More than loss of taste and smell: burning watering eyes in coronavirus disease 19 (COVID-19)

Rokohl, Alexander C.; Loreck, Niklas; Wawer Matos, Philomena A.; Zwingelberg, Sarah; Augustin, Max; Dewald, Felix; Grajewski, Rafael S.; Klein, Florian; Lehmann, Clara; Heindl, Ludwig M.

OBJECTIVES: To evaluate ocular symptoms in European non-hospitalized patients with severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) and to investigate associations with the demographic data as well as nasal and general physical symptoms. METHODS: In this prospective, observational study, 108 non-hospitalized patients with polymerase chain reaction (PCR) confirmed SARS-CoV-2 infection not requiring intensive care were asked using a standardized questionnaire regarding disease associated ocular symptoms, demographic data, as well as general physical and nasal symptoms. Total ocular symptom score (TOSS) was evaluated during and retrospectively prior to coronavirus disease 19 (COVID-19) infection. Associations between TOSS and demographic data as well as general and nasal symptoms were evaluated. RESULTS: 75 out of the 108 COVID-19 patients (69.4 %) suffered from at least one ocular symptom during COVID-19. The most common symptoms included burning sensations in 36.1% (n=39), epiphora in 34.3% (n=37), and redness in 25.9% (n=28), compatible with conjunctivitis. These symptoms occurred 1.96 ± 3.17 days after the beginning of COVID-19 and were rather mild. TOSS was significantly higher during COVID-19 (1.27±1.85) than prior to the infection (0.33±1.04; p<0.001). There were no significant associations between TOSS and gender (beta coefficient: -0.108; p=0.302), age (-0.024; p=0.816), rhinorrhea (-0.127; p=0.353), nasal itching (-0.026; p=0.803), sneezing (0.099; p=0.470), nasal congestion (-0.012; p=0.930), cough (-0.079; p=0.450), headache (0.102; p=0.325), sore throat (0.208; p=0.052), or fever (0.094; p=0.361). CONCLUSIONS: Ocular involvement in European non-hospitalized patients with COVID-19 seems to be highly underestimated. Overall, these ocular symptoms including burning sensations, epiphora, and redness seem to be mild and seem not to need any treatment.