Viral infectious characteristics of cornea donors from the Londrina eye bank: a retrospective study and the impact of the COVID-19 pandemic

ABSTRACT

PURPOSE: To evaluate the impact of the COVID-19 pandemic and characterize the serological profile of discarded corneal donations in the coverage area of the Banco de Olhos de Londrina, through reverse transcription-polymerase chain reaction testing for COVID-19 and serological screening of cornea donors excluded because of positive test results.
METHODS: This observational retrospective study included 776 cornea donors who’s serological and reverse transcription-polymerase chain reaction test results were processed at the Hospital of Universidade Estadual de Londrina between May 2020 and 2022. The number of corneal donations and tissue utilization rates throughout the years of operation of the Banco de Olhos de Londrina were also analyzed.
RESULTS: The mean donor age was 53.14 years; 332 donors (43%) were female, and 444 (57%) were male. Positive results were identified in 15.76% of donors for hepatitis B core antibody antibodies, 0.65% for hepatitis B surface antigen, 1.03% for hepatitis C antibodies, and 0.52% for human immunodeficiency virus and human T-lymphotropic vírus. Positive reverse transcription-polymerase chain reaction results for SARS-CoV-2 were observed in 2.7% of cases. Older adults were 2.6 times more likely to test positive for SARS-CoV-2 (95% CI, 1.06-6.34) and 3.0 times more likely to test positive for hepatitis B core antibody (95% CI, 1.95-4.41) than younger individuals. A 75.2% reduction in corneal donations was observed in 2020 compared with 2019, accompanied by a 5% increase in tissue utilization, possibly associated with the effectiveness of donor screening during the pandemic.
CONCLUSION: The COVID-19 pandemic had a profound impact on the number of corneal transplants worldwide, in Brazil, and at the Banco de Olhos de Londrina because of the substantial decline in donations during this period. Hepatitis B was the leading cause of corneal tissue discard due to positive serology in both this study and previous reports, highlighting the importance of prevention programs and improved vaccination coverage. Strict legislation, comprehensive serological screening, and appropriate processing of donated tissue remain essential to eliminate potential sources of infection and ensure transplantation safety.

Keywords: Cornea; Corneal transplantation; COVID-19; Eye banks; Serology

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