[COVID-19: is transmission through eye contact possible?] / COVID-19: vozmozhen li put' peredachi cherez glaza?

The article reviews international and Russian scientific papers concerning the possibility of transmitting coronavirus infections, particularly the COVID-19, through eye surface. According to the studied literature, the incidence of ocular symptoms in COVID-19 is around 0.8-31.6%, with conjunctivitis being the most frequent manifestation. The review summarizes data on virus detection in conjunctival discharge of COVID-19 patients. Across six studies, the total number of patients is 252, among which were 8 cases (3.17%) of virus detection in the conjunctival cavity. The review discusses the reasons for infrequent detection of the virus in the lacrimal fluid. The analyzed data shows that COVID-19 associated conjunctivitis can be the first symptom, the primary manifestation, or sometimes be detected in the lacrimal fluid of patients without any concomitant signs of eye surface inflammation. The article also presents two clinical cases of patients with keratoconjunctivitis and conjunctivitis associated with COVID-19, as well as the results of experimental transconjunctival and respiratory exposure of Rhesus macaques to SARS-CoV-2 with conclusion of possibility of this type of transmission. Additionally, the review contains the opinion of researchers concerning the influence of several factors on the possibility of virus detection in the lacrimal fluid. The conclusion was made that there is possibility of COVID-19 transmission through the eye surface. While it is not being considered a major transmission route, it should not be ignored. Conjunctival cavity of COVID-19 patients can be the source of infection. Eye protection measures should be undertaken when working with potentially infected patients.

Pathogenesis, Diagnosis, and Treatment of Hemostatic Disorders in COVID-19 Patients.

The novel coronavirus infection named COVID-19 was first detected in Wuhan, China, in December 2019, and it has been responsible for significant morbidity and mortality in scores of countries. At the time this article was being written, the number of infected and deceased patients continued to grow worldwide. Most patients with severe forms of the disease suffer from pneumonia and pulmonary insufficiency; in many cases, the disease is generalized and causes multiple organ failures and a dysfunction of physiological systems. One of the most serious and prognostically ominous complications from COVID-19 is coagulopathy, in particular, decompensated hypercoagulability with the risk of developing disseminated intravascular coagulation. In most cases, local and diffuse macro- and microthromboses are present, a condition which causes multiple-organ failure and thromboembolic complications. The causes and pathogenic mechanisms of coagulopathy in COVID-19 remain largely unclear, but they are associated with systemic inflammation, including the so-called cytokine storm. Despite the relatively short period of the ongoing pandemic, laboratory signs of serious hemostatic disorders have been identified and measures for specific prevention and correction of thrombosis have been developed. This review discusses the causes of COVID-19 coagulopathies and the associated complications, as well as possible approaches to their early diagnosis, prevention, and treatment.

Coronavirus infection and ophthalmology

This article presents a review of the ocular manifestations of coronavirus disease 2019 (COVID-19) by using materials of Russian and international researchers. After the outbreak of COVID-19 began in China in December 2019, isolated works on ocular manifestations of coronavirus infection began to appear in the literature. The review article summarizes data on the origin and species of viruses that infect humans, the structure of coronaviruses, and intermediate hosts of the virus. A separate chapter is devoted to the mode of transmission for infectious. It is shown that the main route of COVID-19 transmission from person to person is airborne. Of great interest to the ophthalmologists is the review of works devoted to the virus detection in the conjunctival sac. In particular, some studies have shown that in patients with COVID-19, the virus is present in the lacrimal fluid. According to the authors, it indicates that coronavirus might be transmitted through the conjunctiva. These statements are confirmed by clinical and experimental researches. The presence of coronavirus in tears indicates the possibility to cause disease by the ocular route. That is a potential infection source for different types of physicians during routine examinations of patients, and especially by ophthalmologists. Therefore healthcare workers should wear eye protection when dealing with patients who may have COVID-19. Ophthalmologists must take necessary safety precautions, even in conducting a routine physical examination. It is also worth noting that conjunctivitis can be the first symptom of COVID-19. It is proved that the virus in the conjunctiva was detected even in patients without symptoms of eye inflammation. Also interesting for researchers is the manifestations of coronavirus infection in animals, which, according to the authors, is essential for understanding the possible mechanisms of disease development and manifestations in humans. Статья представляет собой обзор литературы, посвящённый глазным проявлениям коронавирусной инфекции. В данном обзоре использованы материалы отечественных и зарубежных исследователей. В -декабре 2019 г. в Китае началась эпидемия коронавируса COVID-19. После этого в литературе стали появляться единичные работы, посвящённые глазным проявлениям коронавирусной инфекции. В статье обобщены данные о происхождении, разновидностям вирусов, поражающих человека, структуре коронавирусов, промежуточных хозяевах. Отдельная глава посвящена путям передачи инфекции. Показано, что основной путь передачи COVID-19 от человека к человеку - воздушно-капельный. Большой интерес для офтальмологов представляет обзор работ, посвящённых обнаружению вируса в конъюнктивальной полости. В частности, в ряде исследований было показано, что у пациентов с COVID-19 вирус присутствует в слёзной жидкости, что, по мнению авторов, свидетельствует о возможном заражении через конъюнктивальную полость. Данные высказывания подтверждаются клиническими и экспериментальными работами. Наличие коронавируса в слезе свидетельствует о том, что глазная поверхность может быть источником заражения при проведении рутинных обследований пациентов врачами различных специальностей, а офтальмологов - особенно. Это позволяет сделать вывод о необходимости обязательной защиты глаз медицинского персонала при работе с пациентами, которые потенциально могут быть носителями коронавируса. Врачам-офтальмологам при проведении даже рядового обследования крайне необходимо соблюдать меры предосторожности. Также важна информация о том, что конъюнктивит может быть первым симптомом COVID-19. Доказано, что вирус в конъюнктиве был обнаружен даже у пациентов без признаков воспаления глаза. Интересна для исследователей часть обзора, которая посвящена проявлениям коронавирусной инфекции у животных, что, по мнению авторов, необходимо для понимания возможных механизмов развития заболевания и проявлений у человека.