Evaluation of ocular symptoms and tropism of SARS‐CoV‐2 in patients confirmed with COVID‐19

Abstract

Purpose: The SARS-CoV-2 RNA has been detected in tears and conjunctival samples from infected individuals. Conjunctivitis is also reported in a small number of cases. We evaluated ocular symptoms and ocular tropism of SARS-CoV-2 in a group of patients with COVID-19. Method: Fifty-six patients infected with SARS-CoV-2 were recruited as subjects. Relevant medical histories were obtained from the electronic medical record system. Ocular history and ocular symptoms data were obtained by communicating directly with the subjects. The Ocular Surface Disease Index (OSDI) and Salisbury Eye Evaluation Questionnaire (SEEQ) were used to assess the anterior ocular surface condition before and after the onset of disease. Results: Patients classified as severe COVID-19 cases were more likely to have hypertension compared to mild cases (p = 0.035). Of the 56 subjects, thirteen patients (23%) were infected in Wuhan, 32 patients (57%) were community-infected, 10 patients (18%) were unknown origin, 1 (2%) was a physician likely infected by a confirmed patient. Three patients wore face mask with precaution when contacting the confirmed patients. Fifteen (27%) had aggravated ocular symptoms, of which 6 (11%) had prodromal ocular symptoms before disease onset. The differences in mean scores of OSDI questionnaire and SEEQ between before and after onset of COVID-19 were all significant (p < 0.05 for both). Conclusions: Ocular symptoms are relatively common in COVID-19 disease and may appear just before the onset of respiratory symptoms. Our data provided the anecdotal evidences of transmission of SARS-CoV-2 via ocular surface.We thank all the patients for their participation. We are grateful to the attending physicians in isolated wards of the First

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

“…Prevalence of conjunctival congestion in previous studies[ 3 4 5 6 7 8 9 ] [ Table 5 ] conducted in China showed variable results of 0.81%, 3.33%, 4.68%, 31.57%, 1.1%, 3.57%. Our study shows a prevalence of 6.29%.…”

“…Studies conducted in China showed conjunctivitis as one of the manifestations and the first case was reportedly notified by an ophthalmologist. [ 3 4 5 6 7 8 9 ] To the best of our knowledge, no studies are available in India to find the ocular symptoms among COVID-19 affected populations. This led us to conduct a study to find the prevalence of conjunctivitis and other ocular manifestation in one of the nodal hospitals for COVID-19 patients in India.…”

Ocular surface manifestation of COVID-19 and tear film analysis

“…7 Hong et al, reported that in a group of 56 patients with SARS-CoV-2 infection, 27% either had new-onset ocular symptoms, such as ocular irritation or worsened pre-existing ocular surface irritation symptoms. 23 Wu et al, reported that in a group of 38 patients, 31.6% had ocular manifestations including conjunctival hyperemia, chemosis, epiphora, and increased secretions; however, only one patient presented with conjunctivitis as the rst clinical manifestation of COVID-19. 24 Zhou et al documented ocular ndings in eight patients of a group of 121 with con rmed COVID-19.…”

Ophthalmological manifestations of COVID-19 and its transmissibility via ocular route

“…They concluded that conjunctivitis is more frequent in severe COVID and may be a warning sign of poor outcomes. On the contrary, in a prospective conducted by Hong et al , 2 they noticed that 15 (27%) of the 56 confirmed patients with COVID-19 had aggravated ocular symptoms, of which 6 (11%) had prodromal ocular symptoms before disease onset. They concluded that ocular symptoms are relatively common in COVID-19 and may appear just before the onset of respiratory symptoms.…”