Purpose To report the ocular characteristics and the presence of viral RNA of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in conjunctival swab specimens in a patient with confirmed 2019 novel coronavirus disease (COVID-19).
Participant and methods A 30-year-old man with confirmed COVID-19 and bilateral acute conjunctivitis which occurred 13 days after illness onset. Based on detailed ophthalmic examination, reverse transcription PCR (RT-PCR) was performed to detect SARS-CoV-2 virus in conjunctival swabs. The ocular characteristics, presence of viral RNA and viral dynamics of SARS-CoV-2 in the conjunctival specimens were evaluated.
Results Slit lamp examination showed bilateral acute follicular conjunctivitis. RT-PCR assay demonstrated the presence of viral RNA in conjunctival specimen 13 days after onset (cycle threshold value: 31). The conjunctival swab specimens remained positive for SARS-CoV-2 on 14 and 17 days after onset. On day 19, RT-PCR result was negative for SARS-CoV-2.
Conclusion SARS-CoV-2 is capable of causing ocular complications such as viral conjunctivitis in the middle phase of illness. Precautionary measures are recommended when examining infected patients throughout the clinical course of the infection. However, conjunctival sampling might not be useful for early diagnosis because the virus may not appear initially in the conjunctiva.
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LC and ML contributed equally.
LL, GZ and JW contributed equally.
Contributors Study design: LL, GZ and JW. Data collection: LC, MC, ZH and NX. Analysis and interpretation of the data: ZZ, KQ, TH and ML. Writing of the report: LC. Revision of the draft: LC, ZZ and GZ. Making the decision to submit the paper for publication: LL, GZ, JW, LC, MC, ZH, NX, ZZ, KQ, TH and ML.
Funding This study was supported by the National Natural Science Foundation of China (Grant No 81900877).
Competing interests None declared.
Patient consent for publication Obtained.
Ethics approval Institutional review board approval was obtained from the Third People's Hospital of Shenzhen.
Provenance and peer review Not commissioned; internally peer reviewed.
Data availability statement Data are available on reasonable request.
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