A study in JAMA Ophthalmology examined ocular manifestations and outcomes in children with confirmed coronavirus disease 2019 (COVID-19), the contributors to these symptoms, and the clinical symptoms associated with these manifestations.
Chinese researchers sought to investigate ocular manifestations and clinical characteristics of children with laboratory-confirmed COVID-19, conducting a cross-sectional study at Wuhan Children’s Hospital in Wuhan, China. Included were children with COVID-19 confirmed by severe acute respiratory syndrome coronavirus disease-2 nucleic acid tests of upper respiratory tract specimens between January 26 and March 18, 2020.
The study team was looking at onset clinical symptoms and duration, as well as ocular symptoms and needs for medication. Participants were 216 pediatric patients—62% were boys—with a median (interquartile range) age of 7.25 (2.6-11.6) years.
Based on the exposure history, 193 children (89.4%) had a confirmed (173 [80.1%]) or suspected (20 [9.3%]) family member with COVID-19 infection, according to the study.
Researchers report that the most common symptoms among symptomatic children were fever (81 [37.5%]) and cough (79 [36.6%]). Of 216 children, 93 (43.1%) had no systemic or respiratory symptoms, however. All children with mild (101 [46.8%]) or moderate (115 [53.2%]) symptoms recovered without reported death.
Nearly a fourth of the children, 49, demonstrated various ocular manifestations, of which nine had ocular complaints that were the initial manifestations of COVID-19. The common ocular manifestations were:
• Conjunctival discharge (27 [55.1%]),
• Eye rubbing (19 [38.8%]), and
• Conjunctival congestion (5 [10.2%]).
The authors explain that children with systemic symptoms (29.3% vs. 14.0%; difference, 15.3%; 95% CI, 9.8%-20.7%; P = .008) or with cough (31.6% vs. 17.5%; difference, 14.1%; 95% CI, 8.0%-20.3%; P = .02) were more likely to develop ocular symptoms.
“Ocular symptoms were typically mild, and children recovered or improved,” the researchers said, adding, “In this cross-sectional study, children hospitalized with COVID-19 in Wuhan, China, presented with a series of onset symptoms including fever, cough, and ocular manifestations, such as conjunctival discharge, eye rubbing, and conjunctival congestion. Patients’ systemic clinical symptoms or cough were associated with ocular symptoms.”
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