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J AAPOS . Ocular Manifestations and Viral Shedding in Tears of Pediatric Patients With Coronavirus Disease 2019: A Preliminary Report

tetano

Editor, Senior Moderator
J AAPOS


. 2020 Jun 9;S1091-8531(20)30115-4.
doi: 10.1016/j.jaapos.2020.05.002. Online ahead of print.
Ocular Manifestations and Viral Shedding in Tears of Pediatric Patients With Coronavirus Disease 2019: A Preliminary Report


Paola Valente[SUP] 1 [/SUP], Giancarlo Iarossi[SUP] 2 [/SUP], Matteo Federici[SUP] 2 [/SUP], Sergio Petroni[SUP] 2 [/SUP], Paolo Palma[SUP] 3 [/SUP], Nicola Cotugno[SUP] 3 [/SUP], Maria A De Ioris[SUP] 4 [/SUP], Andrea Campana[SUP] 4 [/SUP], Luca Buzzonetti[SUP] 2 [/SUP]



Affiliations
Free PMC article

Abstract

Purpose: To evaluate ocular manifestations and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) prevalence in the tears of children with coronavirus disease 2019 (COVID-19).
Methods: A total of 27 pediatric patients with confirmed COVID-19 infection hospitalized from March 16 to April 15, 2020, at the Bambino Ges? Children's Hospital were enrolled in the study. At admission, all patients showed ocular manifestations. Reverse transcriptase-polymerase chain reaction from nasopharyngeal and conjunctival swabs were performed every 2-3 days before discharge.
Results: Of the 27 patients, 4 (15%) were asymptomatic, 15 (56%) showed respiratory symptoms, and 8 (30%) had gastrointestinal symptoms. At admission, nasopharyngeal swabs were positive for COVID-19 in all patients; on the second swabs, 7 children (26%) tested negative, and 20 remained positive for COVID-19. Ocular manifestations consistent with mild viral conjunctivitis were observed in 4 patients (15%). At first conjunctival swab, 3 patients (11%), 1 symptomatic and 2 asymptomatic for ocular infection, had positive findings for COVID-19; 2 became negative on the second test and 1 on the third.
Conclusions: In our study cohort, ocular manifestations of COVID-19 seem to have had a milder clinical course in pediatric patients than in adults. Despite the low prevalence and rapid regression of viral presence in the conjunctiva, SARS-CoV-2 transmission through tears may be possible, even in patients without apparent ocular involvement.
 
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