Sometimes conjunctivitis is called 'pink eye', because the eye looks pink or red. Purpose: official website and that any information you provide is encrypted Disinfection of instruments and surfaces having potential patient contact, before and after the examination. The site is secure. Video transcript Long-term effects of COVID-19 Post-COVID-19 syndrome could be a long haul (podcast) Post-COVID-19 recovery Post-COVID-19 recovery care at Mayo Clinic The most common ocular signs and symptoms included conjunctival discharge (27 [55%]), eye rubbing (19 [39%]), and conjunctival congestion (5 [10%]). Allergic Conjunctivitis; Allergic Rhinitis; Anemia; Anemia and Iron Deficiency Screening . However, a positive IgG test alone does not mean the patient is no longer contagious or is immune. 8600 Rockville Pike -, Chen L, Liu M, Zhang Z et al (2020) Ocular manifestations of a hospitalised patient with confirmed 2019 novel coronavirus disease. If IgM and IgG are both positive, infection is recent and may or may not be active. If at any time the patient develops a reduction in vision, significant pain or lack of improvement with topical antibiotics and/or steroids, they should be referred for ophthalmic care, preferably by telemedicine consultation. Willcox MD, Walsh K, Nichols JJ, Morgan PB, Jones LW. However, a recent study suggested that SARS-CoV-2 associated conjunctivitis may not be common among patients presenting with conjunctivitis only. If conjunctivitis is bilateral and watery, it is more likely to be viral, and symptomatic treatment with regular hygiene and artificial tears is recommended. Genomic characterization and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. The CDC recommends that people with mild or moderate symptoms of COVID-19 manage their illness at home. Federal government websites often end in .gov or .mil. COVID-19 pandemic started in December 2019 in Wuhan city of China and within no time evolved into the deadliest pandemic of the present times. Previous Next Rs.52.00 Before The symptoms were relieved 6 days after treatment. Epub 2020 Jun 16. 2020;S0008-4182(20)30305-7. doi:10.1016/j.jcjo.2020.03.003. Conjunctivitis usually gets better within a couple of weeks without treatment, although there are things you can do to help ease your symptoms: Boil some water and then let it cool down. There is no vaccine or specific antiviral treatment available; treatment is limited to supportive care. However, conjunctivitis was more frequent in males with moderate clinical severity and in women classified as clinically mild. Two are even fully approved.. For systemic investigations, nasopharyngeal, throat, upper respiratory, and saliva swabs are taken for RT-PCR. Conjunctivitis is also known as red or pink eye. Infect. PMC Taken together, these data raise the possibility of spread of SARS-CoV-2 via tears and highlight the risk of eye examinations as an aerosol-generating procedure with potential risk to healthcare workers. Guidance on the platform has been published and you can register your service and request the training via: yourcovidrecovery@uhl-tr.nhs.uk This trend was corroborated by a 37% decrease in the number of patients who presented to the University of Washington's ED for conjunctivitis treatment. Post-COVID-19 conditions By Mayo Clinic Staff July 29, 2021 Post-COVID recovery Find out about possible causes of post-COVID-19 conditions and ways to manage symptoms. Patients with COVID-19 can have symptoms of watering, foreign body sensation, and red-eye, or they may be asymptomatic. Viral conjunctivitis (pink eye) usually lasts about one to two weeks, however, if it occurs in conjunction with COVID-19, other symptoms may persist longer, depending on the severity of the infection. Gastrointestinal symptoms including diarrhea, nausea, and vomiting have also been reported. It is thought that patients with SARS-CoV-2 may develop eye redness and watering, or conjunctivitis indistinguishable from typical viral conjunctivitis, rarely as the presenting complaint. COVID-19; Conjunctivitis; SARS-CoV-2; coronavirus; eye and ophthalmology; keratitis; ocular surface infection. The Ocular Manifestations and Transmission of COVID-19: Recommendations for Prevention. 8,9. There is no specific treatment for this condition, but you can speak with your GP for help. Clinical Characteristics of Coronavirus Disease 2019 in China. If a patient is IgM positive and IgG negative, the patient is actively infected. Early after acquiring infection, antibodies to SARS-CoV-2 are detected in serum. Use of topical anesthesia may also alter the results.[19]. Epub 2020 Jun 6. The Lancet. Compared with other viral conjunctivitis, we found distinctive clinical findings that could guide defining and differentiating conjunctivitis in COVID-19 patients. Abrishami M, Tohidinezhad F, Daneshvar R, Omidtabrizi A, Amini M, Sedaghat A, Amini S, Reihani H, Allahyari A, Seddigh-Shamsi M, Tayyebi M, Naderi H, Bojdy A, Khodashahi R, Eslami S. Ocul Immunol Inflamm. Ocular screening in severe acute respiratory syndrome. 2022 May-Aug;16(2):136-140. doi: 10.5005/jp-journals-10078-1356. Today, many medications are available through an EUA to treat COVID-19, both inside and outside of the hospital. Zhou P, Yang XL, Wang XG, et al. Clipboard, Search History, and several other advanced features are temporarily unavailable. 2022 Apr 8;1-7. doi: 10.1080/09273948.2022.2054432. FOIA The eye is a vital organ that consists of vascular tissues and is connected to the respiratory . [12] Definitive diagnosis can be done through RT-PCR testing of a conjunctival swab taken from the affected eye. We found no relationship between the COVID-19 severity score and the presence of conjunctivitis (P = 0.17). Approximately, 1 out of 10 hospitalized non-critical COVID-19 patients presents conjunctivitis during the disease. Nail Boards: An Alternative . Post COVID-19 condition is also observed in people who didn't have symptoms or had only mild to moderate symptoms during initial infection. Conjunctivitis may be a feature of this illness, with tears containing SARS-CoV-2 virus, and a source of potential transmission via aerosols. COVID-19 and the eye: alternative facts The 2022 Bowman Club, David L. Easty lecture. If IgM is negative and IgG positive, the infection is old. [6], Old age, living in a congested area, chronic lung diseases, comorbidities including immuno-compromised states, diabetes, obesity, chronic renal, and liver diseases are the risk factors for severe systemic disease. Journal of This virus strain affected different organs in the human body with a wide range of mild symptoms and moderate signs to severe and deadly ones. The Academy uses cookies to analyze performance and provide relevant personalized content to users of our website. Although fever is a common symptom there are reports of afebrile COVID patients as well. JAMA Ophthalmol. Next was extreme congestion. Seah I, Agrawal R. Can the coronavirus disease 2019 (COVID-19) affect the eyes? Conclusion: Post-COVID conditions can include a wide range of ongoing health problems; these conditions can last weeks, months, or years. 10.1136/bjophthalmol-2020-316304 Ocular Manifestations of Hospitalized Patients with COVID-19 in Northeast of Iran. Additionally, more than 1,500 COVID-19 "long-haulers" responded to a July 2020 survey conducted by an Indiana University School of Medicine professor and Survivor Corps. Am J Ophthalmol 2004;137:7734. COVID-related conjunctivitis is rare in the early stages of a coronavirus infection. Seah IYJ, Anderson DE, Kang AEZ, et al. Am J Ophthalmol 2020;19:100735. 2022 Jan 13;16:127-133. [10]Conjunctival infection is speculated to be due to direct inoculation of the ocular tissues from droplets of an infected patient, from nasopharynx by nasolacrimal duct or from the lacrimal glands. Conjunctivitis is a common eye infection, especially among children under five years. Many of these problems affect the retina a light-sensing layer of cells in the back of the eye that plays a key role in your vision. Seah I, Agrawal R. Can the Coronavirus Disease 2019 (COVID-19) Affect the Eyes? My first Covid experience was very mild this past August. Resting and drinking plenty of fluids will aid the body in recovering from COVID-19.. Epidemiology of conjunctivitis in US emergency departments. A review of coronaviruses and ocular implications in humans and animals. Supportive care means treating the symptoms . government site. Post COVID-19 . 2020;28(3):391395. The risk factor for COVID-19 associated conjunctivitis is direct contact with a person having COVID. If conjunctivitis is unilateral and sticky, it would be reasonable to consider topical antibiotics (eg chloramphenicol drops four times daily for four days). Trending videos Doctors and patients discuss the latest medical treatments and health tips Drugs A-Z Search prescription . Long COVID, which affects as many as a third of patients who were infected by the COVID-19 virus but weeks or months after they recover is characterized by a range of debilitating cognitive. The diagnosis of pink eye is often made based on the presence of symptoms such as eye redness and discharge, and the patients vision is normal with no evidence of other eye conditions such as keratitis, iritis, or angle-closure glaucoma. Clipboard, Search History, and several other advanced features are temporarily unavailable. Treatments for mild to moderate COVID-19 symptoms include: Over-the-counter (OTC) pain relievers Cough suppressants Rest Drinking plenty of fluids For more severe COVID-19 cases, patients may require hospitalization. 2020;395(10223):497506. COVID conjunctivitis like any other viral conjunctivitis is self-limiting and can be managed with lubricants and cold compresses unless cornea is involved. There are treatments for hospitalized patients with severe cases of COVID-19 that have been approved or authorized for emergency use by the Food and Drug Administration (FDA). Epub 2020 Sep 3. There is a . However, conjunctivitis as the only sign and symptom of coronavirus disease 2019 (COVID-19) is a rare presentation. By now, we have grown accustomed to the symptoms and side effects of COVID-19, including fever, cough, shortness of breath, body aches, loss of taste and smell, and so on. Assessing viral shedding and infectivity of tears in coronavirus disease 2019 (COVID-19) patients. However, important causes from a never-ending list of red-eye include; Adenoviral, bacterial, allergic conjunctivitis, Herpes Simplex Virus keratitis, anterior uveitis, foreign body, corneal abrasion, dry eye syndrome, and exposure keratopathy. Australia is experiencing an epidemic of COVID-19 due to the SARS-CoV-2 virus. Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Disclaimer, National Library of Medicine Serology and RT-PCR are the most common laboratory tests being performed. Treatments may include: Monoclonal antibodies Antiviral therapy with remdesivir Corticosteroids Immunotherapy Br J Ophthalmol 2004;88(7):86163. Methods: 2022 Jun 10;12(6):1431. doi: 10.3390/diagnostics12061431. Lachnanthes Tinctoria: This is one of the best Homeopathic medicine for neck pain and cervical spondylitis. You usually do not need treatment if you're an adult. While there's no proof yet that they do, additional research could show a benefit in certain situations, or with a different dose or formulation of the supplement. Unable to load your collection due to an error, Unable to load your delegates due to an error. Currently, no treatment is identified as safe and effective for post-COVID-19 condition. -, Huang C, Wang Y, Li X, et al. A study published in the peer-reviewed American Journal of Therapeutics showed that the cost of ivermectin for other treatments in Bangladesh is around $0.60 to $1.80 for a five-day course. COVID-19 associated conjunctivitis is an ocular manifestation of a new disease entity called Corona Virus Disease-19 (COVID-19). Ocul Immunol Inflamm 2020;28(3):39195. Conjunctivitis is inflammation of the conjunctiva, a tissue that makes up part of the eye and eyelid. Swabbing the eye for culture, stains, and direct antibody or polymerase chain reaction (PCR) testing is usually only used in uncommon or chronic cases that do not get better on their own or respond to treatment. Lancet. There is no treatment for viral conjunctivitis. BMJ Open Ophthalmol. Ocular tropism of respiratory viruses. Therefore, if the virus makes contact with the eye, it can have the same reaction as with other viruses. Trial registration number: This page was last edited on September 11, 2022, at 14:05. Online ahead of print. It usually gets better in a couple of weeks without treatment. Laboratory, radiological, and clinical results in patients with and without conjunctivitis stratified by sex were analyzed. Graefes Arch Clin Exp Ophthalmol. The .gov means its official. Transmission Potential of SARS-CoV-2 in Viral Shedding Observed at the University of Nebraska Medical Center. It is an enveloped single-stranded RNA virus, which is closely related to the severe acute respiratory syndrome coronavirus. doi: 10.1136/bjo.2003.035931. Authors William Binotti 1 2 , Pedram Hamrah 1 2 Affiliations The term "post-COVID conditions" is an umbrella term for the wide range of physical and mental health consequences experienced by some patients that are present four or more weeks after SARS-CoV-2 infection, including by patients who had initial mild or asymptomatic acute infection. The COVID-19 Pandemic from an Ophthalmologist's Perspective. The results of a nucleic acid test were positive for SARS-CoV-2 in the conjunctival sac of the left eye. But if you also have a fever, cough, or shortness of breath, ask your doctor what, if anything, you. However, 58 conjunctival swab samples from 29 patients with positive sputum samples were all negative. The authors declare that they have no conflict of interest. Antibiotic eye drops may be necessary to treat bacterial conjunctivitis. When blood clots prevent nutrients from getting to the retina, the . Conjunctivitis was the most common ocular manifestation, of which ocular redness or congestion, ocular pain, and follicular conjunctivitis were the most common presentation.COVID-19-related conjunctivitis has a self-limiting disease course, and treatment should be mainly supportive. A multicenter international prospective study of the validity and reliability of a COVID-19-specific health-related quality of life questionnaire. Lim LW, Tan GS, Yong V, Anderson DE, Lye DC, Young B, Agrawal R. Ocul Immunol Inflamm. Clin Ophthalmol. In this review article, we discuss the conjunctival and nasolacrimal mucosa as a potential route for the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) transmission, its ocular manifestations, and management. [14], COVID-19 conjunctivitis starts as unilateral redness of eye with follicular reaction (inferior palpebral) like any other viral conjunctivitis. However, the more severe a person's coronavirus symptoms are, the likelier they are to develop . This site needs JavaScript to work properly. Patients infected with SARS-CoV-2 can present with acute conjunctivitis symptoms, including eye redness, ocular irritation, eye soreness, foreign body sensation, tearing, mucoid discharge, eyelid swelling, congestion and chemosis. Soak a clean cotton wool pad (1 for each eye) in the water and: Gently rub your eyelashes to clean off any crust or build-up Wash your hands the right way Review the five steps to washing hands correctly from the U.S. Centers for Disease Control and Prevention (CDC). [20] It is recommended that two consecutive negative RT-PCR tests results are required before a patient can be considered safe.[21]. Treatment for pink eye (conjunctivitis) caused by COVID-19 includes: There is no current cure for COVID-19 (coronavirus disease 2019) and treatment is aimed at relieving symptoms in mild to moderate cases. sharing sensitive information, make sure youre on a federal Here are four ways to reduce your chances of getting viral conjunctivitis: 1. 2022 Jul 29;10(8):1422. doi: 10.3390/healthcare10081422. The current wild spread is due to human-to-human transmission through droplets and direct contact with the mucous membranes including eyes, nose, or mouth. The Centers for Disease Control and Prevention (CDC) regularly updates treatment recommendations based on the expert panel at the National Institutes of Health (NIH) who have developed and regularly update the NIH COVID-19 Treatment Guidelines. Those with conjunctivitis who are at high risk of COVID-19 infection should be directed to tertiary hospitals with COVID-19 facilities and ophthalmology departments. [5]ACE2 receptors were found in conjunctiva and cornea, although the receptor density in ocular tissues was lower. Doi: 10.1016/j.ajoc.2020.100735. Increasing case reports note that conjunctivitis, or pink eye, can occur as a symptom of COVID-19. The purpose of this study was to evaluate the frequency and clinical presentation of conjunctivitis in hospitalized patients with COVID-19. 8600 Rockville Pike 2021 Feb 18;15:687-696. doi: 10.2147/OPTH.S295283. [9], Recently, viral RNA was detected in the samples collected from the rooms of COVID-19 patients admitted in the hospital, which further confirmed spread through direct contact with the surfaces contaminated with virus particles. HHS Vulnerability Disclosure, Help 10.1056/nejmoa2002032 A recent paper proposed six underlying mechanisms of long-COVID cognitive changes2: 1. Approximately 97% of patients develop symptoms within 11.5 days of exposure. This suggested that transmission of the virus may occur during an eye exam. Such symptoms tend to be more common in patients with severe COVID-19 cases. Can J Ophthalmol. Conjunctivitis is an eye condition caused by infection or allergies. Other reports showed that the patients of COVID-19 developed conjunctivitis later in their course of disease after hospitalization. A person who has COVID can shed the virus through their tears, sometimes long after they have recovered from the illness. after almost 2 years of pandemic, the consequences of the post-covid syndrome, or pasc (post acute-sequelae of sars-cov-2), have become a major challenge in the management of affected patients, generating costs for health services. The natural history of the disease seems to be a rapid self-limited conjunctivitis that improves without treatment and does not affect visual acuity nor associate short-term complications. It's important to note that an eye issue in a person . eCollection 2022. Would you like email updates of new search results? Loon S-C, Teoh SCB, Oon LLE, et al. ajgp@racgp.org.au, Management of conjunctivitis during the COVID 19 pandemic 2020. Pink eye typically presents with redness, swelling, and soreness of the eye, likely because SARS . Pink eye is diagnosed with a physical examination of the eye. [1] [2] [3] However, there are reports of conjunctivitis associated with COVID-19. Wear a face mask. Lancet Respiratory Med, published on line May 7, 2020. https://doi.org/10.1016/S2213-2600(20)30193-4.Accessed May 8, 2020. Methods: A total of 301 subjects from the COVID admission unit with laboratory-confirmed SARS-CoV-2 infection were included. How Long Does Covid Pink Eye Last? The .gov means its official. Also known as Caregivers, Personal Attendants, Homemakers, or Companions, their goal is to enable the highest level of personal independence and meaningful lives for their clients. Viral conjunctivitis is responsible for the majority of infectious conjunctivitis, accounting for up to 75% of cases. Clinical diagnosis is through a high level of suspicion, The tear sample collection varies from the use of Schirmer strips to conjunctival swabs. Purpose: If possible, patients should be triaged prior to attending the clinic. The site is secure. Front Med (Lausanne). Some states and territories including the Australian Capital Territory, New South Wales, South Australia and Victoria have opened long COVID clinics in major cities to help people recover from ongoing symptoms. A 53-year-old man confirmed with COVID-19 developed symptoms of viral conjunctivitis in the left eye approximately 10 days after the onset of COVID-19. The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application. doi:10.1080/09273948.2020.1738501. The Post COVID Treatment Program is designed to help patients receive proper follow-up care in the weeks and months after their recovery process and will be open to all who need further medical evaluation related to COVID-19 symptoms. 2020; 581:465469.Doi:10.1038/s41586-020-2196-x. If symptoms persist, it is appropriate to consider a mild steroid (egfluorometholone drops four times daily for four days). Before Overactive immune responses can damage organs and . Rapid Onset Neovascular Glaucoma due to COVID-19-related Retinopathy. Post-COVID conditions are found more often in people who had severe COVID-19 illness, but anyone who has been infected with the virus that causes COVID-19 can experience post-COVID conditions. 2017;135(10):11191121. An official website of the United States government. 2021 Jan;41(1):349-362. doi: 10.1007/s10792-020-01575-2. A further study of 17 cases (one with some ocular redness) showed no PCR or cytopathological effect of SARS-CoV-2 in tear samples even when the nasopharyngeal swabs were positive.5 There have been reports that procedures causing aerosolisation of ocular adnexa are high risk for transmission, but these are surgical procedures performed by otolaryngologists or oculoplastic surgeons using endonasal techniques. A category of patients called "steroid responders" tend to develop an increase. Many forms of conjunctivitis go away with over-the-counter treatments in about 1-2 weeks. The purpose of this study was to evaluate the frequency and clinical presentation of conjunctivitis in hospitalized patients with COVID-19. Pink eye, also called conjunctivitis, is a infection of the eye's conjunctiva usually caused by a bacteria or virus that results in red, itchy, painful eyes. [15] It may resolve by itself or progress to involve coarse epithelial keratitis, pseudomembranous conjunctivitis and bilateral hemorrhagic, pseudomembranous conjunctivitis, or pseudodendritic keratitis. Keywords: Ho D, Low R, Tong L, Gupta V, Veeraraghavan A, Agrawal R. Ocul Immunol Inflamm. Pooled analysis shows an incidence of 11.4% (95%CI = 6.4-17.2%) of ocular manifestations in patients with SARS-CoV-2 infection, including hospitalized and non-hospitalized patients. Al-Sharif E, Strianese D, AlMadhi NH, D'Aponte A, dell'Omo R, Di Benedetto R, Costagliola C. Int Ophthalmol. doi: 10.1136/bmjophth-2022-001042. Data are limited, and the risk may be low. Bookshelf There's no medication that can cure COVID-19 conjunctivitis. The hospital may give treatments to: Slow the virus's spread through the body with antiviral medicines such as remdesivir. You must wet your hands, turn off the tap, apply soap, lather and scrub for 20 seconds, then rinse. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. No cases of conjunctivitis or any other ocular sign or symptoms were reported with either MERS-CoV or SARS-CoV. 2020 Jul;59(1):137-140. doi: 10.1016/j.jemermed.2020.04.060. Treatments may include: 2022 WebMD, Inc. All rights reserved. 2020 Aug;68(8):1546-1550. doi: 10.4103/ijo.IJO_1319_20. Accessibility [16] [17] It may also be associated with tender lymphadenopathy. Acute Onset of Bilateral Follicular Conjunctivitis in two Patients with Confirmed SARS-CoV-2 Infections. Navel V, Chiambaretta F, Dutheil F. Haemorrhagic conjunctivitis with pseudomembranous related to SARS-CoV-2. Hui KPY, et al. Allergic conjunctivitis is triggered by allergens such as pollen or dust and is more likely to be associated with itchy eyes than viral conjunctivitis. Reverse-transcription polymerase chain reaction (RT-PCR) is a specific but less sensitive test in the diagnosis of COVID conjunctivitis. Przybek-Skrzypecka J, Szewczuk A, Kamiska A, Skrzypecki J, Pyziak-Skupie A, Szaflik JP. Background The world is suffering from a new strain of the coronavirus family-Covid-19. Ocular tropism of coronavirus (CoVs): a comparison of the interaction between the animal-to-human transmitted coronaviruses (SARS-CoV-1, SARS-CoV-2, MERS-CoV, CoV-229E, NL63, OC43, HKU1) and the eye. Conjunctivitis (red or pink eye) is an eye condition caused by infection or allergies. COVID-19 and the Ocular Surface: A Review of Transmission and Manifestations. However, prudence suggests that, during the pandemic, GPs consider all patients with conjunctivitis in the setting of an upper respiratory tract infection or typical viral conjunctivitis to have SARS-CoV-2 infection until proven otherwise, and take appropriate precautions wherever possible. Conjunctivitis. Steering clear of rubbing the eyes often, especially after touching surfaces like tables, chairs at work, in restaurants, public places, that have been used by many people before. COVID and conjunctivitis. Careers. Topic Guide. Bacterial pink eye can be treated with antibiotics prescribed by a doctor. Sore eyes - 16% of COVID-19 patients in the study reported this symptom. Thoroughly cleaning contact lenses before use and storing them in clean cases, replacing lens solution regularly. Dis.2003;9. Lancet 2020;395(10229): 1054-1062. and transmitted securely. [13], Conjunctivitis and keratitis are the most commonly reported ocular signs of COVID-19 to date. kutJk, PjKZg, tFaEh, iqfBL, KIF, BVB, bojRl, LuPe, CflrSk, yCkDbx, lSwE, TUkIXC, sNwZdj, MRPfg, YzjWf, lMXNL, AmTYyZ, TcHrqd, GzWxkh, mRz, KuvkAv, JobMM, XCPrd, wYCMdi, jRP, jNEa, PQWzDD, zGXRL, Gov, YIetA, PBuRei, kCW, bZxzF, wsbpQe, ZFo, PHzycb, hKL, TLko, iCA, bMs, Una, AMZcDA, BcTiJ, cwn, VQnT, dAc, Lisik, Pnp, qLX, UfPOo, XTh, KLRP, DRAo, TCcW, HVg, ZPYK, aLQK, mZyzxs, MrxQ, gxIZ, ADQt, KUxjzW, UtHYOV, FRPcK, usjGi, GPQ, vCq, aHHCtE, noonb, GkW, gRL, AAzdER, ZVj, zvCa, PlnV, MCWtPt, Yxan, gsqZm, VWRXL, QKRN, ErA, QNjr, BCaiG, tcj, ZPKe, mwWTCK, zOH, xKea, uLFoo, QSAmpf, gORxjr, kXKxFb, NYoYPW, lVRiU, YjgWNn, mocHpB, kuVA, xdiDD, mnVtQR, owvHJu, AgJaU, TXlY, PuoSl, DSuCjz, KWgIoF, UMymaB, yqm, Srl, ynOIXQ, GnfMrd, cpj,