With input from Dr Monica Vasudev

1072: Nearly One Quarter of Children Hospitalized With COVID-19 Developed Eye Symptoms in China

Among Chinese children hospitalized for COVID-19, about a quarter of them developed ocular symptoms.

Most of them developed eye symptoms later in the disease; however, ocular manifestations were the first sign of SARS-CoV-2 infection in 9 of them. Ocular symptoms resolved in all the children. The report is published in JAMA Ophthalmology.

Out of 216 children hospitalized with COVID-19 in Wuhan, China, 49, i.e., 22.7% had ocular manifestations, including conjunctival discharge, eye rubbing, and conjunctival congestion.

Children with systemic symptoms or cough had a higher likelihood of developing ocular symptoms, which were mild and recovered or improved by minimal eye-drops or self-healing.

Overall, 193 children had an exposure to a family member with confirmed (173) or suspected (20) COVID-19. Among the study children, 93 experienced no systemic or respiratory symptoms before being tested. The most common symptoms among symptomatic children included fever and cough. All the children with mild (101) or moderate (115) symptoms recovered.

The initial symptoms were predominantly fever and cough, while there were other symptoms including diarrhea, fatigue, nasal discharge, nasal congestion, conjunctival discharge and conjunctival congestion.

Forty nine children had ocular manifestations. Conjunctival discharge was the most common manifestation, followed by eye rubbing and conjunctival congestion.

Children with systemic symptoms were more likely to develop ocular symptoms. It seems possible that cough can lead to ocular infection through hand-eye contact in children. It is also possible that the force of the cough could push nasopharyngeal secretions from the nasolacrimal duct into the conjunctival sac.

Most of the children had other symptoms before the ocular manifestations started.

The new findings are reassuring as all the children recovered from their eye symptoms.

(Source: Medscape; JAMA Ophthalmology, online August 26, 2020.)

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA