Dockery Dominique M, Rowe Susannah G, Murphy Marjorie A, Krzystolik Magdalena G
Department of Ophthalmology, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Department of Ophthalmology, Boston University School of Medicine, Boston, Massachusetts.
J Emerg Med. 2020 Jul;59(1):137-140. doi: 10.1016/j.jemermed.2020.04.060. Epub 2020 May 8.
Coronavirus disease-2019 (COVID-19), caused by a novel coronavirus termed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has been linked to ocular signs and symptoms in several case reports. Research has demonstrated that SARS-CoV-2 is spread primarily through close contact via respiratory droplets, but there is the possibility for ocular transmission, with the conjunctiva as a conduit as well as a source of infection.
Ocular manifestations of SARS-CoV-2 include follicular conjunctivitis, and have been repeatedly noted as an initial or subsequent symptom of COVID-19-positive patients. Particularly in patients with ocular manifestations, there is evidence that the virus may present in tears, based on the detection of SARS-CoV-2 in conjunctival swab samples via reverse transcription polymerase chain reaction. The virus may therefore be transmittable from the ocular surface to a new host via contact with the ocular mucosa, tears, or subsequent fomites.
All health care professionals should ask patients about ocular symptoms consistent with SARS-CoV-2, and use eye protection such as goggles or face shields as part of the standard personal protective equipment for high-risk patients in addition to wearing of masks by both the patient and provider, and should consider tears to be potentially infectious.
2019冠状病毒病(COVID-19)由一种名为严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的新型冠状病毒引起,在一些病例报告中已发现其与眼部体征和症状有关。研究表明,SARS-CoV-2主要通过呼吸道飞沫近距离接触传播,但存在眼部传播的可能性,结膜既是传播途径也是感染源。
SARS-CoV-2的眼部表现包括滤泡性结膜炎,并且已多次被指出是COVID-19阳性患者的初始或后续症状。特别是在有眼部表现的患者中,基于通过逆转录聚合酶链反应在结膜拭子样本中检测到SARS-CoV-2,有证据表明病毒可能存在于泪液中。因此,病毒可能通过与眼黏膜、泪液或后续污染物接触,从眼表传播给新宿主。
所有医护人员都应询问患者是否有与SARS-CoV-2一致的眼部症状,除了患者和医护人员都佩戴口罩外,还应使用护目镜或面罩等眼部防护用品作为高危患者标准个人防护装备的一部分,并且应认为泪液具有潜在传染性。