Symptoms of Dry Eye Disease in Hospitalized Patients with Coronavirus Disease 2019 (COVID-19)

Abstract

Background. We aimed to investigate the symptoms of the dry eye disease (DED) of hospitalized patients with coronavirus disease 2019 (COVID-19). Methods. This cross-sectional, observational study analysis included 91 hospitalized patients with confirmed COVID-19 in Wuhan, China. The Ocular Surface Disease Index (OSDI) and the five-item Dry Eye Questionnaire (DEQ-5) were used to assess the severity of DED symptoms in the patients, and the analysis of variance was used to determine the factors associated with DED. Results. A total of 42 patients consented to complete the investigation (response rate 46.15%). There were 26 (61.90%) patients who were diagnosed with DED symptoms by OSDI, and there were 28 (66.67%) patients with DED symptoms who were diagnosed by DEQ-5 score. For the biochemical tests, the patients with DED symptoms had lower aspartate aminotransferase (AST) levels compared to those with no DED symptoms (20.86 vs. 42.14, p = 0.04 ). Further analysis showed that a previous history of cardiac or stroke disease ( p = 0.02 ) and typical symptoms of muscle soreness ( p = 0.03 ) were significantly different among the four DED symptoms groups on the basis of OSDI scores. The contributing factors of OSDI were mainly focused on visual function and environmental triggers. Conclusion. The incidence of DED symptoms is higher in hospitalized patients with COVID-19. The serum AST levels, history of cardiac or stroke disease, and the typical symptoms of muscle soreness may be the main impact factors on DED symptoms. We also need to pay more attention to the visual function and environmental triggers of hospitalized patients with COVID-19.

Ocular manifestations of COVID-19: A systematic review of current evidence

“…Less prevalent manifestations were as follows: tearing, red eyes, irritation, eye pain, blurry vision, and retinal hemorrhage. Some studies reported treatments for these manifestations, with most patients recovering fully ( Giampietro et al, 2023 , Silveira et al, 2022 , Pirraglia et al, 2020 , Wang et al, 2021 , Reinhold et al, 2021 , Wan et al, 2022 , Abrishami et al, 2020 ). However, one study noted visual loss in two patients ( Chen et al, 2020 ).…”

“… Rokohl et al (2020) Germany 108 patients N/A burning sensations (36.1), epiphora (34.3), redness (25.9) 1.96 ± 3.17 days after the beginning of COVID-19 N/A Do not need treatment N/A Kumar et al (2021) India 2742 N/A Bilateral viral conjunctivitis, orbital cellulitis secondary to pansinusitis Ocular examinations were performed every 72 h N/A N/A N/A Ma et al (2020) China 216 pediatric patients N/A Exhibited conjunctival discharge (12.5), eye rubbing (8.8), conjunctival congestion (2.3) N/A Observation without treatment and minimal eye drop Complete recovery for 41 patients and persistent eye rubbing for the other 8. Children with systematic symptoms had a higher chance of developing ocular manifestations Jiang et al (2021) China 255 COVID-19 N/A Asthenopia (4.3), mild conjunctival congestion, and serous secretion (0.8) Hepokur et al (2023) Turkey 16 COVID-19 17 control N/A Decrease in Subfoveal choroidal thickness (SFC), SFCT increase in late post-infectious period, peripapillary choroidal thickness, Decrease in choroidal stroma and blood vessels N/A N/A N/A N/A Zhou et al (2020) China 243 patients N/A Exhibited ocular manifestations (6.6) N/A N/A N/A N/A Wang et al (2021) China 42 patients N/A Dry eye disease (61.9) N/A N/A N/A N/A Dag Seker and Erbahceci Timur (2021) Turkey 32 COVID-19 36 control N...…”

Investigating the Impact of COVID-19 Infection on Dry Eye Parameters

“…These studies mostly indicate that dry eye has worsened during the COVID-19 pandemic. However, there are fewer studies focusing on post-COVID patients, such as Turkey's study [37], which found a shorter tear break-up time in post-COVID-19 patients; the UK's study [38], which found sore eyes in COVID-19 patients; and China's cross-sectional study [39], which found a higher incidence of DED symptoms in hospitalized patients with COVID-19. The innovation of our study is that we compare the dry eye parameters of the same patient before and after COVID-19, which further explains the impact of the coronavirus on dry eye.…”

Conjunctival Swabs Reveal Higher Detection Rate Compared to Schirmer Strips for SARS-CoV-2 RNA Detection in Tears of Hospitalized COVID-19 Patients

“…Almost half of the patients in the study reported at least one ocular symptom, but COVID-19 does not have pathognomonic features and ocular findings that could relate to a broad variety of diseases and conditions, including dry eye syndrome, corneal abrasions, and trauma. None of the patients reported trauma or showed signs of ocular infections, even though hospitalization is known to cause ocular discomfort because of medications, oxygen devices, and stress [ 52 ]. The only statistically significant symptom between the patients whose tears contained SARS-CoV-2 and those that did not was tearing.…”