Ocular compromise in COVID-19 – COVID-19

This is indicated by a meta-analysis of studies published between November 2019 and July 2020. The most frequent clinical manifestations in children and adults are symptoms conjunctival like foreign body sensation, red eye and secretions.

(Agencia CyTA-Leloir)

Foreign body sensation, red eye, watery discharge and pain are some of the eye symptoms that can occur in up to 7% of children and adults infected with COVID-19, according to a meta-analysis by researchers from Taiwan and China.

“The cellular receptors used by viruses, as well as their genome, are present in the conjunctival mucosa and infected ocular surface, which shows that the virus could use the conjunctiva as a gateway to the body,” Víctor Reviglio told CyTA Agency, professor and researcher in ophthalmology at the Faculty of Health Sciences of the Catholic University of Córdoba.

The new work analyzed 14 studies released before July 2020 and was published in “Taiwan Journal of Ophthalmology”. According to the authors, led by ophthalmologists David Hui-Kang Ma and Wei-Chi Wu, from Chang Gung Memorial Hospital in Taoyuán, Taiwan, conjunctiva symptoms are the most frequent.

“Although the prevalence of ocular symptoms is low among patients infected with SARS-CoV-2, it is imperative for ophthalmologists to understand the full spectrum of COVID-19 symptoms or signs, including ocular ones, as well as to adopt protective measures during clinical practice. ”They affirmed.

Since the pandemic, there have been anecdotal reports of ocular infection, and description of retinal vascular and immunological inflammatory lesions of the optic nerve and central nervous system associated with COVID-19 infection.

Ophthalmologists around the world are trying to decipher and better understand the biological mechanisms that regulate these disease processes in order to improve their early diagnosis and appropriate treatment.

There are more than 500 published research papers on the impact of COVID-19 on the visual health of the human and animal population. “Not only with regard to ocular pathological alterations due to COVID, but also about strategies to improve visual health care in times of pandemic,” said Evangelina Espósito, ophthalmologist at the Reina Fabiola University Clinic and professor at the Catholic University of Córdoba.

Espósito, who has a master’s degree in Clinical Ophthalmology from the University of Edinburgh, Scotland, also noted that ocular manifestations of COVID-19 therapies can occur.

“It is clear that we still do not know the implications of this virus in the immediate and much less long term. The investigation of the infectious, immunological and inflammatory mechanisms associated with this disease and the follow-up of patients over time will shed light on these questions ”, concluded Reviglio, who trained in infectious diseases of the cornea and ocular immunology at the Wilmer Eye Institute of the Johns Hopkins Hospital, in Baltimore, United States.

Conjunctival symptoms such as a foreign body sensation, red eye, and secretions are some of the clinical manifestations experienced by a percentage of children and adults with COVID-19.

Ocular manifestation, comorbidities, and detection of severe acute respiratory syndrome-coronavirus 2 from conjunctiva in coronavirus disease 2019: A systematic review and meta-analysis. Xiao Chun Ling1, Eugene Yu-Chuan Kang1, Jui-Yen Lin1, Hung-Chi Chen2, Chi-Chun Lai3, David Hui-Kang Ma4, Wei-Chi Wu. DOI: 10.4103/tjo.tjo_53_20 “Taiwan Journal of Ophthalmology

Summary

The coronavirus disease 2019 (COVID 19) pandemic has presented significant challenges for ophthalmologists. Reports have shown that ocular manifestations may be the first presenting symptoms of COVID 19 infection and the conjunctiva may be a gateway for severe acute respiratory syndrome (SARS) coronavirus 2 (SARS CoV 2).

The purpose of this article is to provide general guidance for ophthalmologists to understand the prevalence of ocular presentation in COVID 19 patients and to reduce the risk of transmission during practice.

Relevant studies published in the period from November 1, 2019 to July 15, 2020, regarding the ocular manifestations of COVID 19 and the detection of SARS CoV 2 in the eye were included in this systematic review and meta-analysis. The combined prevalence of ocular manifestations has been estimated at 7% (confidence interval [IC] 95%: 0.03-0.10) among COVID 19 patients. The combined conjunctival SARS CoV 2 detection rate was low (1%, 95% CI 0.00-0.03) .

Conjunctival symptoms were the most common ocular manifestations in COVID 19, but the positive detection rate of SARS CoV 2 virus by reverse transcription – polymerase chain reaction of conjunctival tears or secretions remained low. No studies have shown definitive transmission of COVID 19 through the ocular mucosa or secretions.

In summary, ocular manifestations in COVID 19 patients commonly included ocular surface symptoms. Although a low prevalence of ocular symptoms was found among SARS CoV 2 infected patients, it is imperative that all ophthalmologists understand the full spectrum of COVID 19 symptoms or signs, including those in the eyes, as well as adopt appropriate measures. adequate protection during clinical practice.

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