Pattern of Ocular Findings and Conjunctival Swab Positivity in Patients With Coronavirus Disease-19 at Kenyatta National Hospital in Kenya

Abstract

background: On 11th March 2020, Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) which causes Corona Virus disease-2019 (COVID-19) was declared a global pandemic. Ocular signs have been documented in several studies conducted outside of East Africa, in addition to usual symptoms like fever, cough, dyspnea, and other respiratory symptoms. This study aimed at understanding the range of findings in the eyes of those infected with COVID-19 in Kenya and provides a reference for other clinicians. Objectives: To determine the pattern of ocular findings and positivity of conjunctival swab RTPCR in individuals with COVID-19 in a Kenyan Population. Material and Method: The study employed cross-sectional design conducted in Kenyatta National Hospital (KNH), including KNH’s Infectious Disease Unit (IDU) to the patients that tested SARS-CoV-2 positive by Polymerase Chain Reaction (PCR). They were interviewed using a structured questionnaire. Anterior segment examination was performed using a Smart Eye Camera (SEC) and posterior segment examination by indirect ophthalmoscope. Conjunctival swabs were collected for PCR analysis. The data were entered into and analysed using SPSS software package version 25.0. Results: A total of 70 patients (27 male and 43 females) with a mean age of 39.1 (SD 12.8) were examined. The most common ocular symptoms were grittiness (36%), itchiness (24%), and blurred vision (17%). Ocular findings included hyperemia (36%), follicular reaction (37%), epiphora (4%), and episcleritis (1%) in the anterior segment. Few patients were found to have CWS (7%), microvascular retinal haemorrhages (2%), Vitreous haemorrhage (1%), and exudates (1%) in the posterior segment. The conjunctival positivity rate was at 1.4%. Conclusion: COVID-19 patients were found to have ocular findings but the conjunctival positivity rate was low. However, prevention of possible transmission via ocular secretions is still recommended.