COVID-19 ocular findings in children: a case series

Excerpt

Children account for 1% of cases of COVID-19 in most published series, with significantly reduced risk of developing severe forms of disease or death [1‐3]. Because most children present with mild forms of acute respiratory infections, interest has been focused initially on children with underlying/comorbid diseases and concentrated rare fatalities [1, 4]. In children with active COVID-19, the most common clinical manifestations are fever and cough, sometimes accompanied by fatigue, myalgia, rhinorrhoea, sneezing, sore throat, headache, dizziness, diarrhoea, vomiting, and abdominal pain [1, 2, 5]. Dyspnea is more common in adults and has been described in more than 20% of patients, although lower respiratory tract infection can also develop in children [6, 7]. Conjunctival congestion is the most common ocular manifestation described, although it is rarely mentioned in non-ophthalmology-specific studies [6]. However, it is present in 1 to 5% of adults, consistent with mild follicular conjunctivitis without pseudomembrane formation [8]. Concern with COVID-19 in children began when they started to develop a wide range of manifestations from chilblains, to a severe pediatric inflammatory multisystem syndrome (PIMS) mimiquing Kawasaki disease (KD) [9‐11]. Scarce literature has been published thus far regarding ocular findings in the COVID-19 pediatric population. A cross-sectional study performed in Wuhan (China) showed conjunctival discharge and conjunctival congestion as the most common manifestation, and a higher risk of developing ocular symptoms when systemic clinic was present [12]. Therefore, we aimed to share our experience in managing children with ocular involvement possibly related to COVID-19. …