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Ocular manifestations and viral shedding in tears of pediatric patients with coronavirus disease 2019: a preliminary report.
J AAPOS. 2020 Jun 09 [Online ahead of print]JA

Abstract

PURPOSE

To evaluate ocular manifestations and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) prevalence in the tears of children with coronavirus disease 2019 (COVID-19).

METHODS

A total of 27 pediatric patients with confirmed COVID-19 infection hospitalized from March 16 to April 15, 2020, at the Bambino Gesù Children's Hospital were enrolled in the study. At admission, all patients showed ocular manifestations. Reverse transcriptase-polymerase chain reaction from nasopharyngeal and conjunctival swabs were performed every 2-3 days before discharge.

RESULTS

Of the 27 patients, 4 (15%) were asymptomatic, 15 (56%) showed respiratory symptoms, and 8 (30%) had gastrointestinal symptoms. At admission, nasopharyngeal swabs were positive for COVID-19 in all patients; on the second swabs, 7 children (26%) tested negative, and 20 remained positive for COVID-19. Ocular manifestations consistent with mild viral conjunctivitis were observed in 4 patients (15%). At first conjunctival swab, 3 patients (11%), 1 symptomatic and 2 asymptomatic for ocular infection, had positive findings for COVID-19; 2 became negative on the second test and 1 on the third.

CONCLUSIONS

In our study cohort, ocular manifestations of COVID-19 seem to have had a milder clinical course in pediatric patients than in adults. Despite the low prevalence and rapid regression of viral presence in the conjunctiva, SARS-CoV-2 transmission through tears may be possible, even in patients without apparent ocular involvement.

Authors+Show Affiliations

Ophthalmology Department, Bambino Gesù IRCCS Pediatric Hospital, Rome, Italy. Electronic address: paola.valente@opbg.net.Ophthalmology Department, Bambino Gesù IRCCS Pediatric Hospital, Rome, Italy.Ophthalmology Department, Bambino Gesù IRCCS Pediatric Hospital, Rome, Italy.Ophthalmology Department, Bambino Gesù IRCCS Pediatric Hospital, Rome, Italy.Academic Department of Pediatrics (DPUO), Unit of Perinatal Infection and Congenital Infectious Diseases, Bambino Gesù IRCCS Pediatric Hospital, Rome, Italy.Academic Department of Pediatrics (DPUO), Unit of Perinatal Infection and Congenital Infectious Diseases, Bambino Gesù IRCCS Pediatric Hospital, Rome, Italy.Pediatric Department, Bambino Gesù IRCCS Pediatric Hospital, Rome, Italy.Pediatric Department, Bambino Gesù IRCCS Pediatric Hospital, Rome, Italy.Ophthalmology Department, Bambino Gesù IRCCS Pediatric Hospital, Rome, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32531341

Citation

Valente, Paola, et al. "Ocular Manifestations and Viral Shedding in Tears of Pediatric Patients With Coronavirus Disease 2019: a Preliminary Report." Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus, 2020.
Valente P, Iarossi G, Federici M, et al. Ocular manifestations and viral shedding in tears of pediatric patients with coronavirus disease 2019: a preliminary report. J AAPOS. 2020.
Valente, P., Iarossi, G., Federici, M., Petroni, S., Palma, P., Cotugno, N., De Ioris, M. A., Campana, A., & Buzzonetti, L. (2020). Ocular manifestations and viral shedding in tears of pediatric patients with coronavirus disease 2019: a preliminary report. Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus. https://doi.org/10.1016/j.jaapos.2020.05.002
Valente P, et al. Ocular Manifestations and Viral Shedding in Tears of Pediatric Patients With Coronavirus Disease 2019: a Preliminary Report. J AAPOS. 2020 Jun 9; PubMed PMID: 32531341.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ocular manifestations and viral shedding in tears of pediatric patients with coronavirus disease 2019: a preliminary report. AU - Valente,Paola, AU - Iarossi,Giancarlo, AU - Federici,Matteo, AU - Petroni,Sergio, AU - Palma,Paolo, AU - Cotugno,Nicola, AU - De Ioris,Maria A, AU - Campana,Andrea, AU - Buzzonetti,Luca, Y1 - 2020/06/09/ PY - 2020/05/17/received PY - 2020/05/30/revised PY - 2020/05/30/accepted PY - 2020/6/13/pubmed PY - 2020/6/13/medline PY - 2020/6/13/entrez JF - Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus JO - J AAPOS N2 - PURPOSE: To evaluate ocular manifestations and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) prevalence in the tears of children with coronavirus disease 2019 (COVID-19). METHODS: A total of 27 pediatric patients with confirmed COVID-19 infection hospitalized from March 16 to April 15, 2020, at the Bambino Gesù Children's Hospital were enrolled in the study. At admission, all patients showed ocular manifestations. Reverse transcriptase-polymerase chain reaction from nasopharyngeal and conjunctival swabs were performed every 2-3 days before discharge. RESULTS: Of the 27 patients, 4 (15%) were asymptomatic, 15 (56%) showed respiratory symptoms, and 8 (30%) had gastrointestinal symptoms. At admission, nasopharyngeal swabs were positive for COVID-19 in all patients; on the second swabs, 7 children (26%) tested negative, and 20 remained positive for COVID-19. Ocular manifestations consistent with mild viral conjunctivitis were observed in 4 patients (15%). At first conjunctival swab, 3 patients (11%), 1 symptomatic and 2 asymptomatic for ocular infection, had positive findings for COVID-19; 2 became negative on the second test and 1 on the third. CONCLUSIONS: In our study cohort, ocular manifestations of COVID-19 seem to have had a milder clinical course in pediatric patients than in adults. Despite the low prevalence and rapid regression of viral presence in the conjunctiva, SARS-CoV-2 transmission through tears may be possible, even in patients without apparent ocular involvement. SN - 1528-3933 UR - https://www.unboundmedicine.com/medline/citation/32531341/Ocular_manifestations_and_viral_shedding_in_tears_of_pediatric_patients_with_coronavirus_disease_2019:_a_preliminary_report_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1091-8531(20)30115-4 DB - PRIME DP - Unbound Medicine ER -