Ocular Manifestations of Hospitalized Patients with COVID-19 in Northeast of Iran
Mojtaba Abrishami1 *, Arash Omidtabrizi1 , Ramin Daneshvar1 , Fariba Tohidinezhad2
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Abstract: To evaluate ocular findings in patients with Coronavirus Disease 2019 (COVID-19) in the Northeast of Iran
Methods: In a cross-sectional observational case series, patients with confirmed COVID-19 diagnosis who admitted to the Imam Reza Hospital, the central referral center of the COVID-19 patients in Mashhad, northeast of Iran were included. Ocular examination (external and slit) was randomly performed for the patients who admitted to the Intensive Care Unit (ICU) and six COVID wards of the hospital. Moreover, results of blood tests and presenting symptoms were collected.
Results: A total of 142 patients with the mean age of 62.6 ± 15 years (range: 23-96 years) and almost equal gender distribution (male: N=77, 54.2%) were included in the study. During the initial external examination by the ophthalmologist, 44 (31%) patients were found to have conjunctival hyperemia and 22 (15.5%) patients had chemosis. Consecutive slit examination showed 41 (28.9%) conjunctival hyperemia, 22 (15.5%) chemosis, 11 (7.7%) cataract, and 9 (6.3%) diabetic retinopathy. The patients with at least one ocular manifestation had significantly higher blood urea levels at the time of admission compared to those with no obvious ocular involvement (median: 41.5, IQR: 28-66.3 vs. median: 33, IQR: 23.8-51.8, P=0.023). Moreover, a significant difference was observed in the total white blood cell count, lymphocyte percent, neutrophil count, Erythrocyte Sedimentation Rate (ESR), and blood urea level between patients with positive and negative Polymerase Chain Reaction (PCR) for SARS-CoV-2 virus. None of the patients reported ocular symptoms prior to systemic involvement. The proportion of patients with at least one ocular manifestation was significantly higher in those admitted in the ICU compared to the non-ICU wards. wards. While conjunctival hyperemia was the most prevalent ocular finding in all patients, chemosis was the most common ocular manifestation in ICU admitted patients.
Conclusion: Ocular manifestation was observed in more than half of the patients. The proportion of patients with at least one ocular manifestation was significantly higher in the ICU in compare with the other wards. While conjunctival hyperemia was the most prevalent ocular finding in all patients, chemosis was the most common ocular manifestation in ICU admitted patients. Hence, it seems important to involve ophthalmologist in the diagnosis and management of these patients.
