Ocular involvement in coronavirus disease 2019 (COVID-19): a clinical and molecular analysis
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ORIGINAL PAPER
Ocular involvement in coronavirus disease 2019 (COVID-19): a clinical and molecular analysis Asaf Shemer . Adi Einan-Lifshitz . Amir Itah . Biana Dubinsky-Pertzov . Eran Pras . Idan Hecht
Received: 3 June 2020 / Accepted: 5 September 2020 Ó Springer Nature B.V. 2020
Abstract Purpose Coronavirus disease 2019 (COVID-19) caused a global pandemic with millions infected worldwide. Little is known on the ocular involvement associated with the disease. The aim of this study was to assess the clinical and molecular ocular involvement among patients with confirmed COVID-19 admitted to a tertiary care facility. Methods Consecutive patients admitted to the COVID-19 Ward of the Shamir Medical Center in Israel during March and April, 2020 were included. The control group included patients negative for COVID-19 admitted during a similar period to a different ward. Patients were examined by trained Ophthalmologists. SARS-CoV-2 conjunctival swab samples were obtained.
Results Included were 48 patients, 16 with confirmed COVID-19 and 32 controls. Median patient age was 68.5 (interquartile range: 31.5, mean: 63 ± 21) years and 48% were male. Active conjunctival injection was present in three patients (19%) with COVID19, compared to none in the controls (p = 0.034). Patients with COVID-19 were more likely to complain of foreign body sensation (31.3% vs 3.1%, p = 0.005) and redness of the eye (25% vs 0%, p = 0.003). Conjunctival injection was associated with loss of smell and taste (75% vs 7.7%, p = 0.018). Viral conjunctival swab tests all showed negative results for all three viral genes tested (E, N, and RdRp). Conclusions Among patients admitted to a tertiary referral center with confirmed COVID-19, active conjunctival injection was noted in one out of five cases, and was associated with loss of smell and taste. Conjunctival swabs for viral RNA were negative in patients with and without ocular involvement.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10792-020-01592-1) contains supplementary material, which is available to authorized users. A. Shemer A. Einan-Lifshitz A. Itah B. Dubinsky-Pertzov E. Pras I. Hecht (&) Department of Ophthalmology, Shamir Medical Center (Formerly Assaf-Harofeh), Tzrifin, Israel e-mail: [email protected] A. Shemer A. Einan-Lifshitz B. Dubinsky-Pertzov E. Pras I. Hecht Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
A. Itah Faculty of Medicine, The Hebrew University - Hadassah School of Medicine, Hadassah Campus, Jerusalem, Israel E. Pras The Matlow’s Ophthalmo-Genetics Laboratory, Department of Ophthalmology, Shamir Medical Center (Formerly Assaf-Harofeh), Tzrifin, Israel
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Int Ophthalmol
Keywords COVID-19 SARS-CoV-2 Coronavirus 2019-nCoV Ocular
to enrollment. No animal subjects were included in this study. Patient population
Introduction Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes the coronavirus disease 20
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