From: https://www.contagionlive.com/news/the-eyes-have-it-novel-coronavirus-in-eye-can-be-communicable
KENNETH BENDER, PHARM, MA
It was found that one-third of patients in a series of 38 hospitalized with coronavirus disease 2019 (COVID-19) had symptoms consistent with conjunctivitis. Two of the patients tested positive for SARS-CoV-2 by RT-PCR from conjunctival and nasopharyngeal swabs, and one patient reported excessive tearing as the first symptom of the disease.
"Because unprotected eyes were associated with a higher risk of SARS-CoV-1 transmission (in the 2003 SARS outbreak), in support of our current findings, our results could suggest that SARS-CoV-2 could be transmitted through the eye," cautions Ping Wu, MD, Department of Ophthalmology, The First College of Clinical Medical Science, Yichang Central People's Hospital, China, and colleagues.
After noting that there has been little prior assessment of ocular signs and symptoms in patients infected with SARS-CoV-1 or SARS-CoV-2, and no direct evidence has been reported that the coronavirus causes conjunctivitis or other eye diseases.
Ocular manifestations consistent with conjunctivitis, including conjunctival hyperemia, chemosis, epiphora, and increased secretions, were found in 12 of the 38 patients. These symptoms appeared more likely in patients with more severe COVID-19, as 6 of the 12 patients were considered critical, 2 were severely ill, and 4 had moderate severity. Using univariate analysis, the researchers found that patients with ocular symptoms were also more likely to have higher white blood cell and neutrophil counts, as well as higher levels of procalcitonin, C-reactive protein, and lactate dehydrogenase, than patients without ocular symptoms.
Moderate COVID-19 severity was defined as fever and/or respiratory symptoms and pulmonary involvement demonstrated by chest CT. Severe disease was characterized by dyspnea with 30 or more breaths per minute, blood oxygen saturation of 93% or less, and an arterial partial pressure of oxygen at the fraction of oxygen ratio (FOR) of 300 or less. Patients were classified as critical if they experienced respiratory failure, shock with organ failure, or multiple organ dysfunction.
“This research suggests that among patients with COVID-19, 31.6% (95% CI, 17.5–48.7) have ocular abnormalities, and most of these are among patients with more severe systemic manifestations or abnormal blood test findings,” Wu and colleagues report. “These results suggest that ocular symptoms commonly occur in patients with severe pneumonia.”
In the commentary accompanying the published report, Alfred Sommer, MD, MHS, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, commends the researchers for bringing "necessarily preliminary but valuable insights from the front line."
"The main importance of this finding is epidemiological: it confirms other reports that the virus can invade the conjunctiva, which, in turn, could serve as a source of spread."
Sommer points out that effectively containing the virus requires understanding its mode of transmission and implementing swift and vigorous interventions to stop it. "Unfortunately, this is a lesson we keep forgetting," he observed.
Sommer also recalls that it was an ophthalmologist treating patients in Wuhan, Li Wenliang, MD, who was the first to try to alert the public and call for action about the new disease, facing harsh government action and death from COVID-19.
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