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1.
J Med Virol ; 93(1): 383-388, 2021 01.
Article in English | MEDLINE | ID: covidwho-1196392

ABSTRACT

The main purpose of this study is to evaluate the presence of viral RNA of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in conjunctival swab specimen of coronavirus disease 2019 (COVID-19) patients with and without conjunctivitis to establish the diagnostic value of reverse transcription-polymerase chain reaction (RT-PCR) in each case and to describe its clinical characteristics. A cross-sectional study was conducted at the Hospital Clinico San Carlos of Madrid, Spain. Thirty-six subjects from the COVID admission unit with laboratory-confirmed SARS-CoV-2 infection were included. Conjunctival swabs were collected from 18 patients with conjunctivitis and 18 patients without conjunctivitis and RT-PCR was performed. Conjunctival swab was collected from both eyes of 36 patients (72 eyes), detecting SARS-CoV-2 RNA in conjunctival swab of two patients (5.5%). Among the 18 patients with conjunctivitis, only one of them (5.5%) showed positive results. Likewise, SARS-CoV-2 RNA was detected in one patient without conjunctivitis (5.5%). The mean age of the 36 patients was 67.9 years (range, 28-92 years) and the male-to-female ratio was 0.44 (16:20). The mean days since the onset of COVID-19 symptoms until conjunctivitis manifestation was 8 (range, 1-24 days). The mean duration of the conjunctivitis was 3 days (range, 1-7 days). SARS-CoV-2 RNA may be detected in conjunctival swabs of both patients with and without conjunctivitis. This study revealed the same rate of positive results amongst the group with and without conjunctivitis, suggesting that detecting SARS-CoV-2 in ocular fluids is not conditioned on the presence of conjunctivitis. The presence of SARS-CoV-2 RNA in ocular samples highlights the role of the eye as a possible route of transmission of the disease.


Subject(s)
Bodily Secretions/virology , COVID-19/diagnosis , Conjunctiva/chemistry , Conjunctivitis, Viral/physiopathology , RNA, Viral/analysis , Adult , Aged , Aged, 80 and over , COVID-19/virology , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Spain , Specimen Handling
2.
Adv Biomed Res ; 9: 71, 2020.
Article in English | MEDLINE | ID: covidwho-1170491

ABSTRACT

An 81-year-old female presented with a loss of consciousness and a history of fever, dry cough, dyspnea, and conjunctivitis during 5 days ago. On initial physical examination, the laboratory examination revealed high levels of lactate dehydrogenase and creatinine concomitant severe thrombocytopenia. Moreover, the peripheral blood smear showed schistocytes 3%, suggesting thrombotic thrombocytopenic purpura (TTP). A ground-glass pattern was reported in the high-resolution computed tomography of the lung. A positive polymerase chain reaction was reported for coronavirus disease 2019 (COVID-19). After initiating treatment for COVID-19, the patient received fresh frozen plasma and 24-h electrocardiogram monitoring in the emergency department. As the patient was being prepared for transfer to another hospital for plasmapheresis treatment, cardiac arrest occurred again, and the patient passed away. This study highlights the atypical behavior of this virus over the course of the disease including TTP with conjunctivitis, which could vary from case to case.

3.
Cureus ; 12(12): e12240, 2020 Dec 23.
Article in English | MEDLINE | ID: covidwho-1027765

ABSTRACT

Introduction The conjunctiva is one of the most frequently damaged targets for inflammatory responses induced by allergic immunological hypersensitivity reactions. Allergic conjunctivitis (AC) typically manifests as a spectrum of potential severity, ranging from mild symptoms to severe troublesome symptoms that might interfere significantly with daily activities and overall quality of life. Aim This study aimed to evaluate impact of the quarantine during the COVID-19 pandemic on the quality of life of allergic conjunctivitis patients. Methodology  This is a cross-sectional study conducted among confirmed patients with allergic conjunctivitis in Saudi Arabia from the period of July 2020 to September 2020. An electronic validated structured-questionnaire explored the participants' demography, symptoms, known allergen and risk factors, and patient psychological and functional domains of life using Eye Allergy Patient Impact Questionnaire (EAPIQ). Data were gathered in MS Excel and all statistical analyses were performed using SPSS version 21. Results The most common symptoms of AC was itching (79.9%) and redness of the eye (38.8%), while the most common causes was dust (46.9%) and pollens (46.9%). With regards to the assessment of EAPIQ, the mean score was higher in the impact of eye allergy symptoms domain (mean 12.6 ± 4.84 SD.), while it was lower in the impact of AC on the psychological and emotional domain (mean 10.7 ± 5.62 SD.). Statistical analysis revealed that previous history of AC and a visit to healthcare provider were the significant factors associated with the increased risk of eye allergy symptoms, troubled daily activities and bothered psychological and emotional life. Conclusion This study demonstrated that a patients' eye allergy symptoms affect many aspects of patients' daily activities. In addition to affecting functionality, these symptoms also affect patients' emotional state. Although the impact of daily activities and emotions due to eye allergy were minimal, the impact of eye allergy symptoms during quarantine period was still found to be moderate. We found the severity of AC & its impact over a patients' quality of life was moderate which suggests there was no major effect found on AC severity during the COVID-19 pandemic quarantine period. Further studies with detailed analysis of triggering factors might lead to a better understanding of the disease and its relation to the patients' activities & lifestyle which can directly affect the AC management & quality of life.

4.
Tumori ; 107(6): 498-503, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-983620

ABSTRACT

OBJECTIVE: During 2020, medical clinical activities were dramatically modified by the coronavirus disease 2019 (COVID-19) emergency. We aim to evaluate the impact of COVID-19 on radiotherapy (RT) practice in a hub cancer center. METHODS: Retrospective data collection of patients with suspected COVID-19 infection, identified by pathognomonic symptoms feedback at triage realized at the entrance to RT division. Inclusion criteria were diagnosis of oncologic disease, COVID-19-related symptoms, and signed written informed consent. RESULTS: Between 1 March and 30 June 2020, 1,006 patients accessed our RT division for RT simulation or treatment. Forty-four patients matched inclusion criteria (4.4% of all patients): 29 women and 15 men. Seventeen patients had metastatic disease. Twenty-one patients reported fever, 6 presented dyspnea, 4 complained of ageusia and anosmia, and 3 developed conjunctivitis. Thirty-six patients underwent nasal swab, with 7 positive results. From our cohort, 4 cases of pneumonia were diagnosed with computed tomography scan imaging: 3 were related to COVID-19 infection, while the fourth was evaluated as an RT adverse event. From the entire series, 4 patients died: 3 during hospitalization in intensive care unit of complications of COVID-19 and 1 of other causes neither COVID-19 nor cancer-related. CONCLUSIONS: Cancer hub allows for safe RT practice continuation while minimizing the spread of contagion in this frail patient population. A challenge for the future will be to understand pandemic consequences in cancer natural history and manage its clinical impact.


Subject(s)
COVID-19/epidemiology , Neoplasms/radiotherapy , Practice Patterns, Physicians'/standards , Radiation Oncology/standards , Radiotherapy/methods , SARS-CoV-2/isolation & purification , Aged , COVID-19/complications , COVID-19/virology , Disease Management , Female , Humans , Intensive Care Units , Italy/epidemiology , Male , Middle Aged , Neoplasms/virology , Retrospective Studies
5.
Front Med (Lausanne) ; 7: 569126, 2020.
Article in English | MEDLINE | ID: covidwho-983750

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic, caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is still underway. An understanding of the virus's mode of transmission and infection is required for its effective containment. Besides the respiratory and digestive tracts, the ocular surface presents an additional mucosal surface that is exposed to infectious droplets and direct/indirect contact. The relationship between SARS-CoV-2 infection and the eye remains controversial. This review examines up-to-date information on ocular manifestation, laboratory testing, transmission, and prevention of COVID-19. Based on clinical observations, the risk of conjunctivitis in COVID-19 is low. Despite the low incidence, positive SARS-CoV-2 results in eye specimens suggest that the ocular surface may harbor SARS-CoV-2, which may increase the infection and transmission risk. We conclude that the ocular surface remains a potential transmission route for the virus that should not be ignored. In addition, the intraocular findings have also been described in COVID-19. The measures for eye and face protection should be widely adopted to stem the tide of the pandemic.

6.
Ocul Immunol Inflamm ; 29(4): 631-633, 2021 May 19.
Article in English | MEDLINE | ID: covidwho-936239

ABSTRACT

PURPOSE: The purpose of this article is to report a bilateral conjunctivitis case in a patient with confirmed 2019 novel coronavirus disease (COVID-19). CASE REPORT/OBSERVATIONS: A 24-year-old healthy man developed severe conjunctivitis in his right eye, followed by his left eye 4 days after fever and myalgia. He reported yellowish conjunctival discharge, foreign body sensation, redness, and tearing, and those symptoms were resolved in 10 days. Analyses of nasopharyngeal secretions identified SARS-CoV-2 by polymerase chain reaction (PCR). CONCLUSION: Mild COVID-19 can cause severe bilateral conjunctivitis. The ophthalmologist may be aware of conjunctival secretions, a possible path of infection, during eye checkup.


Subject(s)
COVID-19/complications , Conjunctiva/pathology , Conjunctivitis/etiology , Eye Infections, Viral/etiology , COVID-19/diagnosis , COVID-19/virology , Conjunctiva/virology , Conjunctivitis/diagnosis , Conjunctivitis/virology , DNA, Viral/analysis , Eye Infections, Viral/diagnosis , Eye Infections, Viral/virology , Humans , Male , SARS-CoV-2/genetics , Young Adult
7.
Ital J Pediatr ; 46(1): 146, 2020 Oct 06.
Article in English | MEDLINE | ID: covidwho-818113

ABSTRACT

BACKGROUND: There is ample evidence that COVID-19 is significantly less severe in children than in adults and asthma and allergy, the most common chronic disorders in children, are not included in the top 10 comorbidities related to COVID-19 fatalities. Nevertheless, concerns about asthma and allergy are still high.. In order to evaluate the impact of paediatric COVID-19 among Italian paediatricians, we sent a 20-questions anonymous internet-based survey to 250 Italian paediatricians with particular address to allergic symptoms and those affecting the upper airways. METHODS: The questionnaire was conceived and pretested in April 2020, by a working group of experts of the Italian Paediatric Society for Allergy and Immunology (SIAIP), and structured into different sections of 20 categorized and multiple choice questions. The first part included questions about epidemiological data follows by a second part assessing the way to manage a suspected COVID-19 infection and personal experiences about that. The third part concerned questions about patients' clinical characteristics and clinical manifestations. The survey was emailed once between April and mid-May 2020. RESULTS: A total 99 participants had participated in our survey and provided responses to our electronic questionnaire. The distribution of patients reported per month varies significantly according to the geographical area (P = 0.02). Data confirmed that in the North part of Italy the rate of patients referred is higher than in the rest of Italy. Almost all respondents (98%) reported caring for up to a maximum of 10 infected children and the last 2% more than twenty. Among these patients, according to the 75% of responders, a maximum rate of 20% were affected by allergic rhino-conjunctivitis and in particular in the North of Italy while in the Centre and in the South there was a higher incidence (P = 0.09). Almost the same applies for asthma, 83% of responders declared that up to a maximum of 20% of affected children were asthmatic, from 20 to 40% for the 13,5% of responders and from 40 to 60% for the last 3,5%. As for the allergic conjunctivitis also for asthma, we found a higher incidence in the Centre and in South than in the North (P = 0.03). CONCLUSIONS: This study is the first to provide a comprehensive review of COVID-19 knowledge and impact among paediatricians in Italy about allergic asthma and upper airway involvement. From our point of view, it provides important information clearly useful for improving a good practice.


Subject(s)
Conjunctivitis, Allergic/epidemiology , Coronavirus Infections/epidemiology , Pandemics/statistics & numerical data , Pneumonia, Viral/epidemiology , Rhinitis, Allergic/epidemiology , Surveys and Questionnaires , Adolescent , Age Distribution , COVID-19 , Causality , Child , Conjunctivitis, Allergic/diagnosis , Coronavirus Infections/prevention & control , Cross-Sectional Studies , Female , Humans , Incidence , Italy/epidemiology , Male , Pandemics/prevention & control , Pediatricians/statistics & numerical data , Pediatrics/standards , Pneumonia, Viral/prevention & control , Rhinitis, Allergic/diagnosis , Risk Assessment , Sex Distribution , Societies, Medical
8.
Ocul Immunol Inflamm ; 28(8): 1280-1284, 2020 Nov 16.
Article in English | MEDLINE | ID: covidwho-817307

ABSTRACT

PURPOSE: To report bilateral follicular conjunctivitis in two confirmed Coronavirus (COVID-19) patients with the presence of Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) in conjunctival swab specimens. PARTICIPANTS AND METHODS: Two unrelated patients with confirmed SARS-CoV-2 infection and bilateral acute conjunctivitis were examined. Conjunctival swabs were assessed for the presence of SARS-CoV-2 by quantitative real-time polymerase chain reaction (RT-PCR) and viral culture. RESULTS: Both patients developed eye redness 3 days after the onset of COVID-19 symptoms. Slit lamp examination showed bilateral acute follicular conjunctivitis, which was resolved within 6 days. RT-PCR demonstrated the presence of viral RNA in conjunctival specimens from both eyes, which was unrelated to viral RNA from throat swabs. CONCLUSION: SARS-CoV-2 may cause ocular manifestations such as viral conjunctivitis. Conjunctival sampling may be useful for infected patients with conjunctivitis and fever. Precautionary measures are recommended when examining infected patients throughout the clinical course of the infection.


Subject(s)
Betacoronavirus/genetics , Conjunctivitis, Viral/virology , Coronavirus Infections/epidemiology , Eye Infections, Viral/virology , Pneumonia, Viral/epidemiology , RNA, Viral/analysis , Adult , COVID-19 , Conjunctivitis, Viral/epidemiology , Coronavirus Infections/transmission , Eye Infections, Viral/epidemiology , Humans , Incidence , Male , Pandemics , Pneumonia, Viral/transmission , Real-Time Polymerase Chain Reaction , SARS-CoV-2 , Singapore/epidemiology
9.
Indian J Occup Environ Med ; 24(2): 129-130, 2020.
Article in English | MEDLINE | ID: covidwho-789650
10.
J Ophthalmol ; 2020: 4827304, 2020.
Article in English | MEDLINE | ID: covidwho-788242

ABSTRACT

The novel pandemic coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has challenged the medical community. While diagnostic and therapeutic efforts have been focused on respiratory complications of the disease, several ocular implications have also emerged. SARS-CoV-2 RNA has been found in tears of the infected patients, and reports suggest that the ocular surface could serve as a portal of entry and a reservoir for viral transmission. Clinically, COVID-19 has been associated with mild conjunctivitis, which can be the first and only symptom of the disease. Subtle retinal changes like hyperreflective lesions in the inner layers on optical coherence tomography (OCT), cotton-wool spots, and microhemorrhages have also been reported. In addition, COVID-19 has been associated with an increased incidence of systemic diseases like diabetes mellitus and Kawasaki disease, which are particularly relevant for ophthalmologists due to their potentially severe ocular manifestations. Several treatment strategies are currently under investigation for COVID-19, but none of them have been proved to be safe and effective to date. Intensive care unit patients, due to risk factors like invasive mechanical ventilation, prone position, and multiresistant bacterial exposure, may develop ocular complications like ocular surface disorders, secondary infections, and less frequently acute ischemic optic neuropathy and intraocular pressure elevation. Among the array of drugs that have shown positive results, the use of hydroxychloroquine and chloroquine has raised a concern due to their well-known retinal toxic effects. However, the risk of retinal toxicity with short-term high-dose use of antimalarials is still unknown. Ocular side effects have also been reported with other investigational drugs like lopinavir-ritonavir, interferons, and interleukin-1 and interleukin-6 inhibitors. The aim of this review was to summarize ophthalmological implications of SARS-CoV-2 infection to serve as a reference for eye care and other physicians for prompt diagnosis and management.

11.
Pediatr Allergy Immunol ; 32(1): 17-22, 2021 01.
Article in English | MEDLINE | ID: covidwho-748746

ABSTRACT

Multisystem inflammatory syndrome in children (MIS-C) during the COVID-19 pandemic raised a global alert from the Centers for Disease Control and Prevention's Health Alert Network. The main manifestations of MIS-C (also known as pediatric MIS (PMIS)) in the setting of a severe inflammatory state include fever, diarrhea, shock, and variable presence of rash, conjunctivitis, extremity edema, and mucous membrane changes. In some cases, these symptoms progressed to multi-organ failure. The low percentage of children with asymptomatic cases compared with mild illness and moderate illness could be correlated with the rare cases of MIS-C. One potential explanation for the progression to severe MIS-C disease despite the presence of readily detectable anti-SARS-CoV-2 antibodies could be due to the potential role of antibody-dependent enhancement (ADE). We reason that the incidence of the ADE phenomenon whereby the pathogen-specific antibodies can promote pathology should be considered in vaccine development against SARS-CoV-2.


Subject(s)
COVID-19/epidemiology , Systemic Inflammatory Response Syndrome/epidemiology , Adolescent , Antibodies, Viral/immunology , Antibody-Dependent Enhancement/immunology , COVID-19/immunology , Child , Child, Preschool , Conjunctivitis/epidemiology , Diarrhea/epidemiology , Exanthema/epidemiology , Humans , Infant , Macrophage Activation/immunology , Pandemics , SARS-CoV-2/immunology , Severity of Illness Index , Systemic Inflammatory Response Syndrome/immunology , Young Adult
12.
Ocul Immunol Inflamm ; 28(6): 916-921, 2020 Aug 17.
Article in English | MEDLINE | ID: covidwho-737751

ABSTRACT

PURPOSES: To describe the prevalence of ocular features among COVID-19 patients and their relationship with clinical data, inflammatory markers and respiratory support therapy (including CPAP); to investigate SARS-CoV-2 in ocular secretions of symptomatic patients. METHODS: 172 COVID-19 patients were evaluated for presence of ocular manifestations. Clinical and laboratory data were also reviewed. Conjunctival swabs were analyzed for SARS-CoV-2 by RT-PCR. RESULTS: Forty-five patients (26.2%) reported ocular manifestations. Patients treated with CPAP were more likely to have ocular abnormalities (p <.01). The presence of ocular symptoms was not associated with more significant alterations on blood tests. Conjunctival swabs from patients with suspect conjunctivitis yielded negative results for SARS-CoV-2. CONCLUSIONS: Ocular features are not infrequent in COVID-19 patients, but the presence of SARS-CoV-2 in ocular secretions is low. Ocular manifestations in hospitalized COVID-19 patients can also be a consequence of respiratory support therapy. Prevention of possible transmission through ocular secretions is still recommended.


Subject(s)
Betacoronavirus/genetics , Conjunctiva/virology , Conjunctivitis, Viral/etiology , Coronavirus Infections/complications , Pandemics , Pneumonia, Viral/complications , RNA, Viral/analysis , COVID-19 , Conjunctivitis, Viral/diagnosis , Conjunctivitis, Viral/virology , Coronavirus Infections/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Pneumonia, Viral/epidemiology , SARS-CoV-2
13.
Graefes Arch Clin Exp Ophthalmol ; 258(11): 2501-2507, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-734094

ABSTRACT

PURPOSE: The purpose of this study was to evaluate the frequency and clinical presentation of conjunctivitis in hospitalized patients with COVID-19. METHODS: A cross-sectional study was conducted at the Hospital Clinico San Carlos of Madrid, Spain. A total of 301 subjects from the COVID admission unit with laboratory-confirmed SARS-CoV-2 infection were included. The presence and clinical characteristics of conjunctivitis were evaluated. Laboratory, radiological, and clinical results in patients with and without conjunctivitis stratified by sex were analyzed. RESULTS: Of the 301 subjects included, 180 patients (59.8%) were male and the median age was 72 years (IQ 59-82). Overall, 35 patients (11.6%) were diagnosed with acute conjunctivitis. We found no relationship between the COVID-19 severity score and the presence of conjunctivitis (P = 0.17). However, conjunctivitis was more frequent in males with moderate clinical severity and in women classified as clinically mild. The natural history of the disease seems to be a rapid self-limited conjunctivitis that improves without treatment and does not affect visual acuity nor associate short-term complications. CONCLUSIONS: Approximately, 1 out of 10 hospitalized non-critical COVID-19 patients presents conjunctivitis during the disease. Compared with other viral conjunctivitis, we found distinctive clinical findings that could guide defining and differentiating conjunctivitis in COVID-19 patients. TRIAL REGISTRATION NUMBER: 20/336_E_COVID.


Subject(s)
Betacoronavirus/isolation & purification , Conjunctivitis, Viral/epidemiology , Coronavirus Infections/epidemiology , Eye Infections, Viral/epidemiology , Pneumonia, Viral/epidemiology , Aged , Aged, 80 and over , COVID-19 , Conjunctivitis, Viral/diagnosis , Coronavirus Infections/diagnosis , Cross-Sectional Studies , Eye Infections, Viral/diagnosis , Female , Hospitalization , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/diagnosis , Prevalence , Risk Factors , SARS-CoV-2 , Spain/epidemiology
14.
Am J Ophthalmol Case Rep ; 20: 100875, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-720400

ABSTRACT

PURPOSE: The severe acute respiratory syndrome coronavirus-2 and its associated infection known as COVID-19 have resulted in a global pandemic. Ocular manifestations of COVID-19 are nonspecific and include hyperemia, chemosis, epiphora, secretions, and eyelid edema. There is a paucity in the literature regarding COVID-19 related inflammatory syndromes which may also include ocular manifestations. OBSERVATIONS: In pediatric patients, conjunctivitis has been recently reported in association with a multisystem inflammatory condition related to COVID-19 that shares features with Kawasaki disease and toxic shock syndrome. We describe the clinical course of an adult patient with symptoms and signs consistent with a Kawasaki-like syndrome. CONCLUSIONS AND IMPORTANCE: To our knowledge, this report may be the first case of a Kawasaki-like syndrome in an adult with COVID-19 infection.

15.
MMWR Morb Mortal Wkly Rep ; 69(32): 1074-1080, 2020 08 14.
Article in English | MEDLINE | ID: covidwho-695725

ABSTRACT

In April 2020, during the peak of the coronavirus disease 2019 (COVID-19) pandemic in Europe, a cluster of children with hyperinflammatory shock with features similar to Kawasaki disease and toxic shock syndrome was reported in England* (1). The patients' signs and symptoms were temporally associated with COVID-19 but presumed to have developed 2-4 weeks after acute COVID-19; all children had serologic evidence of infection with SARS-CoV-2, the virus that causes COVID-19 (1). The clinical signs and symptoms present in this first cluster included fever, rash, conjunctivitis, peripheral edema, gastrointestinal symptoms, shock, and elevated markers of inflammation and cardiac damage (1). On May 14, 2020, CDC published an online Health Advisory that summarized the manifestations of reported multisystem inflammatory syndrome in children (MIS-C), outlined a case definition,† and asked clinicians to report suspected U.S. cases to local and state health departments. As of July 29, a total of 570 U.S. MIS-C patients who met the case definition had been reported to CDC. A total of 203 (35.6%) of the patients had a clinical course consistent with previously published MIS-C reports, characterized predominantly by shock, cardiac dysfunction, abdominal pain, and markedly elevated inflammatory markers, and almost all had positive SARS-CoV-2 test results. The remaining 367 (64.4%) of MIS-C patients had manifestations that appeared to overlap with acute COVID-19 (2-4), had a less severe clinical course, or had features of Kawasaki disease.§ Median duration of hospitalization was 6 days; 364 patients (63.9%) required care in an intensive care unit (ICU), and 10 patients (1.8%) died. As the COVID-19 pandemic continues to expand in many jurisdictions, clinicians should be aware of the signs and symptoms of MIS-C and report suspected cases to their state or local health departments; analysis of reported cases can enhance understanding of MIS-C and improve characterization of the illness for early detection and treatment.


Subject(s)
Coronavirus Infections/complications , Pneumonia, Viral/complications , Systemic Inflammatory Response Syndrome/epidemiology , Systemic Inflammatory Response Syndrome/virology , Adolescent , COVID-19 , Child , Child, Preschool , Coronavirus Infections/epidemiology , Female , Humans , Male , Pandemics , Pneumonia, Viral/epidemiology , United States/epidemiology
16.
J Pediatric Infect Dis Soc ; 9(3): 393-398, 2020 Jul 13.
Article in English | MEDLINE | ID: covidwho-681598

ABSTRACT

We present a series of 6 critically ill children with multisystem inflammatory syndrome in children. Key findings of this syndrome include fever, diarrhea, shock, and variable presence of rash, conjunctivitis, extremity edema, and mucous membrane changes.


Subject(s)
Betacoronavirus , Coronavirus Infections/complications , Pneumonia, Viral/complications , Systemic Inflammatory Response Syndrome/etiology , Adolescent , COVID-19 , Child , Child, Preschool , Coronavirus Infections/pathology , Female , Humans , Male , Pandemics , Pneumonia, Viral/pathology , SARS-CoV-2 , Systemic Inflammatory Response Syndrome/pathology , Systemic Inflammatory Response Syndrome/virology
17.
J Vitreoretin Dis ; 4(5): 411-419, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-680424

ABSTRACT

PURPOSE: The current SARS-CoV-2 pandemic has escalated rapidly since December 2019. Understanding the ophthalmic manifestations in patients and animal models of the novel coronavirus may have implications for disease surveillance. Recognition of the potential for viral transmission through the tear film has ramification for protection of patients, physicians, and the public. METHODS: Information from relevant published journal articles was surveyed using a computerized PubMed search and public health websites. We summarize current knowledge of ophthalmic manifestations of SARS-CoV-2 infection in patients and animal models, risk mitigation measures for patients and their providers, and implications for retina specialists. RESULTS: SARS-CoV-2 is efficiently transmitted among humans, and while the clinical course is mild in the majority of infected patients, severe complications including pneumonia, acute respiratory distress syndrome, and death can ensue, most often in elderly patients and individuals with co-morbidities. Conjunctivitis occurs in a small minority of patients with COVID-19 and SARS-CoV-2 RNA has been identified primarily in association with conjunctivitis. Uveitis has been observed in animal models of coronavirus infection and cotton-wool spots have been reported recently. CONCLUSION: SARS-CoV-2 and other coronaviruses have been rarely associated with conjunctivitis. The identification of SARS-CoV and SARS-CoV-2 RNA in the tear film of patients and its highly efficient transmission via respiratory aerosols supports eye protection, mask and gloves as part of infection prevention and control recommendations for retina providers. Disease surveillance during the COVID-19 pandemic outbreak may also include ongoing evaluation for uveitis and retinal disease given prior findings observed in animal models and a recent report of retinal manifestations.

18.
Am J Ophthalmol Case Rep ; 20: 100843, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-679505

ABSTRACT

PURPOSE: To report a case of an adult who developed toxic shock syndrome following COVID-19 infection. OBSERVATIONS: A 28-year-old female tested positive for COVID-19. 19 days later, she developed a fever, rash and a burning sensation in both eyes. Her examination revealed mild ocular inflammation with bilateral eyelid and conjunctival involvement. Skin biopsy favored a diagnosis of toxic shock syndrome. She was initiated on corticosteroid eye drops and her ocular symptoms resolved three days later. CONCLUSION AND IMPORTANCE: Toxic shock syndrome is almost always associated with conjunctival inflammation. To our knowledge, this is the first report of an adult patient with toxic shock syndrome following COVID-19 infection. The association between toxic shock syndrome and COVID-19 is unclear; however, patients should be vigilant for symptoms as toxic shock syndrome can progress rapidly and cause multi-organ failure.

19.
Indian J Ophthalmol ; 68(8): 1675-1677, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-679354

ABSTRACT

A 65-year-old known diabetic, hypertensive, and asthmatic patient was admitted for suspected coronavirus disease 19 (COVID-19) infection following complaints of breathlessness. He tested positive for COVID-19 and was put on ventilation. He developed severe follicular conjunctivitis of the right eye while on a ventilator, which was treated conservatively. The resolution of ocular signs was noted over 2 weeks without any complications. This case highlights the timeline of events and discusses the late ophthalmic manifestations in patients with COVID-19 infection.


Subject(s)
Betacoronavirus , Conjunctivitis, Viral/diagnosis , Coronavirus Infections/diagnosis , Eye Infections, Viral/diagnosis , Pneumonia, Viral/diagnosis , Respiration, Artificial , Aged , Anti-Bacterial Agents/therapeutic use , COVID-19 , Conjunctivitis, Viral/drug therapy , Conjunctivitis, Viral/physiopathology , Coronavirus Infections/drug therapy , Coronavirus Infections/physiopathology , Eye Infections, Viral/drug therapy , Eye Infections, Viral/physiopathology , Follow-Up Studies , Humans , Lubricants/administration & dosage , Male , Moxifloxacin/therapeutic use , Ophthalmic Solutions , Pandemics , Pneumonia, Viral/drug therapy , Pneumonia, Viral/physiopathology , SARS-CoV-2
20.
J Optom ; 14(2): 114-119, 2021.
Article in English | MEDLINE | ID: covidwho-645146

ABSTRACT

The coronavirus family is a group of zoonotic viruses with some recognized reservoirs particularly some bats. A novel coronavirus emerged in the province of Wuhan (China) in December of 2019.The number of infected patient with serious respiratory infection quickly spread around the world to become a global pandemic. The clinical presentation and viral pathogenesis of the coronavirus disease named COVID-19 indicated that the virus is transmitted from person to person through infected droplets entering the respiratory mucosa. Close contact with infected individuals particularly in crowded environments has characterized the rapid spread of the infection. Clinical manifestations of the viral infection have mentioned the presence of some ocular findings such as conjunctival congestion, conjunctivitis and even corneal injury associated with the classical COVID-19 infection. Some animal models of different coronaviruses eye infections have described the viral pathogenesis through tear and conjunctival sampling. On the other hand, we are recommended protective measure to prevent contagion and limit the spread of the virus in health care professionals and contact lenses wearers.


Subject(s)
COVID-19/epidemiology , Conjunctivitis, Viral/epidemiology , Eye Infections, Viral/epidemiology , Eye , SARS-CoV-2/isolation & purification , Tears/virology , Animals , Conjunctivitis, Viral/diagnosis , Disease Models, Animal , Eye Infections, Viral/diagnosis , Humans
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