Outpatient human coronavirus associated conjunctivitis in India

Area of Science:

• Ophthalmology
• Virology
• Public Health

Background:

• Viral conjunctivitis, or pink eye, is a significant public health concern due to its high contagiousness.
• The role of SARS-CoV-2 as a primary cause of conjunctivitis remains debated.
• This study investigated pathogens linked to infectious conjunctivitis during the COVID-19 Delta variant surge.

Purpose of the Study:

• To determine the pathogens associated with outpatient infectious conjunctivitis.
• To investigate the potential of SARS-CoV-2 as a cause of conjunctivitis.
• To assess coinfections in patients presenting with conjunctivitis during the COVID-19 Delta surge.

Main Methods:

• A prospective study enrolled 106 patients with acute conjunctivitis in Madurai, India.
• Anterior nasal and conjunctival swabs were collected for each patient.
• Unbiased metagenomic RNA deep sequencing (RNA-seq) was performed to identify pathogens.

Main Results:

• SARS-CoV-2 RNA fragments were detected in 13 patients; 6 had SARS-CoV-2 infection.
• Coinfections were common: 5 patients had SARS-CoV-2 and human adenovirus (HAdV); others had HAdV, human coronavirus OC43, or Vittaforma corneae.
• Clinical findings included bilateral disease (30%) and petechial hemorrhage (33% of SARS-CoV-2 cases); no systemic symptoms were reported.

Conclusions:

• Human coronavirus infections, including SARS-CoV-2, can manifest as conjunctivitis.
• Over 50% of human coronavirus-associated conjunctivitis cases involved coinfections with other pathogens.
• Broad pathogen testing and surveillance are crucial for outpatient conjunctivitis management.