A COVID-19 patient in Italy had the coronavirus lingering in her eye longer than in her nose, according to a case study.
The unnamed 65-year-old woman, Italy’s first confirmed COVID-19 case, had travelled from Wuhan—the Chinese city which was the initial epicenter of the COVID-19 pandemic—to Italy on January 29, according to a research letter published in the Annals of Internal Medicine. She had arrived a day after her symptoms started.
The woman was taken to an isolation unit at Italy’s Lazzaro Spallanzani National Institute for Infectious Diseases hospital in Rome. Her COVID-19 symptoms included a dry cough and a sore throat. She also had and an inflamed nasal cavity, and conjunctivitis in both her eyes—which is thought to be a COVID-19 symptom.
The woman later developed a fever of 100.4 degrees Fahrenheit and became nauseous. This happened on day four, but it was not clear if this was four days after her symptoms started or four days after she was admitted to hospital. A test confirmed she was infected with the coronavirus.
As her conjunctivitis wouldn’t clear up, doctors decided to take a swab from her eye on her third day at the institution, and repeated this almost daily. The virus was present, but less concentrated, in her eye up to day 21.
“Conjunctivitis greatly improved at day 15 and apparently resolved at day 20,” the team wrote.
But it returned on day 27, five days after the coronavirus was apparently no longer present in the woman’s eye. Doctors found genetic material from the virus in eye swabs days after it was no longer present in samples from the nose. The team said their findings suggest that eye fluids from COVID-19 patients “may be a potential source of infection.”
“These findings highlight the importance of control measures, such as avoiding touching the nose, mouth, and eyes and frequent hand washing.”
In addition, it re-emphasizes that opticians should wear personal protective equipment while examining patients, because the mucous membrane of the eye may not only be an entry site for viruses, but also a means of transmission, they said. Next, researchers should try to pinpoint the eye cells which enable the coronavirus to replicate, the team suggested.
The authors noted that conjunctivitis “has been occasionally reported among COVID-19 symptoms, similar to infections caused by other human coronaviruses.”
For instance, eye fluids were linked with a higher chance of healthcare workers catching the germ which causes SARS, also a member of the large coronavirus family of viruses, during that epidemic almost two decades ago.
Studies which have emerged from the ongoing COVID-19 pandemic cited by the authors also suggest the eye can carry the coronavirus.
Dr. Joshua Barocas, assistant professor of Medicine at the Boston University School of Medicine and infectious diseases physician at Boston Medical Center who did not work on the case study, previously explained to Newsweek that conjunctivitis is common in those with upper respiratory illnesses.
That’s because our eyes, ears, nose, throat, and lungs are connected “so viruses (even common ones) can cause a constellation of symptoms in those locations,” he said.
At the time, he said: “As of now, we do not know enough to say that it is completely consistent with COVID-19 infection though it could certainly be a symptom.”
As shown by the Statista map below, Italy is among the countries with the highest known COVID-19 cases. According to Johns Hopkins University, more than 2.5 million cases have been confirmed worldwide, over 177,000 people have died, and over 686,000 are known to have survived.
Centers for Disease Control and Prevention Advice on Using Face Coverings to Slow Spread of COVID-19
- CDC recommends wearing a cloth face covering in public where social distancing measures are difficult to maintain.
- A simple cloth face covering can help slow the spread of the virus by those infected and by those who do not exhibit symptoms.
- Cloth face coverings can be fashioned from household items. Guides are offered by the CDC. (https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html)
- Cloth face coverings should be washed regularly. A washing machine will suffice.
- Practice safe removal of face coverings by not touching eyes, nose, and mouth, and wash hands immediately after removing the covering.
World Health Organization advice for avoiding spread of coronavirus disease (COVID-19)
Hygiene advice
- Clean hands frequently with soap and water, or alcohol-based hand rub.
- Wash hands after coughing or sneezing; when caring for the sick; before, during and after food preparation; before eating; after using the toilet; when hands are visibly dirty; and after handling animals or waste.
- Maintain at least 1 meter (3 feet) distance from anyone who is coughing or sneezing.
- Avoid touching your hands, nose and mouth. Do not spit in public.
- Cover your mouth and nose with a tissue or bent elbow when coughing or sneezing. Discard the tissue immediately and clean your hands.
Medical advice
- Avoid close contact with others if you have any symptoms.
- Stay at home if you feel unwell, even with mild symptoms such as headache and runny nose, to avoid potential spread of the disease to medical facilities and other people.
- If you develop serious symptoms (fever, cough, difficulty breathing) seek medical care early and contact local health authorities in advance.
- Note any recent contact with others and travel details to provide to authorities who can trace and prevent spread of the disease.
- Stay up to date on COVID-19 developments issued by health authorities and follow their guidance.
Mask and glove usage
- Healthy individuals only need to wear a mask if taking care of a sick person.
- Wear a mask if you are coughing or sneezing.
- Masks are effective when used in combination with frequent hand cleaning.
- Do not touch the mask while wearing it. Clean hands if you touch the mask.
- Learn how to properly put on, remove and dispose of masks. Clean hands after disposing of the mask.
- Do not reuse single-use masks.
- Regularly washing bare hands is more effective against catching COVID-19 than wearing rubber gloves.
- The COVID-19 virus can still be picked up on rubber gloves and transmitted by touching your face.
