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Relapsing viral keratoconjunctivitis in COVID-19: a case report.
Virol J. 2020 07 08; 17(1):97.VJ

Abstract

BACKGROUND

Since the outbreak of Coronavirus Disease 2019 (COVID-19) in December 2019, many studies have reported the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the conjunctival sac of patients infected with this virus, with several patients displaying symptoms of viral conjunctivitis. However, to our best knowledge, there is no in-depth report on the course of patients with COVID-19 complicated by relapsing viral conjunctivitis or keratoconjunctivitis.

CASE PRESENTATION

A 53-year-old man confirmed with COVID-19 developed symptoms of viral conjunctivitis in the left eye approximately 10 days after the onset of COVID-19. The results of a nucleic acid test were positive for SARS-CoV-2 in the conjunctival sac of the left eye. The symptoms were relieved 6 days after treatment. However, the patient was subsequently diagnosed with viral keratoconjunctivitis in both eyes 5 days after the symptoms in the left eye were satisfactorily relieved. The disease progressed rapidly, with spot staining observed at the periphery of the corneal epithelium. Although SARS-CoV-2 could not be detected in conjunctival secretions, the levels of inflammatory factors, such as interleukin-6, were increased in both eyes. Both eyes were treated with glucocorticoids, and symptoms were controlled within 5 days. There was no recurrence.

CONCLUSIONS

In this case report, the pathogenesis, clinical manifestations, treatment, and outcome of a case with COVID-19 complicated by relapsing viral keratoconjunctivitis is described, and the involvement of topical cytokine surge in the pathogenesis of COVID-19 as it relates to viral keratoconjunctivitis is reported.

Authors+Show Affiliations

Department of Ophthalmology, Zhejiang University School of Medicine First Affiliated Hospital, Hangzhou, 310003, Zhejiang, China.Department of Ophthalmology, Zhejiang University School of Medicine First Affiliated Hospital, Hangzhou, 310003, Zhejiang, China.Department of Ophthalmology, Zhejiang University School of Medicine First Affiliated Hospital, Hangzhou, 310003, Zhejiang, China.Department of Ophthalmology, Zhejiang University School of Medicine First Affiliated Hospital, Hangzhou, 310003, Zhejiang, China.Department of Ophthalmology, Zhejiang University School of Medicine First Affiliated Hospital, Hangzhou, 310003, Zhejiang, China. idrshen@zju.edu.cn.Department of Ophthalmology, Zhejiang University School of Medicine First Affiliated Hospital, Hangzhou, 310003, Zhejiang, China. tongjp2000@hotmail.com.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

32641169

Citation

Guo, Dongyu, et al. "Relapsing Viral Keratoconjunctivitis in COVID-19: a Case Report." Virology Journal, vol. 17, no. 1, 2020, p. 97.
Guo D, Xia J, Wang Y, et al. Relapsing viral keratoconjunctivitis in COVID-19: a case report. Virol J. 2020;17(1):97.
Guo, D., Xia, J., Wang, Y., Zhang, X., Shen, Y., & Tong, J. P. (2020). Relapsing viral keratoconjunctivitis in COVID-19: a case report. Virology Journal, 17(1), 97. https://doi.org/10.1186/s12985-020-01370-6
Guo D, et al. Relapsing Viral Keratoconjunctivitis in COVID-19: a Case Report. Virol J. 2020 07 8;17(1):97. PubMed PMID: 32641169.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relapsing viral keratoconjunctivitis in COVID-19: a case report. AU - Guo,Dongyu, AU - Xia,Jianhua, AU - Wang,Yang, AU - Zhang,Xuhong, AU - Shen,Ye, AU - Tong,Jian-Ping, Y1 - 2020/07/08/ PY - 2020/04/20/received PY - 2020/06/23/accepted PY - 2020/7/10/entrez PY - 2020/7/10/pubmed PY - 2020/7/21/medline KW - Coronavirus, SARS-CoV-2, COVID-19, Conjunctivitis, Cytokine surge SP - 97 EP - 97 JF - Virology journal JO - Virol. J. VL - 17 IS - 1 N2 - BACKGROUND: Since the outbreak of Coronavirus Disease 2019 (COVID-19) in December 2019, many studies have reported the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the conjunctival sac of patients infected with this virus, with several patients displaying symptoms of viral conjunctivitis. However, to our best knowledge, there is no in-depth report on the course of patients with COVID-19 complicated by relapsing viral conjunctivitis or keratoconjunctivitis. CASE PRESENTATION: A 53-year-old man confirmed with COVID-19 developed symptoms of viral conjunctivitis in the left eye approximately 10 days after the onset of COVID-19. The results of a nucleic acid test were positive for SARS-CoV-2 in the conjunctival sac of the left eye. The symptoms were relieved 6 days after treatment. However, the patient was subsequently diagnosed with viral keratoconjunctivitis in both eyes 5 days after the symptoms in the left eye were satisfactorily relieved. The disease progressed rapidly, with spot staining observed at the periphery of the corneal epithelium. Although SARS-CoV-2 could not be detected in conjunctival secretions, the levels of inflammatory factors, such as interleukin-6, were increased in both eyes. Both eyes were treated with glucocorticoids, and symptoms were controlled within 5 days. There was no recurrence. CONCLUSIONS: In this case report, the pathogenesis, clinical manifestations, treatment, and outcome of a case with COVID-19 complicated by relapsing viral keratoconjunctivitis is described, and the involvement of topical cytokine surge in the pathogenesis of COVID-19 as it relates to viral keratoconjunctivitis is reported. SN - 1743-422X UR - https://www.unboundmedicine.com/medline/citation/32641169/Relapsing_viral_keratoconjunctivitis_in_COVID_19:_a_case_report_ L2 - https://virologyj.biomedcentral.com/articles/10.1186/s12985-020-01370-6 DB - PRIME DP - Unbound Medicine ER -