key: cord-0724941-matuyvln
authors: Arias-Peso, Borja; Rendón-Fernández, y Helena
title: Conjunctivitis and COVID-19: The importance of an earlydetection
date: 2020-11-26
journal: nan
DOI: 10.1016/j.eimce.2020.11.008
sha: b4afa26099b33528941b63c5a0712b66653f6b4a
doc_id: 724941
cord_uid: matuyvln

nan

This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. the importance of suspecting and diagnosing them lies in the fact that conjunctivitis may be the first sign of the disease 4 and, in some cases, the only one. 5 Since various studies at the start of the epidemic documented the possibility of isolating SARS-CoV-2 in patients' tears and therefore suggested its transmission by this route, 6 different case series and isolated case reports of patients diagnosed with COVID-19 and conjunctivitis have been published. Cases of conjunctivitis associated with COVID-19, with a broad, highly varied clinical spectrum, have been reported both in paediatric patients 7 and in adults. 8 In most cases published to date, signs and symptoms of COVID-19-related conjunctivitis have been mild, bilateral and follicular, and have not usually included corneal involvement; this is consistent with other forms of conjunctivitis of viral origin, such as adenoviral conjunctivitis. Additionally, the onset of maxillary and preauricular lymphadenopathy accompanying signs and symptoms of conjunctivitis has been reported, 8 this being a trait shared by viral forms of conjunctivitis. Nonetheless, more variegated cases of pseudomembranous and haemorrhagic conjunctivitis have been reported, 9 meaning that there is no established characteristic pattern in relation to this specific aetiology.

A recent meta-analysis suggested that there is a relationship between conjunctivitis and severity of signs and symptoms of COVID-19, 10 although the relevant data may have significant limitations, such as inclusion of patients with a clinical diagnosis of conjunctivitis but no microbiological confirmation.

Therefore, in the context of the current pandemic, we believe that it is important to consider COVID-19 among all different possible diagnoses of conjunctivitis. This means that it is important to ask all patients with suspected conjunctivitis about any systemic symptoms that might accompany their ocular signs and symptoms, and about possible epidemiological environments with suspected or confirmed cases. For now, no characteristics differentiating this type of conjunctivitis from other types have been identified, owing to which more studies are needed to determine the specific characteristics of these cases, as well as other possible implications for the disease's prognosis.

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The authors declare that they have no conflicts of interest.J o u r n a l P r e -p r o o f