Information about the SARS-CoV-2 virus continues to unfold. Since this virus has never been seen before, researchers are scrambling to understand the infection and mortality rates, how it spreads and how it can be treated.

Engineers from Johns Hopkins¹ created an online digital database that gets updated every day with the number of confirmed cases, deaths and the total number of tests conducted for reporting countries. The mortality rate can be found by taking the total number of deaths and dividing by the total number of confirmed cases.

This has been the percentage of deaths reported in the news. However, the number is not accurate because states have not had the resources for mass COVID-19 testing.² Most of those tested have also presented with symptoms, so it’s unknown how many may have had and recovered from COVID-19, but were unaware when they had mild or no symptoms of infection.

From late March to early April 2020, all pregnant women entering New York–Presbyterian Allen Hospital and Columbia University Irving Medical Center to deliver their babies were screened for SARS-CoV-2.³ The results revealed that 87.9% who tested positive had no symptoms.

Results from a separate round of testing⁴ at a homeless shelter in Boston showed that 36% tested positive but, of those, only 7.5% had a cough, 1.4% had shortness of breath and 0.7% had a fever. If the percentage of people in the general population who are infected without symptoms is just half of the 87.9% tested in New York, it significantly reduces the mortality rate, since it increases the number who will test positive.

This would mean that the published mortality rates are far from accurate, as most of the testing now is on people who have symptoms, which artificially elevates the rate and skews the statistics.

SARS-CoV-2 Found One Week After Infection Cleared

Researchers know most human-to-human transmission has been through respiratory droplets. However, other routes are still under investigation, including exposure to feces and blood.⁵ While some patients with COVID-19 present with conjunctivitis, data on viral replication in eye samples has been sparse.

During the SARS-CoV-1 pandemic, exposure to eye fluid was associated with an increased risk of transmission and infection. A new case study published in the journal Annals of Internal Medicine⁶ indicates that coronavirus may live in eye fluid long after the infection appears to have cleared.

Researchers used data gathered from a 65-year-old woman who had traveled from Wuhan, China, to Italy in late January and was the first confirmed case in Italy.⁷ She was admitted to the hospital six days after arriving in the country.

Doctors report that she had conjunctivitis on the day of admission to the Roman hospital, Lazzaro Spallanzani National Institute for Infectious Diseases.⁸ After the third day her eye was swabbed because the condition was not improving. Samples were collected almost daily after SARS-CoV-2 was detected in the fluid. The conjunctivitis appeared to have improved by Day 15 and resolved by Day 20.

The testing showed declining concentration of the virus through Day 21. By Day 22 the virus was not detectable. Yet, five days later it was again found in a sample from her eyes. The lab values suggest the virus continued replicating in the conjunctiva. Further testing revealed it was infectious and could represent a source for infecting others.

Conjunctivitis — One Symptom of COVID-19

Symptoms of conjunctivitis have “occasionally been reported”⁹ with COVID-19, in much the same way other types of coronaviruses are associated with conjunctivitis.¹⁰ However, it was not associated with SARS-CoV or MERS-CoV.

Viral conjunctivitis is extremely contagious and often self-limiting. The condition may develop after exposure to someone with an upper respiratory infection such as COVID-19, or it may develop after a virus spreads throughout the body along mucus membranes connecting the lungs, nose, throat and tear ducts.¹¹

There is no treatment for viral conjunctivitis, which usually runs its course in two to three weeks. Antibiotics, ointments and drops are not effective, as the condition is caused by a virus rather than bacteria. Cold compresses and artificial tear solutions may help relieve the symptoms.

Speaking to a reporter from The Washington Post, infectious disease specialist W. David Hardy pointed out most people don’t always remember the connection between the nose and eyes.¹²

Symptoms of COVID-19 have included cough and shortness of breath.¹³ You should seek medical attention if you’re having trouble breathing or if you’re having persistent pain or pressure in your chest. If your lips or face are blue call 911. It’s also an emergency if someone has new confusion or if you’re unable to arouse them.

Recently, the Center for Disease Control and Prevention added six more conditions that may appear with SARS CoV-2.¹⁴ The symptoms of coughing and shortness of breath may appear within two to 14 days after having been exposed to the virus. The CDC said that people with these two symptoms or those who have at least two of the following may have COVID-19:¹⁵

Fever	Repeated shaking with chills
Chills	Muscle pain
Headache	Sore throat
New loss of taste or smell