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. 2020 Aug;98(5):e649-e655.
doi: 10.1111/aos.14445. Epub 2020 Apr 26.

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

Nan Hong #  1 , Wangshu Yu #  1 , Jianhua Xia  1 , Ye Shen  1 , Maurice Yap  2 , Wei Han  1
Affiliations

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

Nan Hong et al. Acta Ophthalmol. 2020 Aug.

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.

Keywords: conjunctivitis; coronavirus disease 2019; dry eye; severe acute respiratory syndrome coronavirus.

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Figures

Fig. 1
Fig. 1
The photograph of the both eyes of patient No. 35 showing more significant conjunctival congestion in the left eye than the right eye.
See this image and copyright information in PMC

Comment in

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