Infectious rate of ocular discharges in patients with approved COVID-19 respiratory infection

Background: Since the relation between ocular manifestation and coronavirus disease 2019 (COVID-19) has been not elucidated well, thus this study was performed to assess the transmission to patients and healthcare providers via ocular secretions, and to decide if there is a link between ocular symptoms and COVID-19. Methods: A total of 101 patients who have been diagnosed with COVID-19 based on the clinical symptoms, radiological studies and confirmed by reverse transcriptase-polymerase chain reaction (RT-PCR), and hospitalized in Corona ward of Imam klomeini Hospital in Ardabil from April 15, 2020 to September 15, 2020. Ocular examination was done and patients' demographical data and ocular symptoms were recorded. Also, ocular secretion specimens were obtained to evaluate the COVID-19 RT-PCR test to detect the virus in ocular secretion specimen. Results: In this study, we observed that 15.8% of patients had positive RT-PCR test for COVID-19 in their ocular secretion specimens. In addition, we showed that there is no difference between male and female as well as age in patients with positive RT-PCR and negative tests obtained from ocular secretion. In addition. we observed that 27 patients (26.7%) were symptomatic patients for ocular manifestations including conjunctivitis, epiphora, injection, discharge, etc., but only 2 patients (1.98%) had follicular conjunctivitis during examination. Besides, nonsymptomatic patients (for ocular manifestations) had significant lower rate of positive RT-PCR test from their ocular secretion. Conclusion: This study showed that ocular secretion might be a source of COVID-19 infection even in nonsymptomatic patients. Thus, self-protection from ocular secretion should be observed by ophthalmologists from all patients (even nonsymptomatic patients).