COVID-19 Clinical Features

Is Conjunctivitis a Feature of COVID-19 Infection?

BACKGROUND AND PURPOSE:

Wu et al. (JAMA Ophthalmol., 2020) investigated ocular findings in patients with COVID-19 including whether the virus is present in the conjunctiva of patients

38 patients
- Mean age: 65.8 years
- COVID-19 confirmation from either (1) positive NP swabs or (2) fever and/or respiratory symptoms and lung CT consistent with COVID-19 pneumonia (National Chinese Guidelines)
RT-PCR test results
- NP swabs: 73.7% positive for the virus
- Both NP and conjunctival swabs: 5.2% positive for virus
Ocular manifestations (conjunctivitis): 31.6% (95% CI, 17.5 to 48.7)
- Conjunctival hyperemia
- Chemosis
- Epiphora
- Increased secretions
Disease severity
- Moderate: 4 cases
- Severe: 2 cases
- Critical: 6 cases
Patients with ocular symptoms were more likely to have higher levels for the following
- White blood cell and neutrophil counts
- Procalcitonin
- CRP
- Lactate dehydrogenase
RT-PCR results for patients with ocular abnormalities
- Nasopharyngeal swabs: 91.7% were positive
- Nasopharyngeal and conjunctival swabs: 16.7% were positive

A third of the patients in this study with COVID-19 had ocular abnormalities
- Ocular abnormalities were more common in patients with more severe disease
In one patient, conjunctivitis was the first symptom
Although the authors found a low prevalence of SARS-CoV-2 in conjunctival samples, they suggest that the virus might be transmitted via the eyes
- Researchers only performed one conjunctival sample and therefore false negatives may have resulted

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