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Some 23 percent of children hospitalized with COVID-19 in Wuhan, China, had ocular manifestations
Due to several reported cases, it is understood that patients with COVID-19 and ocular symptoms are at an increased risk of transmitting SARS-CoV-2 through a conjunctival route.1-3 However, virtually all currently reported cases of conjunctival transmission have occurred in adults, and little is known about the ocular manifestations of COVID-19 in children.
When compared with adults, exposure history, clinical characteristics, and ocular manifestations in children with COVID-19 could present very differently.4-9
A cross-sectional study was conducted at Wuhan Children’s Hospital in Wuhan, China, to investigate ocular manifestations and clinical characteristics of children with laboratory-confirmed COVID-19 between January 26 and March 18, 2020.
A total of 216 pediatric patients were studied, among whom 134 (62 percent) were boys, with a median age of 7.25 (3 to 12) years. Some 90 percent of participants had family members with suspected or confirmed COVID-19 infections, and some 43 percent of COVID-19–positive children were asymptomatic before laboratory confirmation.
The common initial symptoms that were reported include fever and cough, which is consistent with those observed in adult patients.10 Differing from adults, all infected children subjects had mild or moderate symptoms. This finding is consistent with previous studies which determined that children show milder cases and a better prognosis than adults infected with COVID-19.11-13
The most common ocular manifestations were conjunctival discharge (55 percent), eye rubbing (39 percent), and conjunctival congestion (10 percent).
Children with systemic symptoms or with cough were more likely to develop ocular symptoms, which were typically mild. All children recovered or improved.
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11. Ludvigsson JF. Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults. Acta Paediatr. 2020;109(6):1088-1095.
12. Chang T-H, Wu J-L, Chang L-Y. Clinical characteristics and diagnostic challenges of pediatric COVID-19: a systematic review and meta-analysis. J Formos Med Assoc. 2020;119(5):982-989.
13. Castagnoli R, Votto M, Licari A, et al. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children and adolescents: a systematic review. JAMA Pediatr. Published online April 22, 2020.