pink eye a symptom of COVID-19

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Recently Canadian scientists identified pink eye as a primary symptom of COVID-19.

Globally there have been over 8.5 million cases of COVID-19 reported and more than 465,000 deaths. When the first cases were reported in January 2020, the World Health Organization compared the virus to other respiratory illnesses such as SARS and MERS. The signs and symptoms were fever, cough, fatigue, headache, and diarrhea. 

One symptom not widely reported is conjunctival congestion, which has been found in 0.8% of patients. One Chinese expert involved in the early investigation of Wuhan COVID-19 patients contracted the virus even though he wore an N95 mask. However, he did not wear protective eye equipment. Before showing any respiratory signs of COVID-19, he developed a red eye.

Researchers from the University of Alberta Faculty of Medicine and Dentistry recently published a case study, which determined that pink eye is an early symptom of COVID-19. The study was published in the Canadian Journal of Ophthalmology.

The study centered on a young woman who returned from a one-month vacation to the Philippines in February. Her return journey took her from the Philippines, through San Francisco, to Canada. The day after she returned she began to experience congestion, a runny nose, and symptoms of pink eye in her right eye, but no fever. 

She went to her family physician the first day symptoms developed and was referred to an ophthalmologist. The following day she visited the ophthalmologist, and her pink eye symptoms had worsened. She tested negative for strep and was given prescription medicines to treat her pink eye.

In the following week, she returned to the ophthalmologist two more times, each time with worsening pink eye symptoms, but no fever. Tests for other diseases that can result in pink eye were performed and returned negative. On her last visit to the ophthalmologist, health authority recommendations for testing for COVID-19 had been updated to include any out of country travel. She was tested and found positive for COVID-19.

This case study highlights the potential risk to health care providers for infection not only through the already established pathways of air and person to person contact, but also transmitting through the eye. The study also presents evidence of pink eye as a symptom of COVID-19.

The study authors recommend all healthcare practitioners wear appropriate eye protection in addition to other forms of personal protective equipment. Disinfection practices should also be carefully followed for any patient presenting with symptoms of pink eye. 

Written by Rebecca K. Blankenship, B.Sc.

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Reference:

1. Cheema M, Aghazadeh H, Nazarali S et al. Keratoconjunctivitis as the initial medical presentation of the novel coronavirus disease 2019 (COVID-19). Canadian Journal of Ophthalmology. 2020. doi:10.1016/j.jcjo.2020.03.003

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