PMC:7455778 / 3087-7058 JSONTXT

{"target":"http://pubannotation.org/docs/sourcedb/PMC/sourceid/7455778","sourcedb":"PMC","sourceid":"7455778","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7455778","text":"Methods\nThis cross-sectional study was conducted at the Hospital Clinico San Carlos of Madrid, Spain, a tertiary hospital which attends patients within the Madrid metropolitan area. The study was approved by the Clinical Research Ethics Committee of this institution and was conducted in accordance with the tenets of the Declaration of Helsinki. Informed consent was obtained from all patients.\nHospitalized patients with laboratory-confirmed SARS-CoV-2 infection were included. Based on the hospital's protocol, the general admission criteria for patients were as follows: (1) \u003c 50 years of age without comorbidities with bilateral pneumonia, or unilateral pneumonia with respiratory failure (saturation \u003c 96% and respiratory rate \u003e 20); or (2) \u003e 50 years of age or patient with comorbidity: with pneumonia, respiratory failure (saturation \u003c 96% and respiratory rate \u003e 20), or laboratory/clinical severity (arterial blood gas, hemogram, D-dimer, C-reactive protein, procalcitonin, lactate dehydrogenase—LDH, transaminases).\nPatients were asked about symptoms of conjunctivitis (current and previous) and they underwent a basic ophthalmological examination at their bedside by two experienced ophthalmologists on a 72-h period. A total of 301 subjects from the COVID admission unit, whose clinical situation allowed us to conduct the aforementioned ophthalmological examination and interview, were systematically explored. To examine the patients, the investigators wore double gloves, a fluid-resistant gown, a full face shield, and both FFP2 and surgical masks.\nThe inclusion criteria were as follows: over 18 years of age, patient with positive reverse transcriptase-polymerase chain reaction (RT-PCR) test from nasopharyngeal swab for SARS-CoV-2, hospitalized due to COVID-19, and ability to give verbal consent. Those patients admitted to the intensive care unit, unable or unwilling to give verbal consent, and unable to adequately report previous eye symptoms due to general health status were excluded.\nThe patient’s age, sex, the onset of COVID-19 symptoms, chest X-ray, and laboratory tests results were noted. Laboratory work-up included the levels of leukocytes, neutrophils, lymphocytes, C-reactive protein, ferritin, D-dimer, creatinine, and LDH, considering the blood test results that represented the greater severity prior to the date of the ophthalmological examination. Chest X-ray results were analyzed separately, since it is not uncommon to find a discrepancy between the radiological and clinical findings, especially in the early stages of the disease. Additionally, patients were classified according to their clinical severity as mild, moderate, and severe, following the CURB-65 score, physical examination, respiratory assessment (respiratory rate, dyspnea, blood oxygen saturation, ventilation system requirements), or organ failure. The main outcome measure is the overall prevalence of conjunctivitis among inpatients diagnosed with COVID-19.\nThe overall prevalence results from adding patients who had conjunctivitis at the time of the evaluation and those who reported having conjunctivitis prior to the examination. Prevalence will be presented as a percentage of those with conjunctivitis along with its 95% confidence interval (CI). The distribution of gender, acute pneumonia, and bilateral pneumonia depending on the outcome status (conjunctivitis or not) will be presented as percentages and the differences addressed through the chi-squared test (of the Fisher’s exact test in case the frequencies be low). Differences in prevalence and clinical presentation of conjunctivitis were analyzed by sex. Likewise, the distribution of the quantitative covariates (leucocytes, neutrophils, lymphocytes, C-reactive protein, ferritin, D-dimer, creatinine, and LDH) will be depicted through the median, first, and third quartile, using the Mann-Whitney U test to assess their differences depending on the presence of conjunctivitis and 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