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确诊 2019 年新型冠状病毒病患者的眼部表现。

Ocular manifestations of a hospitalised patient with confirmed 2019 novel coronavirus disease.

机构信息

Ophthalmology, Shenzhen Eye Hospital, Shenzhen, China.

The Third People's Hospital of Shenzhen, Shenzhen, Guangdong, China.

出版信息

Br J Ophthalmol. 2020 Jun;104(6):748-751. doi: 10.1136/bjophthalmol-2020-316304. Epub 2020 Apr 7.

Abstract

PURPOSE

To report the ocular characteristics and the presence of viral RNA of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in conjunctival swab specimens in a patient with confirmed 2019 novel coronavirus disease (COVID-19).

PARTICIPANT AND METHODS

A 30-year-old man with confirmed COVID-19 and bilateral acute conjunctivitis which occurred 13 days after illness onset. Based on detailed ophthalmic examination, reverse transcription PCR (RT-PCR) was performed to detect SARS-CoV-2 virus in conjunctival swabs. The ocular characteristics, presence of viral RNA and viral dynamics of SARS-CoV-2 in the conjunctival specimens were evaluated.

RESULTS

Slit lamp examination showed bilateral acute follicular conjunctivitis. RT-PCR assay demonstrated the presence of viral RNA in conjunctival specimen 13 days after onset (cycle threshold value: 31). The conjunctival swab specimens remained positive for SARS-CoV-2 on 14 and 17 days after onset. On day 19, RT-PCR result was negative for SARS-CoV-2.

CONCLUSION

SARS-CoV-2 is capable of causing ocular complications such as viral conjunctivitis in the middle phase of illness. Precautionary measures are recommended when examining infected patients throughout the clinical course of the infection. However, conjunctival sampling might not be useful for early diagnosis because the virus may not appear initially in the conjunctiva.

摘要

目的

报告 1 例新型冠状病毒病(COVID-19)确诊患者结膜拭子标本中的严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)的眼部特征和病毒 RNA 存在情况。

参与者和方法

1 例 30 岁男性,COVID-19 确诊,发病后 13 天出现双侧急性结膜炎。根据详细的眼科检查,对结膜拭子进行逆转录 PCR(RT-PCR)检测 SARS-CoV-2 病毒。评估结膜标本中 SARS-CoV-2 的眼部特征、病毒 RNA 存在情况和病毒动力学。

结果

裂隙灯检查显示双侧急性滤泡性结膜炎。RT-PCR 检测结膜标本发病后 13 天检测到病毒 RNA(循环阈值:31)。发病后 14 天和 17 天,结膜拭子仍为 SARS-CoV-2 阳性。第 19 天,RT-PCR 结果 SARS-CoV-2 为阴性。

结论

SARS-CoV-2 能够在疾病中期引起眼部并发症,如病毒性结膜炎。在感染的整个临床过程中检查感染者时,建议采取预防措施。然而,由于病毒最初可能不会出现在结膜中,因此结膜采样可能对早期诊断没有帮助。

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