Type and frequency of ocular and other known symptoms experienced by people who self–diagnosed as suffering from COVID-19 in the UK

  1. Shahina Pardhan
  2. Megan Vaughan
  3. Jufen Zhang
  4. Lee Smith
  5. Havovi Chichger

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Abstract

Background

Recent literature suggests that ocular manifestations present in people suffering from COVID-19. However, the prevalence and the type of ocular symptoms varies substantially, and most studies report retrospective data from patients suffering from more serious versions of the disease. Little is known of exactly which ocular symptoms manifest in people with milder forms of COVID-19.

Methods

An online questionnaire obtained self-report data from people in the community, who reported to be inflicted with COVID-19. The type and frequency of different symptoms suffered during COVID-19 were obtained. Details of any pre-existing ocular conditions and the duration of symptoms of COVID-19 were ascertained.

Results

Data from 132 participants showed that the four most reported COVID-19 symptoms were Dry Cough (63%), Fever (67%), Fatigue (83%), and loss of Smell/Taste (63%). 56% of the participants reported to having experienced an eye symptom, 46% reported to having a new or different eye symptom compared to pre-COVID-19 state. Three ocular symptoms (watery eyes, sore eyes, sensitivity to light) were significantly different from Pre-COVID-19 state (p<0.05). Logistic regression showed a significant association of eye symptoms with Fever (p=0.035).

Conclusion

Nearly half of the sample of people studied experienced ocular symptoms. The significant ocular symptoms, indicative of viral conjunctivitis, might have been missed in patients with more serious manifestations of the disease. It is also important to differentiate between the types of ocular manifestation, as symptoms of bacterial conjunctivitis (i.e. mucous discharge, gritty eyes) were not significant. Possible mechanisms for SARS-CoV-2 infection within the eye are discussed.

Key message

To date, there are no studies on ocular symptoms experienced by people who self-reported as suffering from mild case of COVID-19. In the absence of population –wide testing in the UK, our study shows that nearly half of the population reported to having experienced an eye symptom. It is likely that the significant ocular symptoms, indicative of viral conjunctivitis, might have been overlooked in the light of other more serious and critical manifestations of COVID-19. The data are important, especially in countries that rely on self –report of COVID-19 symptoms when confirmative tests for COVID-19 are not available.

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  1. ScreenIT

    SciScore for 10.1101/2020.06.20.20134817: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: All patients provided informed consent for taking part in the study.
    IRB: Ethical approval was granted by the Faculty of Health, Education, Medicine and Social Care Ethics Committee at Anglia Ruskin University.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    However, findings must be interpreted in light of the study limitations. Although the number of people in this study sample is relatively small and may not be representative of the population in the UK, the prevalence of other symptoms of COVID-19 agree with those in the literature. It is also possible that some of the responders may have had other diseases /infections and not COVID-19. However, in the absence of community-based swab tests or antibody tests which were not readily available to the population of UK, we employed a criterion of including only those responders who had experienced at least two of the well-known COVID-19 symptoms. In addition, a substantial percentage of the responders (90%) had self-isolated due to the possibility of having suffered from COVID-19. It is possible that some of the ocular symptoms may have been due to other eye infections and not COVID-19 but the ocular symptoms were experienced within the same time frame as the other COVID-19 symptoms, strongly suggesting a connection to the disease. In conclusion, findings from this UK sample found that the significant ocular manifestations of COVID-19 (sore eyes, watery eyes, photophobia) are similar to those experienced with viral conjunctivitis. This should be confirmed with a larger scale study. It is also important to note that ocular symptoms might have been under-reported in the presence of other, more serious manifestations of the disease. These findings are important for countries that also...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
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    About SciScore

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  2. Version published to 10.1101/2020.06.20.20134817v1 on medRxiv