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COVID-19 Clinical Features

Is Conjunctivitis a Feature of COVID-19 Infection?

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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

METHODS:

  • Retrospective case series
  • Setting
    • Hubei province, China from February 9 to February 15, 2020
  • Participants
    • Patients with COVID-19
  • Study design
    • Cases reviewed for
      • Ocular signs and symptoms
      • Chest CT scans
      • Results of blood tests
      • RT-PCR tests for the virus from nasopharyngeal (NP) and conjunctival swabs

RESULTS:

  • 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

CONCLUSION:

  • 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

Learn More – Primary Sources:

Characteristics of Ocular Findings of Patients With Coronavirus Disease 2019 (COVID-19) in Hubei Province, China

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Related ObG Topics:

Loss of Taste and Smell: Key Symptoms of COVID-19 Infection
COVID-19: The Importance of GI Symptoms and Elevated LFTs
Surgical Masks Reduce Viral Shedding

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