be an entrance route for SARS-CoV-2 to the human body. Thus, in high-risk conditions, in addition to covering the mouth and nose with mask, the protection of the eyes is also strongly recommended.

Abstract

Introduction

Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) resulted in a worldwide pandemic, due to its great capacity to invade the human body. Previous studies have shown that the primary route of invasion of this virus is the human respiratory tract via the co-expression of ACE2 receptor and TMPRSS2, a serine protease on the cellular surface. Interestingly, this condition is present not only on the respiratory epithelium but on the conjunctival mucosa, as well. Thus, we hypothesized that SARS-CoV-2 is present on the conjunctival mucosa.

Aim

To prove that SARS-CoV-2 can be detected in the conjunctiva.

Methods

Previously nasopharyngeal swab-sample based real-time polymerase chain reaction (PCR) positive COVID-19 infected patients were selected at the COVID Care Centers of Semmelweis University, Budapest, Hungary. The study was approved by the ethical committee of Semmelweis University. During their recovery, both nasopharyngeal and conjunctival swab-samples were taken and PCR method was used to detect the presence of SARS-CoV-2 RNA. Appropriate statistical analysis was performed.

Results

The study population consisted of 97 patients, 49 females (50.5%) and 48 males (49.5%), with a mean age of 67.2 ± 11.9 years. During recovery, with nasopharyngeal swabs, the PCR test was positive in 55 cases (56.70%), whereas with conjunctival swabs it was positive in 8 cases (8.25%). Both tests were positive in 5 cases (5.15%). In some patients, ocular symptoms were observed as well. The rest of the patients (29 cases) had negative nasopharyngeal PCR tests during recovery.

Conclusions

Although only in few cases, the data of the present study provides a proof of concept that SARS-CoV-2 can be present on the conjunctival mucosa even in nasopharyngeal negative patients, a finding, which can have clinical importance. Also, on the basis of these findings one can hypothesize that - in addition to the respiratory tract – the conjunctiva can be an entrance route for SARS-CoV-2 to the human body. Thus, in high-risk conditions, in addition to covering the mouth and nose with mask, the protection of the eyes is also strongly recommended.

Introduction

The COVID-19 pandemic

Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been the greatest worldwide pandemic since the Spanish flu in 1918–1919 [1]. It has greatly impacted the national and global healthcare systems and demanded over 4 million lives out of more than 190 million people infected [2]. The primary entrance location of SARS-CoV-2 infection is in the mucosal cells after being exposed to the virus directly or indirectly and facilitated by the binding of coronavirus spike protein subunit to the angiotensin-converting enzyme 2 (ACE2) receptor [3–15]. The cellular entry also requires the priming of the protein by a serine protease, TMPRSS2, or other proteases [11, 15]. Thus, the co-expression of ACE2 and TMPRSS2 on the cellular surface are necessary for the cellular infection, a condition, which is present both on the epithelium of the respiratory tract and the conjunctival mucosa [11, 15].

Pulmonary and extra-pulmonary manifestations

COVID-19 is best known for its respiratory and systematic symptoms that manifest from asymptomatic infection to acute respiratory distress syndrome (ARDS) [7, 15]. Classical symptoms are fever, cough, fatigue, weakness, loss of olfaction and taste [15, 16]. In addition to the respiratory symptoms, this disease can affect other tissues and organs, such as hematologic-, cardiovascular-, gastrointestinal-, hepatobiliary-, endocrine-, dermatological-, neurological- and ophthalmological systems [15]. This latter one is not always appreciated and sometimes overlooked [17].

Previous ocular findings

As mentioned above, the conjunctival mucosa also can be exposed for SARS-CoV-2 infection, which than can elicit various ocular symptoms. The most common ocular manifestation of COVID-19 is conjunctivitis with epiphora, conjunctival congestion or chemosis, itching, foreign body sensation and/or watery discharge [7–28]. Other pathologies and subjective symptoms as blurred vision, tarsal petechiae, hemorrhage or pseudomembrane, mucous filaments, anterior or posterior uveitis, retinal microangiopathy, microhemorrhages, cotton-wool dots and neuro-ophthalmologic manifestations such as diplopia, ophthalmoparesis and Miller-Fischer syndrome can also frequently occur [7–28]. All of these underlines the importance of extending medical attention and care to the ocular system as well, during COVID-19 infection.

Hypothesis and aim

Because of the aforementioned, we hypothesized that SARS-CoV-2 is present on the conjunctival mucosa and accompanied with ocular syndromes. Thus, we aimed to prove that SARS-CoV-2 can be detected in the conjunctiva in patients hospitalized due to COVID-19 and to identify ocular symptoms. [3, 4, 11–16, 18–21].

Patients and methods

The patients included in the present study provided an informed consent for the investigation, which was approved by the ethical committee of Semmelweis University. Patients had been previously admitted with SARS-CoV-2 positive nasopharyngeal swab to the COVID Care Centers of Semmelweis University, Budapest. During recovery, the conjunctival swab test was performed within 24 h after the control nasopharyngeal swab. There were 97 patients examined between January and April of 2021.

During recovery, both nasopharyngeal and conjunctival swabs were taken and analyzed with real-time polymerase chain reaction (PCR) in order to show the presence of SARS-CoV-2 RNA in the sample (in the Central Laboratory of Department of Laboratory Medicine, Semmelweis University). Conjunctival samples were taken from both eye (inferior conjunctival fornix) with synthetic fiber swabs and placed into the same test tube, meaning that infection on only one eye caused PCR positivity. Vital (body temperature, blood pressure, pulse, oxygen saturation, the amount of oxygen supplementation, respiratory rate) and laboratory parameters (CRP, PCT, IL-6, ferritin, blood count, renal and liver function, necro-enzymes and D-dimer) as well as symptoms (e.g., presence of fever or cough) were routinely recorded during the admission of the patient.

In some patients in the COVID-19 Centers, ophthalmological history was taken and basic examination was performed.

Statistics

Statistical analysis was performed using IBM® SPSS® Statistics for Windows, version 25.0 (IBM Corp., Armonk, N.Y., USA). All continuous variables were expressed as mean, median and interquartile ratio (IQR). Kolmogorov-Smirnov test was used to assess normality. Mann-Whitney test was used for comparison of continuous variables. Categorical variables were summarized as counts (percentages). Fisher’s exact test was used for comparison of categorical variables. In all analysis, the level of significance was considered at P < 0.05.

Results

The mean age of the patients was 67.22 ± 11.91 (n = 97) years; 49 (50.52%) of them were females, 48 (49.48%) were males. The anamnestic, vital and laboratory parameters as well as symptoms of patients occurring are included in Table 1.

Table 1.

Anamnestic, vital and laboratory parameters presented in the group of patients, the level of P < 0.05 considered as statistically significant

Conjunctival swabOcular symptoms
ParameterPCR− (n = 89)PCR+ (n = 8)PAbsent (n = 91)Present (n = 6)P
Age (years)*67.64 (median 69, IQR 59–78)62.50 (median 58.5, IQR 52.5–67.25)0.27667.03 (median 68, IQR 55.5–78)70.00 (median 71, IQR 63.75–76)0.824
Hypertension in anamnesis**73.03%50.00%0.22383.33%70.33%0.669
Diabetes in anamnesis**49.43%87.50%0.29466.67%47.25%0.689
Other disease(s) in anamnesis**4.49%25.00%1.00083.33%81.32%1.000
Ophthalmologic anamnesis**15.73%12.50%1.00050.00%13.87%0.046
Fever**29.07%50.00%0.24616.67%31.82%0.662
Cough**37.93%25.00%0.70633.33%37.08%1.000
Other symptom(s)**81.82%87.50%0.07650.00%84.44%0.066
Days since the onset of symptom(s)*14.80 (median 12, IQR 8–19)13.50 (median 12, IQR 9.25–16)0.81814.47 (median 12, IQR 8–18)18.00 (median 16, IQR 10–26.5)0.505
Days since hospitalization*8.63 (median 7, IQR 4–11)7.00 (median 6.5, IQR 3.25–8.25)0.5628.21 (median 7, IQR 4–11)11.33 (median 11.5, IQR 4.25–18.75)0.537
Body temperature (°C)*36.76 (median 36.79, IQR 36.5–37)36.61 (median 36.6, IQR 36.3–36.95)0.66136.76 (median 36.7, IQR 36.5–37)36.56 (median 36.6, IQR 36.6–36.6)0.211
Systolic blood pressure (Hgmm)*128.10 (median 125, IQR 112–144.5)119.16 (median 118.5, IQR 112.25–126.75)0.247127.81 (median 125, IQR 110.75–143)120.33 (median 117, IQR 113.25–123)0.318
Dyastolic blood pressure (Hgmm)*77.40 (median 77, IQR 70–84)75.88 (median 73.5, IQR 68.5–84.5)0.73070.55 (median 77.5, IQR 69.75–84.25)73.17 (median 70.5, IQR 68.25–74.25)0.275
Pulse (1/min)*84.00 (median 82, IQR 71–92.75)91.75 (median 89, IQR 86–104.25)0.12184.77 (median 83.5, IQR 71–94.25)83.00 (median 86, IQR 80–86.75)0.932
Oxygen saturation (%)*95.06 (median 96, IQR 94–97)96.67 (median 69.5, IQR 96–97)0.23795.15 (median 96, IQR 94–97)95.6 (median 96, IQR 95–98)0.696
Oxygen supplementation (l min−1)*3.24 (median 0, IQR 0–6)1.83 (median 1, IQR 0–2.75)0.6963.23 (median 0, IQR 0–6)1.6 (median 0, IQR 63, 0–2)0.494
Respiratory rate (1/min)*19.46 (median 18, IQR 17–20)18.43 (median 20, IQR 16.5–20)0.72219.35 (median 18, IQR 17–20)19.60 (median 18, IQR 18–20)0.930
C-reactive protein (mg l−1)*86.75 (median 77.7, IQR 29.6–121)108.00 (median 95.1, IQR 32.7–173.425)0.52589.51 (median 83.7, IQR 29.3–129.75)73.32 (median 60.75, IQR 38.725–101.75)0.765
Procalcintonine (ug/l)0.78 (median 0.09, IQR 0.05–0.245)0.42 (median 0.05, IQR 0.025–0.48)0.7570.78 (median 0.08, IQR 0.05–0.26)0.17 (median 0.1, IQR 0.04–0.16)0.948
Interleukin-6 (pg ml−1)*78.23 (median 41.62, IQR 14.825–78.025)12.65 (median 12.625, IQR 10.3925–14.8975)0.12379.62 (median 41.62, IQR 14.545–80.53)24.01 (median 18, IQR 13.66–28.35)0.255
Ferritine (ug/l)*804.54 (median 612.5, IQR 297–993)962.67 (median 613.5, IQR 243–1154.25)0.970843.35 (median 632, IQR 315–1.104)427.60 (median 284, IQR 218–534)0.150
Red blood cell count (T l−1)*4.29 (median 4.27, IQR 3.86–4.81)4.305 ±(median 4.2, IQR 4.125–4.6425)0.9904.30 (median 4.23, IQR 3.91–4.82)4.20 (median 4.335, IQR 4.08–4.523)0.846
White blood cell count (G l−1)*7.68 (median 6.55, IQR 4.92–9.32)6.78 (median 6.32, IQR 5.0375–7.5375)0.5917.85 (median 6.49, IQR 4.905–9.27)8.04 (median 7.885, IQR 6.15–10.775)0.559
Platelet count (G l−1)*246.52 (median 224, IQR 180–288)246.75 (median 231.5, IQR 205–259.75)0.637246.66 (median 216, IQR 178.5–299.5)244.67 (median 236.5, IQR 232–249.25)0.393
GFR (mlmin−11.73 m2)*66.09 (median 80.5, IQR 45.45–90)66.63 (median 82.3, IQR 58.525–90)0.97366.52 (median 81.2, IQR 46.2–90)60.30 (median 66.5 IQR 44.9–84.425)0.397
Carbamide (urea) (mmol l−1)*9.58 (median 6.7, IQR 4.9–10.1)12.83 (median 5.4, IQR 4–11.25)0.3769.59 (median 6.5, IQR 4.85–10.35)13.72 (median 7.15, IQR 5.75–8.625)0.816
Creatinine (umol/l)*128.87 (median 79, IQR 66–114)142.75 (median 69, IQR 55.25–135.25)0.491128.59 (median 78, IQR 66–111.5)151.50 (median 91, IQR 63.25–121)0.863
Aspartate aminotransferase (U/l)*50.30 (median 41, IQR 26–60)48.25 (median 46.5, IQR 32.75–56.5)0.67350.51 (median 41, IQR 27–60)44.50 (median 40.5, IQR 29.5–46.25)0.771
Alanine aminotransferase (U/l)*38.76 (median 30, IQR 15.5–45.5)39.88 (median 36, IQR 19.75–50.25)0.64839.08 (median 30, IQR 16–47)35.50 (median 27, IQR 13.75–41)0.624
Gamma-glutamil transferase (U/l)*81.65 (median 54, IQR 28–91)88.50 (median 82, IQR 65.5–99.75)0.27384.32 (median 54, IQR 30.5–93)52.00 (median 75, IQR 21.75–80.25)0.403
Lactate dehydrogenase (U/l)*340.18 (median 304, IQR 210.5–387.5)341.67 (median 329.5, IQR 225–425)0.781340.34 (median 306, IQR 210.5–387.5)339.50 (median 321, IQR 229.75–400.25)0.756
Creatine kinase (U/l)*315.85 (median 125, IQR 48.5–266)167.83 (median 124, IQR 71.5–169)0.746314.50 (median 103, IQR 49.75–275.25)114.75 (median 72.5, IQR 68–119.25)0.619
D-dimer (ug/ml)*1.70 (median 1.4, IQR 0.6975–2.455)0.85 (median 0.65, IQR 0.52–0.83)0.1211.62 (median 1.6, IQR 0.89–2.645)1.94 (median 1.6, IQR 0.89–2.645)0.818

* Fischer exact test was performed with categorical parameters.

** Mann-Whitney test was performed with continuous parameters.

The nasopharyngeal swabs resulted in positive PCR test in 55 cases (56.70%), the conjunctival swabs were positive in 8 cases (8.25%), whereas both tests were positive in 5 cases (5.15%). The percentage distribution of the tests is depicted in Fig. 1.

Fig. 1.
Fig. 1.

Prevalence of positive and negative nasopharyngeal and conjunctival SARS-CoV-2 PCR results among the 97 patients investigated during recovery

NP: nasopharyngeal test, C: conjunctival test, whereas + and – signs indicate positive or negative SARS-CoV-2 PCR test, respectively.

Citation: Physiology International 2022; 10.1556/2060.2022.00113

In several patients in the COVID-19 Centers, ophthalmologic history was taken and basic examination was performed, the findings are included in Table 2. Six (6.19%) patients presented ocular symptoms, such as foreign body sensation (1 patient), acute glaucoma (1 patient), strabismus (1 patient), exophthalmos (1 patient), ectropium (1 patient) and ocular discharge (2 patients). Two of these patients were positive for conjunctival SARS-CoV-2 PCR test, and both presented ocular discharge; that is, 25% of the patients with positive conjunctival swab had ocular symptoms. Every ocular finding that had not been presented in the anamnesis was considered a symptom. Fifteen patients (15.46%) had ophthalmologic anamnesis, such as glaucoma (1 patient), pseudophakia (6 patients), retinal thrombosis (1 patient), central serous chorioretinopathy (1 patient), diabetic retinopathy (1 patient), endocrine orbitopathy (1 patient), cataract (1 patient), ptosis (1 patient) and age-related macular degeneration (AMD, 1 patient). Of the patients with PCR positive conjunctival swab 12.50% had ocular symptoms and 50.00% of them had ophthalmologic anamnesis (Table 2).

Table 2.

Summary of ocular symptoms and ophthalmologic anamnesis among the 97 patients investigated in COVID Care Centers at Semmelweis University

Ocular symptoms (6 cases)Ophthalmologic anamnesis (15 cases)
  1. foreign body sensation (1 case)

  2. acute glaucoma (1 case)

  3. strabismus (1 case)

  4. exophthalmos (1 case)

  5. ectropium (1 case)

  6. ocular discharge (2 cases)

  1. glaucoma (1 case)

  2. pseudophakia (6 cases)

  3. retinal thrombosis (1 case)

  4. central serous chorioretinopathy (1 case)

  5. diabetic retinopathy (1 case)

  6. endocrine orbitopathy (1 case)

  7. cataract (1 case)

  8. ptosis (1 case)

  9. AMD (1 case)

AMD: age-related macular degeneration.

Patients were divided in two groups in two ways: 1) whether they had ocular symptoms revealed during the examination and 2) if their conjunctival swab tested positive for SARS-CoV-2 PCR test. We have found that the only statistically significant difference between the two groups of patients with and without ocular symptoms was the prevalence of ophthalmologic anamnesis, which was significantly higher in patients with ocular symptom(s) (Table 1).

Discussion

The salient finding of the present study is that – although only in few cases – conjunctival tissue sample was positive for COVID-19 in the absence of nasopharyngeal positivity.

During the study of 97 hospitalized elderly patients (∼60 years old) with serious pulmonary and general COVID-19, symptoms were evaluated. Their majority required oxygen supplementation but none of them needed mechanical ventilation. In the present study 41 of all 97 patients required oxygen supplementation (42.3%).

At admission, the routine blood laboratory tests did not show significant difference between patients with or without ocular symptoms (Table 1). Also, there was no statistically significant difference between the vital and laboratory variables in patients with or without positive conjunctival SARS-CoV-2 PCR test result. Samples for PCR tests were taken from the conjunctival epithelium within 24 h after performing the control nasopharyngeal swab tests. Nasopharyngeal tissue sample showed positive SARS-CoV-2 PCR result in 55 cases (56.70%), whereas conjunctival swabs were positive in 8 cases (8.25%). The relatively low number of PCR positive nasopharyngeal swabs test is likely due to the fact that many patients were recovering from COVID-19 after 1–3 weeks of admission. Also, it is interesting to note that human conjunctival epithelium contains much less ACE2 receptors compared to the lower respiratory tract [11, 15]. Perhaps because of this reason, conjunctival swab can be PCR negative in spite of being a potential entrance route for SARS-CoV-2 virus.

Although conjunctivitis can be a present in COVID-19, previous findings of Bertoli et al. indicated that the exact incidence of conjunctivitis in COVID-19 patients is unclear, ranging between 0.8% and 31.6% [7]. In 2020, Güemes-Villahoz et al. reported that about 12% of COVID-19 patients presented conjunctivitis symptoms, which were associated with the disease and usually occurred in the early phase of the disease [19]. Moreover, Wu et al. have shown that in 73.7% of patients hospitalized due to COVID-19 had positive RT-PCR test for COVID-19 from the nasopharyngeal swabs, and of these, 5.2% of them yielded positive tests for SARS-CoV-2 in their conjunctival as well as nasopharyngeal specimens. A total of 31.6% of their patients had ocular manifestations consistent with conjunctivitis, including conjunctival hyperemia, chemosis, epiphora, or increased secretions. Patients with ocular symptoms were more likely to have higher white blood cell and neutrophil counts and higher levels of procalcitonin, C-reactive protein, and lactate dehydrogenase than patients without ocular symptoms [3]. Feng et al. reported in 2021 that 9.5% of hospitalized COVID-19 patients exhibited ocular signs and symptoms, whereas Chen et al. found that 5.0% of their 535 studied patients presented with conjunctival congestion as the initial COVID-19 symptom [4]. In the present study 8.25% of the hospitalized patients were positive for conjunctival COVID-19 swab PCR test.

On the basis of previous experimental [29, 30] and human [31] studies one can consider a secondary conjunctival infection due to spreading of infection along mucus membranes. Also, human studies have shown that ACE2 and other SARS-CoV-2 co-receptors are expressed in human ocular tissues [31] and that certain diseases can change protein expressions. This may be important, since our study demonstrated that ocular symptoms were present in patients whom had a history of ophthalmologic diseases, which can potentially change the expression of viral receptor proteins [31].

In hospital settings SARS-CoV-2 can be also transmitted by virus carrying stuff or patients derived respiratory droplets [32] reaching the conjunctiva of patients. In addition, SARS-CoV-2 RNA has been detected post mortem in conjunctival tissues and intravitreal biopsies [33]. Thus the original entry of virus cannot always be ascertained.

All in all, the previous and present findings suggest that the conjunctiva can be seriously affected by COVID-19, either directly by the virus or indirectly from systemic COVID diseases. Also, due to the special anatomical connection between the conjunctiva and nasal cavities, the ocular surface can be an entry route of nasopharyngeal COVID-19 infection, as the tear film is transported to the inferior nasal meatus by the nasolacrimal duct [8].

Limitation of the study

There are limitations of our pilot study. In the COVID Care Centers of Semmelweis University detailed ophthalmic assessment was not possible due to the personal protective equipment including compulsory face shield. Thus, we focused the investigation on laboratory parameters and the ocular anterior segment symptoms. In addition, we could investigate only limited number of cases, and no technical replicates were done. During the time of our investigation in early 2021, only limited amount of COVID vaccines was available in Hungary, mostly distributed among healthcare workers and elderly patients above the age of 80 years. Thus, the patients included in this study received none or only one dose of one of the COVID vaccines, mostly Pfizer, Moderna, AstraZeneca, Sinopharm or Sputnik, and because of that we did not record immunization history.

Conclusions

Although only in few cases, the data of the present study provides a proof of concept that SARS-CoV-2 can be present on the conjunctival mucosa even in nasopharyngeal negative patients, a finding, which can have clinical importance. Also, on the basis of this findings one can hypothesize that – in addition to the respiratory tract – the conjunctiva can be an entrance route for SARS-CoV-2 to the human body, which however needs to be substantiated by follow up studies. Nevertheless, in high risk conditions in addition to covering the mouth and nose with mask, the protection of the eyes is also strongly recommended.

Acknowledgements

This study was supported by TKP2021-EGA-37 and HAS/MTA Post-Covid 2021–34.

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    Hui KPY, Cheung MC, Perera R, Ng KC, Bui CHT, Ho JCW, et al. Tropism, replication competence, and innate immune responses of the coronavirus SARS-CoV-2 in human respiratory tract and conjunctiva: an analysis in ex-vivo and in-vitro cultures. Lancet Respir Med 2020; 8(7): 687695. https://doi.org/10.1016/S2213-2600(20)30193-4.

    • Crossref
    • Search Google Scholar
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  • 11.

    Bernabei F, Versura P, Rossini G, Re MC. There is a role in detection of SARS-CoV-2 in conjunctiva and tears: a comprehensive review. New Microbiol 2020; 43(4): 149155.

    • Search Google Scholar
    • Export Citation
  • 12.

    Leonardi A, Rosani U, Brun P. Ocular surface expression of SARS-CoV-2 receptors. Ocul Immunol Inflamm 2020; 28(5): 735738. https://doi.org/10.1080/09273948.2020.1772314.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Zhou L, Xu Z, Castiglione GM, Soiberman US, Eberhart CG, Duh EJ. ACE2 and TMPRSS2 are expressed on the human ocular surface, suggesting susceptibility to SARS-CoV-2 infection. bioRxiv 2020. https://doi.org/10.1101/2020.05.09.086165.

    • Search Google Scholar
    • Export Citation
  • 14.

    Grajewski RS, Rokohl AC, Becker M, Dewald F, Lehmann C, Fatkenheuer G, et al. A missing link between SARS-CoV-2 and the eye?: ACE2 expression on the ocular surface. J Med Virol 2021; 93(1): 7879. https://doi.org/10.1002/jmv.26136.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S, Sehrawat TS, et al. Extrapulmonary manifestations of COVID-19. Nat Med 2020; 26(7): 10171032. https://doi.org/10.1038/s41591-020-0968-3.

    • Crossref
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    • Export Citation
  • 16.

    Feng Y, Park J, Zhou Y, Armenti ST, Musch DC, Mian SI. Ocular manifestations of hospitalized COVID-19 patients in a tertiary care academic medical center in the United States: a cross-sectional study. Clin Ophthalmol 2021; 15: 15511556. https://doi.org/10.2147/OPTH.S301040.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17.

    Nagy ZZ. Ophthalmic signs and complications of the COVID-19 infection. Dev Health Sci 2020; 3: 7982. https://doi.org/10.1556/2066.2021.40001.

    • Search Google Scholar
    • Export Citation
  • 18.

    Arora R, Goel R, Kumar S, Chhabra M, Saxena S, Manchanda V, et al. Evaluation of SARS-CoV-2 in tears of patients with moderate to severe COVID-19. Ophthalmology 2021; 128(4): 494503. https://doi.org/10.1016/j.ophtha.2020.08.029.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19.

    Guemes-Villahoz N, Burgos-Blasco B, Garcia-Feijoo J, Saenz-Frances F, Arriola-Villalobos P, Martinez-de-la-Casa JM, et al. Conjunctivitis in COVID-19 patients: frequency and clinical presentation. Graefes Arch Clin Exp Ophthalmol 2020; 258(11): 25012507. https://doi.org/10.1007/s00417-020-04916-0.

    • Crossref
    • Search Google Scholar
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  • 20.

    Nagy ZZ, Gadó K. A COVID-19-járvánnyal kapcsolatos legfontosabb szemészeti teendők az ambuláns és műtéti ellátás területén (The most important things to do during the ophthalmic outpatient and surgical care related to COVID-19 epidemic). Szemészet 2020; 157(3): 182190.

    • Search Google Scholar
    • Export Citation
  • 21.

    Nagy ZZ. A koronavírus- (COVID-19-) fertőzés szemészeti tüneteiről és a szemészeti teendőkről (About the ophthalmic symptoms and what to do in case of Coronavirus (COVID-19) infection). Orvosképzés 2020; 95(3): 527531.

    • Search Google Scholar
    • Export Citation
  • 22.

    Deng W, Bao L, Gao H, Xiang Z, Qu Y, Song Z, et al. Ocular conjunctival inoculation of SARS-CoV-2 can cause mild COVID-19 in rhesus macaques. Nat Commun 2020; 11(1): 4400. https://doi.org/10.1038/s41467-020-18149-6.

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  • 23.

    Xia J, Tong J, Liu M, Shen Y, Guo D. Evaluation of coronavirus in tears and conjunctival secretions of patients with SARS-CoV-2 infection. J Med Virol 2020; 92(6): 589-594. https://doi.org/10.1002/jmv.25725.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 24.

    Sun CB, Wang YY, Liu GH, Liu Z. Role of the eye in transmitting human coronavirus: what we know and what we do not know. Front Public Health 2020; 8: 155. https://doi.org/10.3389/fpubh.2020.00155.

    • Crossref
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    • Export Citation
  • 25.

    Guemes–Villahoz N, Burgos-Blasco B, Vidal-Villegas B, Garcia-Feijoo J, Arriola-Villalobos P, Martinez-de-la-Casa JM, et al. Novel insights into the transmission of SARS-CoV-2 through the ocular surface and its detection in tears and conjunctival secretions: a review. Adv Ther 2020; 37(10): 40864095. https://doi.org/10.1007/s12325-020-01442-7.

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  • 26.

    Liu Z, Sun CB. Conjunctiva is not a preferred gateway of entry for SARS-CoV-2 to infect respiratory tract. J Med Virol 2020; 92(9): 14101412. https://doi.org/10.1002/jmv.25859.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27.

    Colavita F, Lapa D, Carletti F, Lalle E, Bordi L, Marsella P, et al. SARS-CoV-2 isolation from ocular secretions of a patient with COVID-19 in Italy with prolonged viral RNA detection. Ann Intern Med 2020; 173(3): 242243. https://doi.org/10.7326/M20-1176.

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  • 28.

    Colavita F, Curiale S, Lapa D, Castilletti C. Live and replication-competent SARS-CoV-2 in ocular fluids. JAMA Ophthalmol 2021; 139(9): 1041. https://doi.org/10.1001/jamaophthalmol.2021.2681.

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  • 29.

    Shen J, Wu J, Yang Y, Wang P, Luo T, Guo Y, et al. The paradoxical problem with COVID-19 ocular infection: moderate clinical manifestation and potential infection risk. Comput Struct Biotechnol J 2021; 19: 10631071. https://doi.org/10.1016/j.csbj.2021.01.039.

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    Yaguchi S, Ogawa Y, Shimmura S, Hatou S, Nakamura S, Inaba T, et al. Presence and physiologic function of the renin-angiotensin system in mouse lacrimal gland. Invest Ophthalmol Vis Sci 2012; 53(9): 54165425. https://doi.org/10.1167/iovs.12-9891.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 31.

    Martin G, Wolf J, Lapp T, Agostini HT, Schlunck G, Auw-Hadrich C, et al. Viral S protein histochemistry reveals few potential SARS-CoV-2 entry sites in human ocular tissues. Sci Rep 2021; 11(1): 19140. https://doi.org/10.1038/s41598-021-98709-y.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 32.

    Nagy A, Horvath A, Farkas A, Furi P, Erdelyi T, Madas BG, et al. Modeling of nursing care-associated airborne transmission of SARS-CoV-2 in a real-world hospital setting. Geroscience 2022; 44(2): 585595. https://doi.org/10.1007/s11357-021-00512-0.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 33.

    Penkava J, Muenchhoff M, Badell I, Osterman A, Delbridge C, Niederbuchner F, et al. Detection of SARS-CoV-2-RNA in post-mortem samples of human eyes. Graefes Arch Clin Exp Ophthalmol 2022; 260(5): 17891797. https://doi.org/10.1007/s00417-021-05529-x.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 1.

    Franchini AF, Auxilia F, Galimberti PM, Piga MA, Castaldi S, Porro A. COVID 19 and Spanish flu pandemics: all it changes, nothing changes. Acta Biomed 2020; 91(2): 245250. https://doi.org/10.23750/abm.v91i2.9625.

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    Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis 2020; 20(5): 533534. https://doi.org/10.1016/S1473-3099(20)30120-1.

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  • 3.

    Wu P, Duan F, Luo C, Liu Q, Qu X, Liang L, et al. Characteristics of ocular findings of patients with coronavirus disease 2019 (COVID-19) in Hubei Province, China. JAMA Ophthalmol 2020; 138(5): 575578. https://doi.org/10.1001/jamaophthalmol.2020.1291.

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  • 4.

    Chen L, Deng C, Chen X, Zhang X, Chen B, Yu H, et al. Ocular manifestations and clinical characteristics of 535 cases of COVID-19 in Wuhan, China: a cross-sectional study. Acta Ophthalmol 2020; 98(8): e951e959. https://doi.org/10.1111/aos.14472.

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  • 5.

    Ulhaq ZS, Soraya GV. The prevalence of ophthalmic manifestations in COVID-19 and the diagnostic value of ocular tissue/fluid. Graefes Arch Clin Exp Ophthalmol 2020; 258(6): 13511352. https://doi.org/10.1007/s00417-020-04695-8.

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    Wise J. Covid-19: new coronavirus variant is identified in UK. BMJ 2020; 371: m4857. https://doi.org/10.1136/bmj.m4857.

  • 7.

    Bertoli F, Veritti D, Danese C, Samassa F, Sarao V, Rassu N, et al. Ocular findings in COVID-19 patients: a review of direct manifestations and indirect effects on the eye. J Ophthalmol 2020; 2020: 4827304. https://doi.org/10.1155/2020/4827304.

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  • 8.

    Ho D, Low R, Tong L, Gupta V, Veeraraghavan A, Agrawal R. COVID-19 and the ocular surface: a review of transmission and manifestations. Ocul Immunol Inflamm 2020; 28(5): 726734. https://doi.org/10.1080/09273948.2020.1772313.

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  • 9.

    Olson DJ, Ghosh A, Zhang AY. Ophthalmic manifestations of coronavirus disease 2019 and ocular side effects of investigational pharmacologic agents. Curr Opin Ophthalmol 2020; 31(5): 403415. https://doi.org/10.1097/ICU.0000000000000682.

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  • 10.

    Hui KPY, Cheung MC, Perera R, Ng KC, Bui CHT, Ho JCW, et al. Tropism, replication competence, and innate immune responses of the coronavirus SARS-CoV-2 in human respiratory tract and conjunctiva: an analysis in ex-vivo and in-vitro cultures. Lancet Respir Med 2020; 8(7): 687695. https://doi.org/10.1016/S2213-2600(20)30193-4.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11.

    Bernabei F, Versura P, Rossini G, Re MC. There is a role in detection of SARS-CoV-2 in conjunctiva and tears: a comprehensive review. New Microbiol 2020; 43(4): 149155.

    • Search Google Scholar
    • Export Citation
  • 12.

    Leonardi A, Rosani U, Brun P. Ocular surface expression of SARS-CoV-2 receptors. Ocul Immunol Inflamm 2020; 28(5): 735738. https://doi.org/10.1080/09273948.2020.1772314.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Zhou L, Xu Z, Castiglione GM, Soiberman US, Eberhart CG, Duh EJ. ACE2 and TMPRSS2 are expressed on the human ocular surface, suggesting susceptibility to SARS-CoV-2 infection. bioRxiv 2020. https://doi.org/10.1101/2020.05.09.086165.

    • Search Google Scholar
    • Export Citation
  • 14.

    Grajewski RS, Rokohl AC, Becker M, Dewald F, Lehmann C, Fatkenheuer G, et al. A missing link between SARS-CoV-2 and the eye?: ACE2 expression on the ocular surface. J Med Virol 2021; 93(1): 7879. https://doi.org/10.1002/jmv.26136.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S, Sehrawat TS, et al. Extrapulmonary manifestations of COVID-19. Nat Med 2020; 26(7): 10171032. https://doi.org/10.1038/s41591-020-0968-3.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16.

    Feng Y, Park J, Zhou Y, Armenti ST, Musch DC, Mian SI. Ocular manifestations of hospitalized COVID-19 patients in a tertiary care academic medical center in the United States: a cross-sectional study. Clin Ophthalmol 2021; 15: 15511556. https://doi.org/10.2147/OPTH.S301040.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17.

    Nagy ZZ. Ophthalmic signs and complications of the COVID-19 infection. Dev Health Sci 2020; 3: 7982. https://doi.org/10.1556/2066.2021.40001.

    • Search Google Scholar
    • Export Citation
  • 18.

    Arora R, Goel R, Kumar S, Chhabra M, Saxena S, Manchanda V, et al. Evaluation of SARS-CoV-2 in tears of patients with moderate to severe COVID-19. Ophthalmology 2021; 128(4): 494503. https://doi.org/10.1016/j.ophtha.2020.08.029.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19.

    Guemes-Villahoz N, Burgos-Blasco B, Garcia-Feijoo J, Saenz-Frances F, Arriola-Villalobos P, Martinez-de-la-Casa JM, et al. Conjunctivitis in COVID-19 patients: frequency and clinical presentation. Graefes Arch Clin Exp Ophthalmol 2020; 258(11): 25012507. https://doi.org/10.1007/s00417-020-04916-0.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20.

    Nagy ZZ, Gadó K. A COVID-19-járvánnyal kapcsolatos legfontosabb szemészeti teendők az ambuláns és műtéti ellátás területén (The most important things to do during the ophthalmic outpatient and surgical care related to COVID-19 epidemic). Szemészet 2020; 157(3): 182190.

    • Search Google Scholar
    • Export Citation
  • 21.

    Nagy ZZ. A koronavírus- (COVID-19-) fertőzés szemészeti tüneteiről és a szemészeti teendőkről (About the ophthalmic symptoms and what to do in case of Coronavirus (COVID-19) infection). Orvosképzés 2020; 95(3): 527531.

    • Search Google Scholar
    • Export Citation
  • 22.

    Deng W, Bao L, Gao H, Xiang Z, Qu Y, Song Z, et al. Ocular conjunctival inoculation of SARS-CoV-2 can cause mild COVID-19 in rhesus macaques. Nat Commun 2020; 11(1): 4400. https://doi.org/10.1038/s41467-020-18149-6.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23.

    Xia J, Tong J, Liu M, Shen Y, Guo D. Evaluation of coronavirus in tears and conjunctival secretions of patients with SARS-CoV-2 infection. J Med Virol 2020; 92(6): 589-594. https://doi.org/10.1002/jmv.25725.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 24.

    Sun CB, Wang YY, Liu GH, Liu Z. Role of the eye in transmitting human coronavirus: what we know and what we do not know. Front Public Health 2020; 8: 155. https://doi.org/10.3389/fpubh.2020.00155.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Guemes–Villahoz N, Burgos-Blasco B, Vidal-Villegas B, Garcia-Feijoo J, Arriola-Villalobos P, Martinez-de-la-Casa JM, et al. Novel insights into the transmission of SARS-CoV-2 through the ocular surface and its detection in tears and conjunctival secretions: a review. Adv Ther 2020; 37(10): 40864095. https://doi.org/10.1007/s12325-020-01442-7.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26.

    Liu Z, Sun CB. Conjunctiva is not a preferred gateway of entry for SARS-CoV-2 to infect respiratory tract. J Med Virol 2020; 92(9): 14101412. https://doi.org/10.1002/jmv.25859.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27.

    Colavita F, Lapa D, Carletti F, Lalle E, Bordi L, Marsella P, et al. SARS-CoV-2 isolation from ocular secretions of a patient with COVID-19 in Italy with prolonged viral RNA detection. Ann Intern Med 2020; 173(3): 242243. https://doi.org/10.7326/M20-1176.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28.

    Colavita F, Curiale S, Lapa D, Castilletti C. Live and replication-competent SARS-CoV-2 in ocular fluids. JAMA Ophthalmol 2021; 139(9): 1041. https://doi.org/10.1001/jamaophthalmol.2021.2681.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 29.

    Shen J, Wu J, Yang Y, Wang P, Luo T, Guo Y, et al. The paradoxical problem with COVID-19 ocular infection: moderate clinical manifestation and potential infection risk. Comput Struct Biotechnol J 2021; 19: 10631071. https://doi.org/10.1016/j.csbj.2021.01.039.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 30.

    Yaguchi S, Ogawa Y, Shimmura S, Hatou S, Nakamura S, Inaba T, et al. Presence and physiologic function of the renin-angiotensin system in mouse lacrimal gland. Invest Ophthalmol Vis Sci 2012; 53(9): 54165425. https://doi.org/10.1167/iovs.12-9891.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 31.

    Martin G, Wolf J, Lapp T, Agostini HT, Schlunck G, Auw-Hadrich C, et al. Viral S protein histochemistry reveals few potential SARS-CoV-2 entry sites in human ocular tissues. Sci Rep 2021; 11(1): 19140. https://doi.org/10.1038/s41598-021-98709-y.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 32.

    Nagy A, Horvath A, Farkas A, Furi P, Erdelyi T, Madas BG, et al. Modeling of nursing care-associated airborne transmission of SARS-CoV-2 in a real-world hospital setting. Geroscience 2022; 44(2): 585595. https://doi.org/10.1007/s11357-021-00512-0.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 33.

    Penkava J, Muenchhoff M, Badell I, Osterman A, Delbridge C, Niederbuchner F, et al. Detection of SARS-CoV-2-RNA in post-mortem samples of human eyes. Graefes Arch Clin Exp Ophthalmol 2022; 260(5): 17891797. https://doi.org/10.1007/s00417-021-05529-x.

    • Crossref
    • Search Google Scholar
    • Export Citation
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The author instruction is available in PDF.

Please, download the file from HERE

 

 

Editor-in-Chief

László ROSIVALL (Semmelweis University, Budapest, Hungary)

Managing Editor

Anna BERHIDI (Semmelweis University, Budapest, Hungary)

Co-Editors

  • Gábor SZÉNÁSI (Semmelweis University, Budapest, Hungary)
  • Ákos KOLLER (Semmelweis University, Budapest, Hungary)
  • Zsolt RADÁK (University of Physical Education, Budapest, Hungary)
  • László LÉNÁRD (University of Pécs, Hungary)
  • Zoltán UNGVÁRI (Semmelweis University, Budapest, Hungary)

Assistant Editors

  • Gabriella DÖRNYEI (Semmelweis University, Budapest, Hungary)
  • Zsuzsanna MIKLÓS (Semmelweis University, Budapest, Hungary)
  • György NÁDASY (Semmelweis University, Budapest, Hungary)

Hungarian Editorial Board

  • György BENEDEK (University of Szeged, Hungary)
  • Zoltán BENYÓ (Semmelweis University, Budapest, Hungary)
  • Mihály BOROS (University of Szeged, Hungary)
  • László CSERNOCH (University of Debrecen, Hungary)
  • Magdolna DANK (Semmelweis University, Budapest, Hungary)
  • László DÉTÁRI (Eötvös Loránd University, Budapest, Hungary)
  • Zoltán GIRICZ (Semmelweis University, Budapest, Hungary and Pharmahungary Group, Szeged, Hungary)
  • Zoltán HANTOS (Semmelweis University, Budapest and University of Szeged, Hungary)
  • László HUNYADI (Semmelweis University, Budapest, Hungary)
  • Gábor JANCSÓ (University of Pécs, Hungary)
  • Zoltán KARÁDI (University of Pecs, Hungary)
  • Miklós PALKOVITS (Semmelweis University, Budapest, Hungary)
  • Gyula PAPP (University of Szeged, Hungary)
  • Gábor PAVLIK (University of Physical Education, Budapest, Hungary)
  • András SPÄT (Semmelweis University, Budapest, Hungary)
  • Gyula SZABÓ (University of Szeged, Hungary)
  • Zoltán SZELÉNYI (University of Pécs, Hungary)
  • Lajos SZOLLÁR (Semmelweis University, Budapest, Hungary)
  • Gyula TELEGDY (MTA-SZTE, Neuroscience Research Group and University of Szeged, Hungary)
  • József TOLDI (MTA-SZTE Neuroscience Research Group and University of Szeged, Hungary)
  • Árpád TÓSAKI (University of Debrecen, Hungary)

International Editorial Board

  • Dragan DJURIC (University of Belgrade, Serbia)
  • Christopher H.  FRY (University of Bristol, UK)
  • Stephen E. GREENWALD (Blizard Institute, Barts and Queen Mary University of London, UK)
  • Osmo Otto Päiviö HÄNNINEN (Finnish Institute for Health and Welfare, Kuopio, Finland)
  • Helmut G. HINGHOFER-SZALKAY (Medical University of Graz, Austria)
  • Tibor HORTOBÁGYI (University of Groningen, Netherlands)
  • George KUNOS (National Institutes of Health, Bethesda, USA)
  • Massoud MAHMOUDIAN (Iran University of Medical Sciences, Tehran, Iran)
  • Tadaaki MANO (Gifu University of Medical Science, Japan)
  • Luis Gabriel NAVAR (Tulane University School of Medicine, New Orleans, USA)
  • Hitoo NISHINO (Nagoya City University, Japan)
  • Ole H. PETERSEN (Cardiff University, UK)
  • Ulrich POHL (German Centre for Cardiovascular Research and Ludwig-Maximilians-University, Planegg, Germany)
  • Andrej A. ROMANOVSKY (University of Arizona, USA)
  • Anwar Ali SIDDIQUI (Aga Khan University, Karachi, Pakistan)
  • Csaba SZABÓ (University of Fribourg, Switzerland)
  • Eric VICAUT (Université de Paris, UMRS 942 INSERM, France)
  • Nico WESTERHOF (Vrije Universiteit Amsterdam, The Netherlands)

 

Editorial Correspondence:
Physiology International
Semmelweis University
Faculty of Medicine, Institute of Translational Medicine
Nagyvárad tér 4, H-1089 Budapest, Hungary
Phone/Fax: +36-1-2100-100
E-mail: pi@semmelweis-univ.hu

Indexing and Abstracting Services:

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  • Index Copernicus
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  • Referativnyi Zhurnal
  • SCOPUS
  • WoS - Science Citation Index Expanded

 

2021  
Web of Science  
Total Cites
WoS
330
Journal Impact Factor 1,697
Rank by Impact Factor

Physiology 73/81

Impact Factor
without
Journal Self Cites
1,697
5 Year
Impact Factor
1,806
Journal Citation Indicator 0,47
Rank by Journal Citation Indicator

Physiology 69/86

Scimago  
Scimago
H-index
31
Scimago
Journal Rank
0,32
Scimago Quartile Score Medicine (miscellaneous) (Q3)
Physiology (medical) (Q3)
Scopus  
Scopus
Cite Score
2,7
Scopus
CIte Score Rank
Physiology (medical) 69/101 (Q3)
Scopus
SNIP
0,591

 

2020  
Total Cites 245
WoS
Journal
Impact Factor
2,090
Rank by Physiology 62/81 (Q4)
Impact Factor  
Impact Factor 1,866
without
Journal Self Cites
5 Year 1,703
Impact Factor
Journal  0,51
Citation Indicator  
Rank by Journal  Physiology 67/84 (Q4)
Citation Indicator   
Citable 42
Items
Total 42
Articles
Total 0
Reviews
Scimago 29
H-index
Scimago 0,417
Journal Rank
Scimago Physiology (medical) Q3
Quartile Score  
Scopus 270/1140=1,9
Scite Score  
Scopus Physiology (medical) 71/98 (Q3)
Scite Score Rank  
Scopus 0,528
SNIP  
Days from  172
submission  
to acceptance  
Days from  106
acceptance  
to publication  

2019  
Total Cites
WoS
137
Impact Factor 1,410
Impact Factor
without
Journal Self Cites
1,361
5 Year
Impact Factor
1,221
Immediacy
Index
0,294
Citable
Items
34
Total
Articles
33
Total
Reviews
1
Cited
Half-Life
2,1
Citing
Half-Life
9,3
Eigenfactor
Score
0,00028
Article Influence
Score
0,215
% Articles
in
Citable Items
97,06
Normalized
Eigenfactor
0,03445
Average
IF
Percentile
12,963
Scimago
H-index
27
Scimago
Journal Rank
0,267
Scopus
Scite Score
235/157=1,5
Scopus
Scite Score Rank
Physiology (medical) 73/99 (Q3)
Scopus
SNIP
0,38

 

Physiology International
Publication Model Hybrid
Submission Fee none
Article Processing Charge 1100 EUR/article
Printed Color Illustrations 40 EUR (or 10 000 HUF) + VAT / piece
Regional discounts on country of the funding agency World Bank Lower-middle-income economies: 50%
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Further Discounts Editorial Board / Advisory Board members: 50%
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Subscription fee 2022 Online subsscription: 644 EUR / 806 USD
Print + online subscription: 752 EUR / 942 USD
Subscription fee 2023 Online subsscription: 664 EUR / 806 USD
Print + online subscription: 776 EUR / 942 USD
Subscription Information Online subscribers are entitled access to all back issues published by Akadémiai Kiadó for each title for the duration of the subscription, as well as Online First content for the subscribed content.
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Physiology International
Language English
Size B5
Year of
Foundation
2006 (1950)
Volumes
per Year
1
Issues
per Year
4
Founder Magyar Tudományos Akadémia
Founder's
Address
H-1051 Budapest, Hungary, Széchenyi István tér 9.
Publisher Akadémiai Kiadó
Publisher's
Address
H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
Responsible
Publisher
Chief Executive Officer, Akadémiai Kiadó
ISSN 2498-602X (Print)
ISSN 2677-0164 (Online)

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