Clinical profile and prevalence of conjunctivitis in mild COVID-19 patients in a tertiary care COVID-19 hospital: A retrospective cross-sectional study

Abstract

Purpose: To find the clinical profile and prevalence of conjunctivitis and other ocular manifestations in mild COVID-19 positive patients in a nodal COVID-19 hospital. Methods: A retrospective cross-sectional, single-center study conducted in 127 mild cases of COVID-19 positive patients admitted between 27 th March and 19 th April 2020 in a tertiary care COVID-19 hospital in north India. From the hospital records, demographic data is collected. Ocular history and ocular examinations were done by face-to-face survey during ward rounds. Results: A total of 127 patients were included in the study with a median age of 38.8 years. Forty-eight (37.80%) patients had upper respiratory tract symptoms, 20 (15.75%) patients had systemic illness, 18 (14.17%) patients were using spectacles, and 50 (39.37%) patients had history of hand-eye contact. Out of 12 (9.45%) patients who had ocular complaints, 11 (8.66%) had ocular manifestation after admission. Among 11 patients, eight (6.29%) had conjunctival congestion. Three (3/8) patients had developed conjunctival congestion even before the manifestation of definite COVID-19 symptoms. Five patients (5/8) patients had no other associated ocular symptoms other than congestion. Six patients (6/8) had symptoms of upper respiratory tract infection. Conclusion: Mild conjunctivitis manifesting as conjunctival congestion is common and is one of the major ocular manifestations in COVID-19 positive patients even with milder disease.

Evidence of SARS-CoV-2 Transmission Through the Ocular Route

“…Although a retrospective cross-sectional study involving 127 COVID-19 patients conducted by Sindhuja et al showed no significant association between conjunctival congestion and hand-eye contact, another study enrolled 535 COVID-19 patients showed the difference. 47 , 48 Through searching the electronic medical records and collecting questionnaires, 46 of 535 COVID-19 patients with a history of frequent hand-eye contact were identified, and 286 cases reported an occasional hand-eye contact history. A total of 27 cases presented with conjunctival congestion, of which 13 cases had a history of occasional hand-eye contact, and 6 cases had a history of frequent hand-eye contact.…”

Eyelid Myokymia as a presumed manifestation of Coronavirus Disease 2019 (COVID-19)

“…[5,9,10,3] Non-speci c conjunctivitis, including conjunctival hyperemia, lacrimation, follicular conjunctivitis, ocular pain have been reported in 5 to 31% of patients. [11][12][13][14] While ocular surface diseases ranging from conjunctivitis to keratopathy was seen in up to 60% of critically ill patients. [15,16] Other relatively common ocular manifestations of SARS-CoV-2 include keratoconjunctivitis, epithelial defects subepithelial in ltrates and pseudodendrites.…”

Fundus Lesions in Patients Hospitalized With COVID-19 Infection in Mumbai, India: A Retrospective Review

“…Guan et al have described nine cases among a cohort of 1,099 patients in China [ 9 ]. Sindhuja et al screened 127 patients with COVID-19 in Delhi, India, and of those, 12 patients (9.45%) were symptomatic and eight patients (6.29%) had conjunctival congestion consistent with conjunctivitis [ 10 ]. Kumar et al have demonstrated the presence of SARS-CoV from conjunctival swabs in one of 45 patients (2.23%) using RT-PCR, suggesting a low level of viral detection [ 11 ].…”