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  • SARS-CoV-2 Is Uncommon in Conjunctivitis Cases

    By Lynda Seminara
    Selected by Prem S. Subramanian, MD, PhD
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    Journal Highlights

    Clinical Ophthalmology
    2022;16:127-133

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    Karakus et al. looked at the prevalence of conjunctival SARS-CoV-2 among patients with suspected viral conjunc­tivitis but no respiratory symptoms of COVID-19. They also questioned whether conjunctivitis could be an early sign of COVID infection. Among 36 adults with conjunctivitis treated at their tertiary care center during the pandemic, SARS-CoV-2 RNA was not detected in any specimen collected during the initial visit, and no patient received a COVID-19 diagnosis within the ensuing two weeks.

    Participants of this prospective study were ≥18 years of age and presented to the Wilmer Eye Institute with acute conjunctivitis between May 2020 and May 2021. For each patient, the authors recorded demographics and ocular and systemic symptoms. All patients underwent a slit-lamp exam and collec­tion of tissue specimens. Although the protocol was to obtain five specimens per patient (nasopharyngeal, conjuncti­val from each eye, and nasal from each nostril), three patients did not consent to nasal or nasopharyngeal sampling. The specimens were placed in separate tubes and tested for SARS-CoV-2 by reverse transcription-polymerase chain reaction. Subsequently, each patient was contacted by phone for follow-up regarding their symptoms and any results of adenovirus and COVID testing, if performed elsewhere.

    Among the 36 patients enrolled, the most common ocular symptom at presentation was redness, noted in 35 (97%) of the patients. Fourteen patients (39%) had symptoms in both eyes. Thirty-two patients (89%) pre­sented with acute follicular conjunctivi­tis. SARS-CoV-2 RNA was not found in any sample collected at the study visit (95% confidence interval, 0-0.08), and no participant contracted COVID-19 in the two-week follow-up period. The authors learned that 25 patients were tested for conjunctival adenovirus and that the result was positive for nine. Relatively late testing could play a role in the low positivity rate, said the authors. Cases that were further along may not have been detectable.

    Ruling out common viral causes and testing ocular samples for SARS-CoV-2 had been recommended to detect subclinical COVID-19. However, this work suggests that the precautionary measures for suspected viral conjuncti­vitis need not differ from prepandemic norms. The authors believe that testing for SARS-CoV-2 may not be crucial un­less the conjunctivitis is accompanied by COVID symptoms. They acknowl­edged that larger studies are needed to better estimate the prevalence of conjunctivitis related to SARS-CoV-2.

    The original article can be found here.