Ocular Manifestations of Hospitalized COVID-19 Patients in a Tertiary Care Academic Medical Center in the United States: A Cross-Sectional Study

Abstract

Purpose Studies have identified a wide range of ocular signs and symptoms in coronavirus disease 2019 (COVID-19) patients; however, these studies were often conducted outside of the United States. We aim to investigate the ocular manifestations of hospitalized COVID-19 patients at a tertiary care medical center in the United States. Patients and Methods A retrospective, cross-sectional study was conducted on individuals aged 18 and over who were hospitalized for COVID-19 between March 10, 2020 and April 13, 2020. The electronic health record was reviewed for all patients, and a follow-up phone survey was conducted on patients who were discharged home. Data on patient history, physical exam, laboratory results, and hospital disposition were collected and analyzed. Results A total of 400 patients were included. The mean patient age was 61.7 years (SD 15.5) and 233 (58.3%) were males. Ocular signs and symptoms were noted in 38 (9.5%) patients. The most common ocular abnormality was conjunctival injection, followed by vision changes and ocular irritation. Among the 38 patients, 30 (79.0%) developed ocular involvement prior to day 30 of onset of their COVID symptoms. Univariate analysis showed that age, gender, ocular history, fever, mechanical ventilation, and increasing inflammatory markers were not significantly associated with the presence or development of ocular symptoms. Conclusion In this study, 9.5% of hospitalized COVID-19 patients exhibited ocular signs and symptoms. Factors associated with severe systemic COVID-19 disease were not associated with developing ocular abnormalities. The rate of ocular manifestations of COVID-19 should not be ignored, and thus physicians should routinely evaluate for ocular involvement in hospitalized COVID-19 patients.

Ocular and Systemic Complications of COVID-19: Impact on Patients and Healthcare

“…Ophthalmic manifestations of SARS-CoV-2 are not common, affecting approximately 6-12% of COVID-19 patients. 2,[33][34][35] The ocular symptoms can precede systemic symptoms by 3 hours to 5 days in 13% of patients. 2 Frequent hand-eye contact and more severe systemic illness may be more likely to be associated with ocular findings.…”

Prospective Study: Frequency of Ophthalmic Findings, Relationship with Inflammation Markers, and Effect on Prognosis in Patients Treated in the COVID-19 Intensive Care Unit

“…Although the prevalence of inflammatory ocular surface findings was lower than in our study, the results were similar in terms of the lack of a relationship between eye signs and elevated inflammation markers or mechanical ventilation. 20 The higher frequency of inflammatory findings on ocular surface examination in our study may be because only patients treated in the COVID-19 intensive care unit were included.…”

Ocular manifestations in COVID-19 patients: A systematic review and meta-analysis

“…Full-text assessment was performed on 98 articles, of which 68 were excluded for the following reasons: 32 were reviews, 20 were case reports, nine did not provide adequate information and seven were meta-analyses. Ultimately, 19 case series [ [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] ] and 11 cross-sectional studies [ 12 , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] ] were included in the current meta-analysis. Additionally, 11 case reports of atypical ocular manifestations were included for descriptive analysis.…”