La Distia Nora Rina, Zahra Syaffa Sadida, Riasanti Mei, Fatimah Aliya, Ningtias Rani Dwi, Ibrahim Fera, Bela Budiman, Handayani R R Diah, Yasmon Andi, Susiyanti Made, Edwar Lukman, Aziza Yulia, Sitompul Ratna
Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia - Cipto Mangunkusumo Kirana Eye Hospital, Jakarta, Indonesia.
Universitas Indonesia Hospital (RSUI), Depok, West Java, Indonesia.
Heliyon. 2024 Mar 27;10(7):e28649. doi: 10.1016/j.heliyon.2024.e28649. eCollection 2024 Apr 15.
To evaluate the correlation between dry eye symptoms and coronavirus disease 2019 (COVID-19) infection and to assess the real-time reverse transcription-polymerase chain reaction (RT‒PCR) of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) from the conjunctival swab.
A prospective observational case series study was conducted of all suspected and confirmed COVID-19 patients from Dr. Cipto Mangunkusumo Hospital (RSCM) and the Universitas Indonesia Hospital (RSUI). On the first day of the visit (day 0), systemic clinical symptoms and naso-oropharyngeal (NO) RT‒PCR results will classify all subjects as non-, suspected, or confirmed (mild, moderate, and severe) COVID-19. In all patients, we determined the dry eye symptoms based on the Ocular Surface Disease Index (OSDI) and followed up 7(day 7) and 14 days (day 14) after the first visit. When it was technically possible, we also examined the objective dry eye measurements: tear meniscus height (TMH), noninvasive Keratograph® break-up time (NIKBUT), and ocular redness. Additionally, we took conjunctival swab samples for SARS-CoV-2 RT-PCR in all patients.
The OSDI scores for 157 patients decreased across days 0, 7, and 14 (median (interquartile range): 2.3 (0-8), 0 (0-3), and 0 (0-0), p value < 0.0001 (D0 vs D14). The moderate-severe COVID-19 group had a higher OSDI score than the other groups at median D0 (15.6 vs 0-2.3), p value < 0.0001 and this pattern was consistently seen at follow-up D7 and D14. However, dry eye complaints were not correlated with the three objective dry eye measurements in mild-moderate COVID-19 patients. NO RT‒PCR results were positive in 32 (20.4%) patients, namely, 13 and 19 moderate-severe and mild COVID-19 patients, respectively. Positive RT‒PCR results were observed in 7/157 (4.5%) conjunctival swab samples from 1 in non-COVID-19 group and 6 in mild group.
In the early phase of infection, COVID-19 patients experience dry eye symptoms, which have no correlation with objective dry eye measurements. SARS-CoV-2 in conjunctival swab samples can be detected in patients with normal-to-mild COVID-19, which shows the risk of ocular transmission.
评估干眼症状与2019冠状病毒病（COVID-19）感染之间的相关性，并评估严重急性呼吸综合征冠状病毒2（SARS-CoV-2）在结膜拭子中的实时逆转录聚合酶链反应（RT-PCR）情况。
对来自西托·曼古库苏莫博士医院（RSCM）和印度尼西亚大学医院（RSUI）的所有疑似和确诊COVID-19患者进行了一项前瞻性观察性病例系列研究。在就诊的第一天（第0天），全身临床症状和鼻咽（NO）RT-PCR结果将把所有受试者分类为非COVID-19、疑似或确诊（轻度、中度和重度）COVID-19。在所有患者中，我们根据眼表疾病指数（OSDI）确定干眼症状，并在首次就诊后7天（第7天）和14天（第14天）进行随访。在技术可行的情况下，我们还检查了客观的干眼测量指标：泪膜高度（TMH）、非侵入性角膜地形图仪测量的泪膜破裂时间（NIKBUT）和眼部发红情况。此外，我们对所有患者采集结膜拭子样本进行SARS-CoV-2 RT-PCR检测。
157例患者的OSDI评分在第0天、第7天和第14天有所下降（中位数（四分位间距）：2.3（0-8）、0（0-3）和0（0-0），p值<0.0001（第0天与第14天比较）。中度至重度COVID-19组在第0天的中位数OSDI评分高于其他组（15.6 vs 0-2.3），p值<0.0001，并且在随访的第7天和第14天一直呈现这种模式。然而，在轻度至中度COVID-19患者中，干眼主诉与三项客观干眼测量指标无关。32例（20.4%）患者的NO RT-PCR结果呈阳性，分别为13例中度至重度和19例轻度COVID-19患者。在非COVID-19组的1例患者和轻度组的6例患者的157份结膜拭子样本中，有7份（4.5%）检测到SARS-CoV-2 RT-PCR结果呈阳性。
在感染的早期阶段，COVID-19患者会出现干眼症状，这些症状与客观干眼测量指标无关。在COVID-19病情正常至轻度的患者中可检测到结膜拭子样本中的SARS-CoV-2，这表明存在眼部传播的风险。
