Hong Nan, Yu Wangshu, Xia Jianhua, Shen Ye, Yap Maurice, Han Wei
The Department of Ophthalmology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China.
Acta Ophthalmol. 2020 Aug;98(5):e649-e655. doi: 10.1111/aos.14445. Epub 2020 Apr 26.
The SARS-CoV-2 RNA has been detected in tears and conjunctival samples from infected individuals. Conjunctivitis is also reported in a small number of cases. We evaluated ocular symptoms and ocular tropism of SARS-CoV-2 in a group of patients with COVID-19.
Fifty-six patients infected with SARS-CoV-2 were recruited as subjects. Relevant medical histories were obtained from the electronic medical record system. Ocular history and ocular symptoms data were obtained by communicating directly with the subjects. The Ocular Surface Disease Index (OSDI) and Salisbury Eye Evaluation Questionnaire (SEEQ) were used to assess the anterior ocular surface condition before and after the onset of disease.
Patients classified as severe COVID-19 cases were more likely to have hypertension compared to mild cases (p = 0.035). Of the 56 subjects, thirteen patients (23%) were infected in Wuhan, 32 patients (57%) were community-infected, 10 patients (18%) were unknown origin, 1 (2%) was a physician likely infected by a confirmed patient. Three patients wore face mask with precaution when contacting the confirmed patients. Fifteen (27%) had aggravated ocular symptoms, of which 6 (11%) had prodromal ocular symptoms before disease onset. The differences in mean scores of OSDI questionnaire and SEEQ between before and after onset of COVID-19 were all significant (p < 0.05 for both).
Ocular symptoms are relatively common in COVID-19 disease and may appear just before the onset of respiratory symptoms. Our data provided the anecdotal evidences of transmission of SARS-CoV-2 via ocular surface.
在感染个体的眼泪和结膜样本中检测到了严重急性呼吸综合征冠状病毒2（SARS-CoV-2）RNA。也有少数病例报告了结膜炎。我们评估了一组新型冠状病毒肺炎（COVID-19）患者的眼部症状和SARS-CoV-2的眼部嗜性。
招募56例感染SARS-CoV-2的患者作为研究对象。从电子病历系统获取相关病史。通过直接与研究对象交流获取眼部病史和眼部症状数据。使用眼表疾病指数（OSDI）和索尔兹伯里眼评估问卷（SEEQ）评估疾病发作前后的眼前节表面状况。
与轻症COVID-19病例相比，重症COVID-19病例更易患高血压（p = 0.035）。56名研究对象中，13例（23%）在武汉感染，32例（57%）为社区感染，10例（18%）感染源不明，1例（2%）为可能被确诊患者感染的医生。3例患者在接触确诊患者时佩戴了防护口罩。15例（27%）有眼部症状加重，其中6例（11%）在疾病发作前有前驱眼部症状。COVID-19发作前后OSDI问卷和SEEQ的平均得分差异均有统计学意义（两者p均<0.05）。
眼部症状在COVID-19疾病中相对常见，可能在呼吸道症状发作前就出现。我们的数据提供了SARS-CoV-2通过眼表传播的轶事证据。
