Department of Ophthalmology, Baskent University Istanbul Hospital, Istanbul, Turkey.
Eur J Ophthalmol. 2021 Mar;31(2):NP161-NP166. doi: 10.1177/1120672120946287. Epub 2020 Jul 24.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel virus causing an ongoing pandemic in 2020. Although the symptomatic patients infected by SARS-CoV-2 generally show respiratory distress, atypical manifestations such as conjunctivitis are also observed. A series of cases are reported in which reverse transcriptase polymerase chain reaction (RT-PCR) testing on tears had demonstrated the presence of the virus. However, the transmission of the virus through ocular fluids remains unknown.
In this case report, the development of conjunctivitis is presented as the sole symptom of a new coronavirus disease 2019 (COVID-19) in an emergency health care worker. The patient's first application was to the ophthalmology clinic due to redness, stinging, tearing, and photophobia for one day in the right eye. The patient had no symptoms of fever, cough, shortness of breath, or fatigue. Two days later, the RT-PCR test, blood analysis, and chest computed tomography (CT) were applied to the patient for being in contact with a COVID positive patient. Conjunctival swabs did not identify SARS-CoV-2 by RT-PCR. However, nasopharyngeal swab and blood test confirmed the diagnosis of COVID-19. Chest CT did not show pneumonia.
This phenomenon shows that conjunctivitis may occur as a sole manifestation of COVID-19 which needs to be carefully evaluated by health care workers and eye care professionals during the pandemic.
严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)是一种新型病毒,在 2020 年引发了持续的大流行。虽然感染 SARS-CoV-2 的症状患者通常表现为呼吸窘迫,但也观察到了结膜炎等非典型表现。有一系列病例报告称,通过逆转录酶聚合酶链反应(RT-PCR)检测眼泪中存在该病毒。然而,病毒通过眼液传播的情况仍不清楚。
在本病例报告中,一名急救医护人员出现了结膜炎,这是其唯一的新型冠状病毒病 2019(COVID-19)症状。患者右眼出现眼红、刺痛、流泪和畏光,持续一天,首诊于眼科诊所。患者无发热、咳嗽、呼吸急促或疲劳等症状。两天后,患者因接触 COVID 阳性患者,接受了 RT-PCR 检测、血液分析和胸部计算机断层扫描(CT)检查。结膜拭子 RT-PCR 未检测到 SARS-CoV-2。然而,鼻咽拭子和血液检查确诊了 COVID-19。胸部 CT 未显示肺炎。
这种现象表明,结膜炎可能是 COVID-19 的唯一表现,在大流行期间,医护人员和眼科专业人员需要对此进行仔细评估。