COVID-19 can be transmitted through the eyes, report says
A new report published through JAMA Ophthalmology Preliminary data found may suggest that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19), could be transmitted through the eye.
Researchers analyzed data from 38 patients infected with COVID-19 from Hubei Province, China, and found that 12 (31.6%; 95% CI, 17.5% to 48.7%) had ocular manifestations including epiphora, conjunctival congestion or chemosis.
These symptoms typically occur in patients with severe systemic manifestations of COVID-19 and are consistent with conjunctivitis or pink eye. None of the 12 patients had blurred vision. However, “in univariate analysis, patients with ocular symptoms were more likely to have higher white blood cell and neutrophil counts and higher levels of procalcitonin, C-reactive protein, and lactate dehydrogenase than patients without symptoms. eyepieces, “the researchers discovered.
The study also found that COVID-19 was present on conjunctival swabs from 2 of 11 (18%) patients tested for SARS-CoV-2 via nasopharyngeal swabs.
Previously, the American Academy of Ophthalmology (AAO) observed that some reports suggest that “the virus can cause conjunctivitis and possibly be transmitted by aerosol contact with the conjunctiva”. AAO also reported that there is a low risk of spreading COVID-19 through tears.
The researchers hope their preliminary results will help “educate ophthalmologists and others around the world about the eye symptoms of COVID-19.”
“The primary importance of this finding is epidemiological: it confirms other reports that the virus can invade the conjunctiva, which could, in turn, serve as a source of spread,” said Alfred Sommer, MD, Dean Emeritus and professor at Johns Hopkins. Bloomberg School of Public Health in a comment on the new study.
“Effective containment requires an understanding of how a virus is transmitted and rapid and vigorous use of the appropriate interventions designed to stop it,” Sommer said. “Unfortunately, this is a lesson we keep forgetting.”
Historically, new infectious agents have been underestimated, and in today’s climate, Sommer says, rapid and vigorous public health interventions are warranted to reduce new infections. He points out that the first COVID-19 warnings came from Li Wenliang, MD, a Chinese ophthalmologist who cares for patients in Wuhan. Wenliang died at the age of 34 from the disease. According to the AAO, Wenliang “believed to have been infected by a patient with asymptomatic glaucoma”.
“[Wenliang] won the wrath of the Chinese government for alerting the public and calling for action, ”Sommer said. “We don’t know if he got infected through contact with patients’ eyes.”
AAO has since updated its provisional orientation for triage of patients under the care of an ophthalmologist and its recommendations on appropriate personal protective equipment (PPE) for ophthalmic use.
“The Academy and federal officials recommend protecting the mouth, nose, and eyes when caring for patients potentially infected with SARS-CoV-2,” read the AAO website. For advice on prolonged wear and reuse of masks, AAO urges ophthalmologists to follow CDC Recommendations.
Wu P, Duan F, Luo C, et al. Characteristics of the ocular findings of patients with coronavirus disease 2019 (COVID-19) in Hubei province, China [published online March 31, 2020]. JAMA Ophthalmol. doi: 10.1001 / jamaophthalmol.2020.1291.