Is Pink Eye a Symptom of COVID-19?

En espanol | 'Tis the season for coughs, congestion and itchy, red eyes.

Any other year, these ailments would be chalked up to yet another cold and flu season. But this fall and winter, plenty of people will be wondering: Is it the coronavirus?

While there is a lot of overlap between the symptoms of COVID-19 and the more common seasonal maladies of colds and the flu — a sore throat, runny nose and cough are markers of all three, for example — a red, watery eye, on its own, likely means you're in the clear when it comes to COVID-19, says Alfred Sommer, M.D., professor of epidemiology, international health and ophthalmology at the Johns Hopkins Bloomberg School of Public Health.

Conjunctivitis — an eye infection that's more commonly known as pink eye — can be caused by a number of things, according to the Centers for Disease Control and Prevention (CDC), including bacteria, allergens and different viruses. However, “there is very little evidence that people develop pink eye from COVID-19,” the illness caused by the new coronavirus, Sommer says.

A few studies have drawn a link between conjunctivitis and the coronavirus. A report published in March in JAMA Ophthalmology found that nearly one-third of a small sample of patients with COVID-19 in Hubei province, China, had “ocular manifestations” consistent with pink eye. Most who experienced these eye symptoms had severe cases of COVID-19 (and often had pneumonia); only one patient presented with conjunctivitis as the first symptom.

Another study, also conducted in China and published in JAMA Ophthalmology in August, found that while the most common symptoms among 216 children hospitalized with COVID-19 were fever and cough, about 23 percent had symptoms matching pink eye, including conjunctival discharge, eye rubbing and conjunctival congestion. (The conjunctiva is the clear membrane that covers the white part of the eye.)

Still, Sommer says pink eye is an “unusual presentation” of a coronavirus infection. A meta-analysis of available research in the Journal of Medical Virology comes to a similar conclusion: It found the overall rate of conjunctivitis in COVID-19 patients was 1.1 percent. In patients with severe COVID-19, the incidence was slightly higher, at 3 percent.

"People who get COVID and become sick with COVID are much more likely to get all the other symptoms that you hear about, read about all the time — the coughing, loss of smell, the loss of ability to taste, and so forth,” Sommer says.