Bozkurt, ErdincOzate, SerdarMuhafiz, ErsinYilmaz, FatmaCaliskan, Okan2024-05-252024-05-25202171542-23211542-233X10.1097/ICL.00000000000007522-s2.0-85102299338https://doi.org/10.1097/ICL.0000000000000752https://hdl.handle.net/20.500.14517/1639Bozkurt, Erdinc/0000-0002-5570-799XPurpose: To assess the effect of severe acute respiratory syndrome coronavirus-2 infection on the conjunctiva and tear film. Methods: Thirty-eight patients with confirmed COVID-19 and 31 healthy controls were included in this prospective and observational study. Individuals with COVID-19 formed the patient group, and healthy individuals formed the control group. Conjunctival impression cytology (CIC), TBUT, Schirmer II test, and ocular surface disease index were evaluated in all participants. Results: No significant difference was observed regarding the mean age and gender between the groups (P=0.786 and P=0.122, respectively). The mean TBUT and Schirmer II test results did not differ between the two groups (P=0.496 and P=0.447, respectively). The CIC results revealed decreased density and cell size of goblet cells and moderate to high enlargement, squamous changes, and increased nucleocytoplasmic ratio in nongoblet epithelial cells in the COVID-19 group compared with the control group. Based on the Nelson classification in CIC samples, 60.6% of the COVID-19 group and 19.4% of the control group had changes consistent with grade 2 or above. The presence of neutrophils in CIC was significantly higher in the COVID-19 group (P<0.001), whereas the presence of lymphocyte was similar between the two groups (P=0.247). Conclusion: This study revealed the pathological conjunctival alterations in patients with COVID-19 and demonstrated that pathological ocular surface alterations may present even at the beginning of COVID-19 without clinically significant ocular manifestation.eninfo:eu-repo/semantics/closedAccessCOVID-19Conjunctival impression cytologyTear break-up timeSchirmer II testOcular surfaceOSDIArticleQ3Q1474168173WOS:00065662930000333060413