COVID-19: Ophthalmological Aspects of the SARS-CoV 2 Global PandemicArtikel in mehreren Sprachen: English | deutsch
received 18. April 2020
accepted 23. April 2020
06. Mai 2020 (online)
Purpose To perform a systematic analysis of articles on the ophthalmological implications of the global COVID-19 pandemic.
Methods PubMed.gov was searched for relevant articles using the keywords “COVID-19”, “coronavirus”, and “SARS-CoV-2” in conjunction with “ophthalmology” and “eye”. Moreover, official recommendations of ophthalmological societies were systematically reviewed, with a focus on the American Academy of Ophthalmology (AAO) and the Royal College of Ophthalmologists (RCOphth).
Results As of April 16, 2020, in total, 21 peer-reviewed articles on the ophthalmological aspects of COVID-19 were identified. Of these, 12 (57.1%) were from Asia, 6 (28.6%) from the United States of America, and 3 (14.3%) from Europe. There were 5 (23.8%) original studies, 10 (47.6%) letters, 3 (14.2%) case reports, and 3 (14.2%) reviews. These articles could be classified into the topics “Modes and prevention of (ocular) transmission”, “Ophthalmological manifestations of COVID-19”, “Clinical guidance concerning ophthalmological practice during the COVID-19 pandemic”, and “Practical recommendations for clinical infrastructure”. Practical recommendations could be extracted from official statements of the AAO and the RCOphth.
Conclusion Within a short period, a growing body of articles has started to elucidate the ophthalmological implications of COVID-19. As the eye can represent a route of infection (actively via tears and passively via the nasoacrimal duct), ophthalmological care has to undergo substantial modifications during this pandemic. In the eye, COVID-19 can manifest as keratoconjunctivitis.
- 1 Cucinotta D, Vanelli M. WHO Declares COVID-19 a Pandemic. Acta Biomed 2020; 91: 157-160 doi:10.23750/abm.v91i1.9397
- 2 Parrish II RK, Stewart MW, Duncan Powers SL. Ophthalmologists Are More Than Eye Doctors – In Memoriam Li Wenliang. Am J Ophthalmol DOI: 10.1016/j.ajo.2020.02.014.
- 3 Sommer A. Humans, Viruses, and the Eye-An Early Report from the COVID-19 Front Line. JAMA Ophthalmol 2020; DOI: 10.1001/jamaophthalmol.2020.1294.
- 4 Che C. Europeʼs Doctors Repeat Errors Made in Wuhan, China Medics Say. Available at: https://www.bloomberg.com/news/articles/2020-03-17/europe-s-doctors-getting-sick-like-in-wuhan-chinese-doctors-say Accessed 14.04.2020
- 5 Wu P, Duan F, Luo C. et al. Characteristics of Ocular Findings of Patients with Coronavirus Disease 2019 (COVID-19) in Hubei Province, China. JAMA Ophthalmol 2020; DOI: 10.1001/jamaophthalmol.2020.1291.
- 6 Chen L, Liu M, Zhang Z. et al. Ocular manifestations of a hospitalised patient with confirmed 2019 novel coronavirus disease. Br J Ophthalmol 2020; DOI: 10.1136/bjophthalmol-2020-316304.
- 7 Minocha A, Sim SY, Than J. et al. Survey of ophthalmology practitioners in A&E on current COVID-19 guidance at three Major UK Eye Hospitals. Eye 2020; DOI: 10.1038/s41433-020-0857-5.
- 8 Leung NHL, Chu DKW, Shiu EYC. et al. Respiratory virus shedding in exhaled breath and efficacy of face masks. Nat Med 2020; DOI: 10.1038/s41591-020-0843-2.
- 9 Bai Y, Yao L, Wei T. et al. Presumed Asymptomatic Carrier Transmission of COVID-19. JAMA 2020; DOI: 10.1001/jama.2020.2565.
- 10 Rothe C, Schunk M, Sothmann P. et al. Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany. N Engl J Med 2020; 382: 970-971 doi:10.1056/NEJMc2001468
- 11 Centers for Disease Control and Prevention (CDC). Recommendation Regarding the Use of Cloth Face Coverings, Especially in Areas of Significant Community-Based Transmission. Available at: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover.html%23studies Accessed 14.04.2020
- 12 Klompas M, Morris CA, Sinclair J. et al. Universal Masking in Hospitals in the Covid-19 Era. N Engl J Med 2020; DOI: 10.1056/NEJMp2006372.
- 13 Wan KH, Huang SS, Young A. et al. Precautionary measures needed for ophthalmologists during pandemic of the coronavirus disease 2019 (COVID-19). Acta Ophthalmol 2020; DOI: 10.1111/aos.14438.
- 14 Jacob S. Slit lamp breath protector – from Corona virus and other pathogens. Soosan Jacob with audio 2.5 min. Available at: https://www.youtube.com/watch?v=pXm624pBDUM Accessed 14.04.2020
- 15 van Doremalen N, Bushmaker T, Morris DH. et al. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. N Engl J Med 2020; 382: 1564-1567 doi:10.1056/NEJMc2004973
- 16 Xia J, Tong J, Liu M. et al. Evaluation of coronavirus in tears and conjunctival secretions of patients with SARS-CoV-2 infection. J Med Virol 2020; DOI: 10.1002/jmv.25725.
- 17 Seah IYJ, Anderson DE, Kang AEZ. et al. Assessing Viral Shedding and Infectivity of Tears in Coronavirus Disease 2019 (COVID-19) Patients. Ophthalmology 2020; DOI: 10.1016/j.ophtha.2020.03.026.
- 18 Zhou P, Yang XL, Wang XG. et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 2020; 579: 270-273 doi:10.1038/s41586-020-2012-7
- 19 Senanayake P, Drazba J, Shadrach K. et al. Angiotensin II and its receptor subtypes in the human retina. Invest Ophthalmol Vis Sci 2007; 48: 3301-3311 doi:10.1167/iovs.06-1024
- 20 Holappa M, Vapaatalo H, Vaajanen A. Many Faces of Renin-angiotensin System – Focus on Eye. Open Ophthalmol J 2017; 11: 122-142 doi:10.2174/1874364101711010122
- 21 Qing H, Li Z, Yang Z. et al. The possibility of COVID-19 transmission from eye to nose. Acta Ophthalmol 2020; DOI: 10.1111/aos.14412.
- 22 Liu Z, Sun CB. Conjunctiva is not a preferred gateway of entry for SARS-CoV-2 to infect respiratory tract. J Med Virol 2020; DOI: 10.1002/jmv.25859.
- 23 Lu CW, Liu XF, Jia ZF. 2019-nCoV transmission through the ocular surface must not be ignored. Lancet 2020; 395: e39 doi:10.1016/S0140-6736(20)30313-5
- 24 Li JO, Lam DSC, Chen Y. et al. Novel Coronavirus disease 2019 (COVID-19): The importance of recognising possible early ocular manifestation and using protective eyewear. Br J Ophthalmol 2020; 104: 297-298 doi:10.1136/bjophthalmol-2020-315994
- 25 Lai THT, Tang EWH, Chau SKY. et al. Stepping up infection control measures in ophthalmology during the novel coronavirus outbreak: an experience from Hong Kong. Graefes Arch Clin Exp Ophthalmol 2020; 258: 1049-1055 doi:10.1007/s00417-020-04641-8
- 26 Ong SWX, Tan YK, Chia PY. et al. Air, Surface Environmental, and Personal Protective Equipment Contamination by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) from a Symptomatic Patient. JAMA 2020; DOI: 10.1001/jama.2020.3227.
- 27 Guan WJ, Ni ZY, Hu Y. et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med 2020; DOI: 10.1056/NEJMoa2002032.
- 28 Zhou F, Yu T, Du R. et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395: 1054-1062 doi:10.1016/S0140-6736(20)30566-3
- 29 Cheema M, Aghazadeh H, Nazarali S. et al. Keratoconjunctivitis as the initial medical presentation of the novel coronavirus disease 2019 (COVID-19). Can J Ophthalmol 2020; DOI: 10.1016/j.jcjo.2020.03.003.
- 30 Seah I, Agrawal R. Can the Coronavirus Disease 2019 (COVID-19) Affect the Eyes? A Review of Coronaviruses and Ocular Implications in Humans and Animals. Ocul Immunol Inflamm 2020; 28: 391-395 doi:10.1080/09273948.2020.1738501
- 31 Fineberg HV. Ten Weeks to Crush the Curve. N Engl J Med 2020; 382: e37 doi:10.1056/NEJMe2007263
- 32 American Academy of Ophthalmology. Recommendations for urgent and nonurgent patient care. Available at: https://www.aao.org/headline/new-recommendations-urgent-nonurgent-patient-care Accessed 16.04.2020
- 33 The Royal College of Ophthalmologists. Burdon M. COVID-19 clinical guidance for ophthalmologists. Available at: https://rcophth.ac.uk/2020/04/covid-19-update-and-resources-for-ophthalmologists/ Accessed 16.04.2020
- 34 Moorfields Eye Hospital. Ophthalmological Risk Stratification & Implementation Guidance. Available at: https://www.rcophth.ac.uk/wpcontent/uploads/2020/03/Moorfields-Ophthalmic-Risk-Stratification-Implementation-Guideline-V2.0.pdf Accessed 16.04.2020
- 35 American Academy of Ophthalmology. List of urgent and emergent ophthalmic procedures. Available at: https://www.aao.org/headline/list-of-urgent-emergent-ophthalmic-procedures Accessed 16.04.2020
- 36 The Royal College of Ophthalmologists. Medical Retinal Management Plans during COVID-19. Available at: https://www.rcophth.ac.uk/wp-content/uploads/2020/03/Medical-Retinal-Management-Plan-during-COVID-19-UPDATED-300320-1-3.pdf Accessed 16.04.2020
- 37 Borrelli E, Sacconi R, Querques L. et al. Taking the right measures to control COVID-19 in ophthalmology: the experience of a tertiary eye care referral center in Italy. Eye (Lond) 2020; DOI: 10.1038/s41433-020-0880-6.
- 38 Yu AY, Tu R, Shao X. et al. A comprehensive Chinese experience against SARS-CoV-2 in ophthalmology. Eye Vis (Lond) 2020; 7: 19 doi:10.1186/s40662-020-00187-2
- 39 Huang C, Wang Y, Li X. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395: 497-506 doi:10.1016/s0140-6736(20)30183-5
- 40 Mao L, Jin H, Wang M. et al. Neurologic Manifestations of Hospitalized Patients with Coronavirus Disease 2019 in Wuhan, China. JAMA Neurol 2020; DOI: 10.1001/jamaneurol.2020.1127.
- 41 Hopkins C, Surda P, Kumar N. Presentation of new onset anosmia during the COVID-19 pandemic. Rhinology 2020; DOI: 10.4193/Rhin20.116.
- 42 Walker A, Hopkins C, Surda P. The use of google trends to investigate the loss of smell related searches during COVID-19 outbreak. Int Forum Allergy Rhinol 2020; DOI: 10.1002/alr.22580.
- 43 Romano MR, Montericcio A, Montalbano C. et al. Facing COVID-19 in Ophthalmology Department. Curr Eye Res 2020; DOI: 10.1080/02713683.2020.1752737.