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1
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Mahesh T, Changela S, Duong KS, Henry S, Wang SH, Duong TQ. New-onset conjunctivitis 3.5 years post SARS-CoV-2 infection in an inner-city population in the Bronx. BMJ Open Ophthalmol 2025; 10:e001993. [PMID: 40404339 DOI: 10.1136/bmjophth-2024-001993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2024] [Accepted: 03/12/2025] [Indexed: 05/24/2025] Open
Abstract
BACKGROUND A few studies have reported conjunctivitis is a complication associated with acute COVID-19. It is unknown whether SARS-CoV-2 infection increases the risk of conjunctivitis post-COVID-19 long term. OBJECTIVES This study investigated the incidence of new-onset conjunctivitis 3.5 years post SARS-CoV-2 infection and compared it with patients without SARS-CoV-2 infection. METHODS This retrospective study consisted of 67 702 patients who tested positive for COVID-19 (defined by a positive PCR test), and 1 391 135 COVID-19-negative patients with no prior records of conjunctivitis in the Montefiore Health System from 11 March 2020 to 31 December 2022. The study included adult patients re-presenting to our centre with conjunctivitis. Outcome was new conjunctivitis between 14 days and 3.5 years post index date. Analysis was performed with unmatched and matched cohorts. Matching was done for age, sex, race and ethnicity. Cumulative incidence and hazard ratio (HR) with and without adjustment for competitive risks were analysed. RESULTS There were 1154 (2.27%) individuals with COVID-19 and contemporary 13 899 (1.57%) controls who developed new conjunctivitis. COVID-19-positive patients had a significantly higher risk of developing new incident conjunctivitis (unmatched cohort adjusted HR 1.11 (95% CI 1.04 to 1.17), matched cohort adjusted HR 1.10 (95% CI 1.02 to 1.16)) compared with COVID-19-negative patients. CONCLUSIONS COVID-19-positive patients had significantly higher risk of developing new conjunctivitis compared with contemporary COVID-19-negative controls. Identifying risk factors for developing new-onset conjunctivitis may draw clinical attention for careful follow-up in at-risk individuals for ocular infections.
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Affiliation(s)
- Tanya Mahesh
- Department of Radiology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Sagar Changela
- Department of Radiology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Katie S Duong
- Department of Radiology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Sonya Henry
- Department of Radiology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Stephen H Wang
- Department of Radiology, Albert Einstein College of Medicine, Bronx, New York, USA
- Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Tim Q Duong
- Department of Radiology, Albert Einstein College of Medicine, Bronx, New York, USA
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2
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Li W, Zhu W, Tang X, Peng Z, Ye J, Nie S. Similarity of immune-associated markers in COVID-19 and Kawasaki disease: analyses from bioinformatics and machine learning. BMC Pediatr 2025; 25:400. [PMID: 40383755 PMCID: PMC12087065 DOI: 10.1186/s12887-025-05752-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 05/08/2025] [Indexed: 05/20/2025] Open
Abstract
BACKGROUND Infection by the SARS-CoV-2 virus can cause coronavirus disease 2019 (COVID-19) and can also exacerbate the symptoms of Kawasaki disease (KD), an acute vasculitis that mostly affects children. This study used bioinformatics and machine learning to examine similarities in the molecular pathogenesis of COVID-19 and KD. METHODS We first identified disease-associated modules in KD using weighted gene co-expression network analysis. Then, we determined shared differentially expressed genes (DEGs) in training datasets for KD (GSE100154) and COVID-19 (GSE225220), performed functional annotation of these shared DEGs, and used Cytoscape plug-ins (MCODE and Cytohubba) to characterize the protein-protein interaction (PPI) network and identify the hub genes. We performed Least Absolute Shrinkage and Selection Operator(LASSO) regression and receiver operating characteristic (ROC) curve analysis to identify the most robust markers, validated these results by analysis of two other datasets (GSE73461 and GSE18606), and then calculated the correlations of these key genes with immune cells. RESULTS This analysis identified 26 shared DEGs in COVID-19 and KD. The results from functional annotation showed that the shared DEGs primarily functioned in immune responses, the formation of neutrophil extracellular traps, and NOD-like receptor signaling pathways. There were three key genes (PGLYRP1, DEFA4, RETN), and they had positive correlations with monocytes, M0 macrophages, and dendritic cells, which function as immune infiltrating cells in KD. CONCLUSION The potential immune-associated biomarkers (PGLYRP1, DEFA4, RETN) along with their shared pathways, hold promise for advancing investigations into the underlying pathogenesis of KD and COVID-19.
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Affiliation(s)
- Wang Li
- Department of Clinical laboratory, The Eighth Affiliated Hospital, Sun Yat-sen University, 3025 Shennan Middle Road, Shenzhen, Guangdong, 518000, China
| | - Wenjie Zhu
- Department of Clinical laboratory, The Eighth Affiliated Hospital, Sun Yat-sen University, 3025 Shennan Middle Road, Shenzhen, Guangdong, 518000, China
| | - Xiangting Tang
- Department of Clinical laboratory, The Eighth Affiliated Hospital, Sun Yat-sen University, 3025 Shennan Middle Road, Shenzhen, Guangdong, 518000, China
| | - Zhiting Peng
- Department of Clinical laboratory, The Eighth Affiliated Hospital, Sun Yat-sen University, 3025 Shennan Middle Road, Shenzhen, Guangdong, 518000, China
| | - Jiaqi Ye
- Department of Clinical laboratory, The Eighth Affiliated Hospital, Sun Yat-sen University, 3025 Shennan Middle Road, Shenzhen, Guangdong, 518000, China
| | - Shuping Nie
- Department of Clinical laboratory, The Eighth Affiliated Hospital, Sun Yat-sen University, 3025 Shennan Middle Road, Shenzhen, Guangdong, 518000, China.
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3
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Icoz SGG, Yorgun MA, Bayhan GI, Icoz M, Yahsi A. Ocular hemodynamics in multisystem inflammatory syndrome in children: A cross-sectional study. Indian J Ophthalmol 2025; 73:725-730. [PMID: 39728610 PMCID: PMC12121873 DOI: 10.4103/ijo.ijo_1527_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 10/22/2024] [Accepted: 10/27/2024] [Indexed: 12/28/2024] Open
Abstract
PURPOSE To evaluate retinal vascular changes by optical coherence tomography angiography (OCTA) in multisystem inflammatory syndrome in children (MIS-C). METHODS This cross-sectional study included 21 patients who were diagnosed with MIS-C and had a history of hospitalization, 20 pediatric outpatients with a coronavirus disease 2019 (COVID-19) diagnosis, and 26 healthy children. All patients underwent a detailed ophthalmologic examination and OCTA. In the MIS-C and pediatric COVID-19 groups, these evaluations were made 6 months after diagnosis. The vascular density values of the superficial, deep, and radial peripapillary capillary plexuses (SCP, DCP, and RPCP, respectively), foveal avascular zone (FAZ) parameters (area, perimeter, acircularity index, and foveal density), and outer retinal and choriocapillaris flow area values were recorded using OCTA. RESULTS No pathology was detected in the ophthalmologic examinations of the three groups with similar age and gender distributions. Although the vascular density values of SCP, DCP, and RPCP were found to be higher in most quadrants in the MIS-C group, there was no statistically significant difference among the three groups ( P > 0.05 for all). FAZ parameters and flow area measurements were similar in all three groups ( P > 0.05 for all). CONCLUSION This is the first study to evaluate relatively long-term outcomes in patients with MIS-C and pediatric COVID-19 together. This study shows no changes in the SCP and DCP parameters in pediatric age group, which shows that ocular hemodynamic changes may not be reflected on OCTA after 6 months.
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Affiliation(s)
| | - Mucella Arıkan Yorgun
- Department of Ophthalmology, Yıldırım Beyazıt University Faculty of Medicine, Ankara, Türkiye
| | - Gulsum Iclal Bayhan
- Division of Pediatric Infectious Disease, Ankara City Hospital, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara, Türkiye
| | - Mehmet Icoz
- Department of Ophthalmology, Yozgat City Hospital, Yozgat, Türkiye
| | - Aysun Yahsi
- Division of Pediatric Infectious Disease, Ankara City Hospital, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara, Türkiye
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4
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Zhao Y, Tang Y, Wang QY, Li J. Ocular neuroinflammatory response secondary to SARS-CoV-2 infection-a review. Front Immunol 2025; 16:1515768. [PMID: 39967658 PMCID: PMC11832381 DOI: 10.3389/fimmu.2025.1515768] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2024] [Accepted: 01/13/2025] [Indexed: 02/20/2025] Open
Abstract
With the consistent occurrence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the prevalence of various ocular complications has increased over time. SARS-CoV-2 infection has been shown to have neurotropism and therefore to lead to not only peripheral inflammatory responses but also neuroinflammation. Because the receptor for SARS-CoV-2, angiotensin-converting enzyme 2 (ACE2), can be found in many intraocular tissues, coronavirus disease 2019 (COVID-19) may also contribute to persistent intraocular neuroinflammation, microcirculation dysfunction and ocular symptoms. Increased awareness of neuroinflammation and future research on interventional strategies for SARS-CoV-2 infection are important for improving long-term outcomes, reducing disease burden, and improving quality of life. Therefore, the aim of this review is to focus on SARS-CoV-2 infection and intraocular neuroinflammation and to discuss current evidence and future perspectives, especially possible connections between conditions and potential treatment strategies.
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Affiliation(s)
| | | | | | - Jia Li
- Department of Glaucoma, The Second Hospital of Jilin University, Changchun, China
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Azar G, Abdelmassih Y, Bonnin S, Guindolet D, Vasseur V, Behar Cohen F, Salmon D, Mauget-Faÿsse M. Endothelial Glycocalyx Anomalies and Ocular Manifestations in Patients with Post-Acute COVID-19. J Clin Med 2024; 13:7272. [PMID: 39685729 DOI: 10.3390/jcm13237272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2024] [Revised: 11/13/2024] [Accepted: 11/21/2024] [Indexed: 12/18/2024] Open
Abstract
Objectives: To report ophthalmological and microvascular findings in patients with post-acute COVID-19. Methods: In this prospective, monocentric cohort study, we included patients with post-acute COVID-19 who presented with ophthalmological symptoms. All patients underwent indocyanine green angiography (ICGA), OCT, OCT-angiography, adaptive optics, and GlycoCheck assessments. Results: We included 44 patients, predominantly female (81.8%), with a mean age of 47.5 ± 11.5 years. Key ICGA findings revealed hyperreflective dots in 32 eyes (36.4%) and hemangioma-like lesions in 7 eyes (8.0%). Capillary non-perfusion in the superficial capillary plexus (SCP) and deep capillary plexus (DCP) was observed in 42 eyes (47.7%) and 21 eyes (23.9%), respectively. Eyes with hyperreflective dots exhibited a lower perfused boundary region (PBR), while those with superficial punctate keratitis showed a higher PBR (p = 0.02 and p = 0.002, respectively). Eyes with capillary non-perfusion in the SCP displayed lower capillary densities (CD4, CD5, and CD4-6; p = 0.001, 0.03, and 0.03, respectively), and eyes with non-perfusion in the DCP had lower CD4 (p = 0.03). A negative correlation was identified between capillary density and the wall-to-lumen ratio. Conclusions: Patients with post-acute COVID-19 demonstrate both retinal and choroidal vascular anomalies. Ocular pathology was associated with reduced capillary density. These injuries appear to stem more from microvascular disruptions than from persistent glycocalyx abnormalities.
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Affiliation(s)
- Georges Azar
- Rothschild Foundation Hospital, 75019 Paris, France
| | | | | | | | | | | | - Dominique Salmon
- Infectious and Tropical Diseases Department, Hotel Dieu, 75004 Paris, France
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Rau AL, Schicht M, Zahn I, Ali MJ, Coroneo MT, Paulsen F. Detection of SARS-CoV-2 binding receptors and miscellaneous targets as well as mucosal surface area of the human lacrimal drainage system. Ocul Surf 2024; 34:296-308. [PMID: 39218301 DOI: 10.1016/j.jtos.2024.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 07/23/2024] [Accepted: 08/29/2024] [Indexed: 09/04/2024]
Abstract
PURPOSE Our aim was to evaluate a potential role for the lacrimal drainage system (LDS) as a portal of entry and conduit for SARS-CoV-2 in human infection. We also investigate the mucosal surface area. The relatively long tear contact time in a closed system raises the possibility that this pathway may contribute to the initiation of systemic infection. We looked for expression of ACE2, the main receptor for SARS-CoV-2, as well as cofactors such as TMPRSS2 and other enzymes such as cathepsinB, CD147, elastase1, furin, neuropilin1, neuropilin2, TMPRSS11D and trypsin which also play a role in SARS-CoV-2 infection, in this system. METHODS Human tissue samples of the draining tear ducts from body donors were analyzed by RT-PCR, Western blot and immunohistochemistry. It is not known whether the respective body donors were Sars-Cov-2 positive at any time; they were negative when they entered the institute. Besides, the draining LDS of body donors were measured to determine the mucosal surface in the lacrimal system. RESULTS The expression of the main receptor studied, ACE2, cofactors such as TMPRSS2 and other enzymes such as cathepsinB, CD147, elastase1, furin, neuropilin1, neuropilin2, TMPRSS11D and trypsin were all detected at the gene and protein level. The average mucosal surface area of the lacrimal sac and nasolacrimal duct was calculated to be 110 mm2. CONCLUSION The results show the presence of all analyzed receptors in the efferent LDS. With an average tear passage time of 3 min and a relatively large mucosal surface area, the LDS could therefore be considered as a portal of entry and conduit for SARS-CoV-2. In addition, it represents a surface that should be taken into consideration in the administration of topically applied medication to the ocular surface.
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Affiliation(s)
- Anna-Lena Rau
- Functional and Clinical Anatomy, Friedrich Alexander University, Erlangen, Germany.
| | - Martin Schicht
- Functional and Clinical Anatomy, Friedrich Alexander University, Erlangen, Germany
| | - Ingrid Zahn
- Functional and Clinical Anatomy, Friedrich Alexander University, Erlangen, Germany
| | - Mohammad Javed Ali
- Govindram Seksaria Institute of Dacryology, L.V. Prasad Eye Institute, Hyderabad, India
| | - Minas Theodore Coroneo
- Department of Ophthalmology, Prince of Wales Hospital/University of New South Wales, Sydney, Australia; Department of Ophthalmology, Prince of Wales Clinical School, Faculty of Medicine, The University of New South Wales, Sydney, Australia
| | - Friedrich Paulsen
- Functional and Clinical Anatomy, Friedrich Alexander University, Erlangen, Germany.
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7
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Salvetat ML, Zeppieri M. Management of COVID-19 in Ophthalmology. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1457:401-429. [PMID: 39283440 DOI: 10.1007/978-3-031-61939-7_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2024]
Abstract
From its outbreak in early 2020, the new SARS-CoV-2 infection has deeply affected the entire eye care system for several reasons. Since the beginning of the COVID-19 pandemic, ophthalmologists were among the "high-risk category" for contracting the SARS-CoV-2 infection based on the notion that the eye was suspected to be a site of inoculation, infection, and transmission. Clinical ophthalmologists have been required to learn and promptly recognize the ocular manifestations associated with the COVID-19 disease, with its treatments and vaccinations. Restriction measures, lockdown periods, guidelines to prevent SARS-CoV-2 infection transmission, and the use of telemedicine and artificial intelligence modalities have induced profound modifications. These changes, which are most likely to be irreversible, influence routine clinical practice, education, and research, thus giving rise to a "new ophthalmology in the COVID era". This book chapter aims to provide several notions regarding COVID-19 in ophthalmology, including the SARS-CoV-2 virus infection and transmission modalities; the ocular manifestation associated with the COVID-19 disease; the drugs and vaccines used for COVID-19; the precautions adopted in the ophthalmic practice to limit the spread of the virus; the consequences of the pandemic on the ophthalmic patients, clinicians, and the entire eye care system; and, the future of ophthalmology in the era of "COVID new normal".
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Affiliation(s)
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, P.le S. Maria della Misericordia 15, 33100, Udine, Italy.
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8
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Tajima A, Sassa Y, Ishio D, Yamashita S, Sadashima E, Arai R, Iwanaga K, Yoshida S, Sonoda KH, Enaida H. Clinical features of 26 cases of COVID-19-associated conjunctivitis. Jpn J Ophthalmol 2024; 68:57-63. [PMID: 38017339 DOI: 10.1007/s10384-023-01033-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 08/25/2023] [Indexed: 11/30/2023]
Abstract
PURPOSE To explore the clinical features of COVID-19-associated conjunctivitis with the objective of preventing the spread of infection. STUDY DESIGN Retrospective cohort study. METHODS From March 2020 to March 2021, we retrospectively reviewed 26 (9.8%) consecutive COVID-19 patients with conjunctivitis among 282 COVID-19 cases admitted to our hospital. Clinical symptoms, onset date of conjunctivitis, time to patient recovery, and eye drop intervention were investigated. In addition, risk factors for developing conjunctivitis were statistically examined among 206 inpatients available for within 5 days of the onset. A multivariate analysis of conjunctivitis risk factors was performed. RESULTS Among the 282 COVID-19 patients, 4 (1.4%) had conjunctival hyperemia as the primary symptom. The median time of onset was 4 days after the COVID-19 onset. Hyperemia was observed in all cases, but other ocular symptoms were rare. The median duration of hyperemia was 3 days. A multiple logistic regression analysis revealed that a young age (p=0.005) and current smoking habit (p=0.027) were independent risk factors for conjunctivitis after COVID-19. CONCLUSIONS COVID-19-associated conjunctivitis is rare in the elderly and strongly associated with a history of smoking. It often occurs in the early stages of infection, and while hyperemia is recognized as a clinical symptom, other ocular symptoms are rare or non-existent. Many cases recover within a short time.
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Affiliation(s)
- Asahi Tajima
- Department of Ophthalmology, Saga Medical Centre Koseikan, 400 Nakahara Kase Town, Saga City, 840-8571, Japan
- Department of Ophthalmology, Graduate School of Medicine, Saga University, Saga City, Japan
| | - Yukio Sassa
- Department of Ophthalmology, Saga Medical Centre Koseikan, 400 Nakahara Kase Town, Saga City, 840-8571, Japan.
| | - Daiki Ishio
- Department of Ophthalmology, Graduate School of Medicine, Kurume University, Kurume City, Japan
| | - Shota Yamashita
- Department of Ophthalmology, Saga Medical Centre Koseikan, 400 Nakahara Kase Town, Saga City, 840-8571, Japan
- Department of Ophthalmology, Graduate School of Medicine, Saga University, Saga City, Japan
| | - Eiji Sadashima
- Department of Medical Research Institute, Saga Prefectural Medical Centre Koseikan, Saga City, Japan
| | - Rikki Arai
- Department of Ophthalmology, Graduate School of Medicine, Kurume University, Kurume City, Japan
| | - Kentaro Iwanaga
- Department of Respiratory Medicine, Saga Prefectural Medical Centre Koseikan, Saga City, Japan
| | - Shigeo Yoshida
- Department of Ophthalmology, Graduate School of Medicine, Kurume University, Kurume City, Japan
| | - Koh-Hei Sonoda
- Department of Ophthalmology, Graduate School of Medicine, Kyushu University, Fukuoka City, Japan
| | - Hiroshi Enaida
- Department of Ophthalmology, Graduate School of Medicine, Saga University, Saga City, Japan
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Hu W, Meng L, Wang C, Lu W, Tong X, Lin R, Xu T, Chen L, Cui A, Xu X, Li A, Tang J, Gao H, Pei Z, Zhang R, Wang Y, Wang Y, Han W, Jiang N, Xiong C, Feng Y, Lee K, Chen M. Spatiotemporal observations of host-pathogen interactions in mucosa during SARS-CoV-2 infection indicate a protective role of ILC2s. Microbiol Spectr 2023; 11:e0087823. [PMID: 37937994 PMCID: PMC10714800 DOI: 10.1128/spectrum.00878-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/30/2023] [Indexed: 11/09/2023] Open
Abstract
IMPORTANCE Our study revealed the spatial interaction between humanized ACE2 and pseudovirus expressing Spike, emphasizing the role of type 2 innate lymphoid cells during the initial phase of viral infection. These findings provide a foundation for the development of mucosal vaccines and other treatment approaches for both pre- and post-infection management of coronavirus disease 2019.
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Affiliation(s)
- Wei Hu
- Department of Emergency Medicine, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Institute of Acupuncture and Moxibustion, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Lu Meng
- The Center for Microbes, Development and Health, Key Laboratory of Molecular Virology and Immunology, Institute Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, China
| | - Chao Wang
- Department of Emergency Medicine, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Wenhan Lu
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Institute of Acupuncture and Moxibustion, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Xiaoyu Tong
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Institute of Acupuncture and Moxibustion, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Rui Lin
- State Key Laboratory of Genetic Engineering, School of Life Science, Fudan University, Shanghai, China
| | - Tao Xu
- Department of Infectious Diseases, National Medical Center for Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Liang Chen
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - An Cui
- Department of Emergency Medicine, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiaoqing Xu
- Department of Emergency Medicine, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Anni Li
- Department of Emergency Medicine, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Jia Tang
- Department of Emergency Medicine, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Hongru Gao
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Institute of Acupuncture and Moxibustion, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Zhenle Pei
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Institute of Acupuncture and Moxibustion, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Ruonan Zhang
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Institute of Acupuncture and Moxibustion, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Yicong Wang
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Institute of Acupuncture and Moxibustion, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Yu Wang
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Institute of Acupuncture and Moxibustion, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Wendong Han
- Biosafety Level 3 Laboratory, Shanghai Medical College Fudan University, Shanghai, China
| | - Ning Jiang
- State Key Laboratory of Genetic Engineering, School of Life Science, Fudan University, Shanghai, China
| | - Chenglong Xiong
- Department of Epidemiology, School of Public Health, and Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Yi Feng
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Institute of Acupuncture and Moxibustion, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Kuinyu Lee
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Institute of Acupuncture and Moxibustion, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Mingquan Chen
- Department of Emergency Medicine, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
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10
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Valyi Z, Khalil M, Van den Wijngaert S, Willermain F, Bruyneel M. Ocular surface manifestations and SARS-CoV-2 RNA detection in conjunctival swabs of patients hospitalized for COVID-19 pneumonia. Eur J Intern Med 2023; 114:129-130. [PMID: 37230886 PMCID: PMC10201324 DOI: 10.1016/j.ejim.2023.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 05/12/2023] [Indexed: 05/27/2023]
Affiliation(s)
- Zsuzsanna Valyi
- CHU St Pierre, Department of Ophthalmology, Brussels, Belgium and Université Libre de Bruxelles, Brussels, Belgium.
| | - Maria Khalil
- CHU St Pierre, Department of Ophthalmology, Brussels, Belgium and Université Libre de Bruxelles, Brussels, Belgium.
| | - Sigi Van den Wijngaert
- Laboratoire Hospitalier Universitaire de Bruxelles-Universitair Laboratorium Brussel (LHUB-ULB), Department of Microbiology, Brussels, Belgium and Université Libre de Bruxelles, Brussels, Belgium.
| | - François Willermain
- CHU St Pierre, Department of Ophthalmology, Brussels, Belgium and Université Libre de Bruxelles, Brussels, Belgium.
| | - Marie Bruyneel
- CHU St Pierre, Department of Pneumology, Brussels, Belgium and Université Libre de Bruxelles, Brussels, Belgium.
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11
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Pace JL, Richard D, Khachik A, Mistry M, Singh G, Mostaghni N, Yazdanmehr S. Ophthalmic Presentations and Manifestations of COVID-19: A Systematic Review of Global Observations. Cureus 2023; 15:e40695. [PMID: 37485114 PMCID: PMC10359021 DOI: 10.7759/cureus.40695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2023] [Indexed: 07/25/2023] Open
Abstract
As the presentations and complications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continue to surface, the ocular manifestations have emerged as an area of interest. Research and reports conveyed the presence of several ophthalmic conditions observed in Coronavirus disease 2019 (COVID-19) patients. These publications documented a range of presentations varying from asymptomatic to serious impairments. The aim of this study is to characterize the ophthalmic pathologies and their frequencies observed due to COVID-19 in patients across different regions of the world. The goal is that the paper assists primary care physicians and healthcare providers. A systematic review of 31 articles published between January 1, 2021 to January 13, 2022, explored the presenting ocular symptoms of COVID-19, diagnosis, duration of ophthalmic complications, as well as pre-existing comorbidities. A total of 816 patients, 427 (52.3%) males and 389 (47.7%) females, from various regions of the world were investigated. Studies focusing on patients with a history of ocular pathologies, non-COVID-19 infections, complications associated with the COVID-19 vaccine, and pediatric patients were excluded from this study. Ocular complications were most commonly reported one to two weeks following the initial COVID-19 diagnosis. Analysis suggests that the "red" eye is the most prevalent presenting ophthalmologic symptom, followed by temporary vision loss. Conjunctivitis was also the most common clinical diagnosis reported, followed by neuro-retinal affection in the form of cotton wool spots (n=127 and n=9, respectively). This study summarizes ocular manifestations in COVID-19 patients and serves to help healthcare providers recognize common symptoms and their severity. This may lead to early diagnosis, treatment, and intervention of these manifestations.
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Affiliation(s)
- Jordan L Pace
- Medicine, California University of Science and Medicine, Colton, USA
| | - Drew Richard
- Medicine, California University of Science and Medicine, Colton, USA
| | - Adon Khachik
- Medicine, California University of Science and Medicine, Colton, USA
| | - Mehul Mistry
- Medicine, California University of Science and Medicine, Colton, USA
| | - Gagandeep Singh
- Medicine, California University of Science and Medicine, Colton, USA
| | - Navid Mostaghni
- Medicine, California University of Science and Medicine, Colton, USA
| | - Susan Yazdanmehr
- Medical Education, California University of Science and Medicine, Colton, USA
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12
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Ciacci P, Paraninfi A, Orlando F, Rella S, Maggio E, Oliva A, Cangemi R, Carnevale R, Bartimoccia S, Cammisotto V, D'Amico A, Magna A, Nocella C, Mastroianni CM, Pignatelli P, Violi F, Loffredo L. Endothelial dysfunction, oxidative stress and low-grade endotoxemia in COVID-19 patients hospitalised in medical wards. Microvasc Res 2023:104557. [PMID: 37268038 DOI: 10.1016/j.mvr.2023.104557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 05/19/2023] [Accepted: 05/30/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND Endothelial dysfunction, assessed by flow-mediated dilation (FMD), is related to poor prognosis in patients with COVID-19 pneumonia (CP). In this study, we explored the interplay among FMD, NADPH oxidase type 2 (NOX-2) and lipopolysaccharides (LPS) in hospitalised patients with CP, community acquired pneumonia (CAP) and controls (CT). METHODS We enrolled 20 consecutive patients with CP, 20 hospitalised patients with CAP and 20 CT matched for sex, age, and main cardiovascular risk factors. In all subjects we performed FMD and collected blood samples to analyse markers of oxidative stress (soluble Nox2-derived peptide (sNOX2-dp), hydrogen peroxide breakdown activity (HBA), nitric oxide (NO), hydrogen peroxide (H2O2)), inflammation (TNF-α and IL-6), LPS and zonulin levels. RESULTS Compared with controls, CP had significant higher values of LPS, sNOX-2-dp, H2O2,TNF-α, IL-6 and zonulin; conversely FMD, HBA and NO bioavailability were significantly lower in CP. Compared to CAP patients, CP had significantly higher levels of sNOX2-dp, H2O2, TNF-α, IL-6, LPS, zonulin and lower HBA. Simple linear regression analysis showed that FMD inversely correlated with sNOX2-dp, H2O2, TNF-α, IL-6, LPS and zonulin; conversely FMD was directly correlated with NO bioavailability and HBA. Multiple linear regression analysis highlighted LPS as the only predictor of FMD. CONCLUSION This study shows that patients with COVID-19 have low-grade endotoxemia that could activate NOX-2, generating increased oxidative stress and endothelial dysfunction.
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Affiliation(s)
- Paolo Ciacci
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy
| | - Aurora Paraninfi
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy
| | - Federica Orlando
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy
| | - Silvia Rella
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy
| | - Enrico Maggio
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy
| | - Alessandra Oliva
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Roberto Cangemi
- Department of Translational and Precision Medicine, Sapienza-University of Rome, Viale del Policlinico 155, 00162 Rome, Italy
| | - Roberto Carnevale
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy; Mediterranea Cardiocentro, Naples, Italy
| | - Simona Bartimoccia
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy
| | - Vittoria Cammisotto
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy
| | - Alessandra D'Amico
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", 00135 Rome, Italy
| | - Arianna Magna
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy
| | - Cristina Nocella
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy
| | - Claudio Maria Mastroianni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Pasquale Pignatelli
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy
| | - Francesco Violi
- Mediterranea Cardiocentro, Naples, Italy; Sapienza University of Rome, Rome, Italy
| | - Lorenzo Loffredo
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy.
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13
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Eyfferth T, Koczulla AR, Freytag HW, Krahl G, Ackermann C, Bultmann S, Reimertz R, Dresing K. [The problem of long/post-COVID in expert assessments]. UNFALLCHIRURGIE (HEIDELBERG, GERMANY) 2023; 126:373-386. [PMID: 37079057 PMCID: PMC10117274 DOI: 10.1007/s00113-023-01297-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/16/2023] [Indexed: 04/21/2023]
Abstract
Assessing long/post-COVID syndrome (PCS) following an infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a multidisciplinary challenge due to the diverse and complex symptoms. Besides discipline-specific evaluation of infection-related organ damage, the main issue is expert objectivity and causality assessment regarding subjective symptoms. The consequences of long/PCS raise questions of insurance rights in all fields of law. In cases of persistent impairment of performance, determining reduction in earning capacity is crucial for those affected. Recognition as an occupational disease (BK no. 3101) is vital for employees in healthcare and welfare sectors, along with occupational accident recognition and assessing the illness's consequences, including the reduction in earning capacity (MdE) in other sectors or work areas. Therefore, expert assessments of illness consequences and differentiation from previous illnesses or damage disposition are necessary in all areas of law, individually based on corresponding organ manifestations in medical fields and interdisciplinarily for complex late sequelae, for instance, by internists with appropriate qualifications for pulmonary or cardiac manifestations and neurologists, psychiatrists, and neuropsychologists for neurological and psychiatric manifestations, etc.
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Affiliation(s)
- T Eyfferth
- BG Service- und Rehabilitationszentrum, BG Unfallklinik Frankfurt am Main gGmbH, Akademisches Lehrkrankenhaus, Johann-Wolfgang-Goethe Universität Frankfurt Main, Friedberger Landstr. 430, 60389, Frankfurt am Main, Deutschland.
- Sektion Begutachtung der Deutschen Gesellschaft für Orthopädie und Unfallchirurgie (DGOU), Berlin, Deutschland.
| | - A R Koczulla
- Schön Klinik Berchtesgadener Land, Schönau am Königssee, Deutschland
- Professur für Pneumologische Rehabilitation Philipps Universität Marburg, Deutsches Zentrum für Lungenforschung, Marburg, Deutschland
| | - H W Freytag
- Psychotraumatologie (PZDT), BG Unfallklinik Frankfurt am Main, Frankfurt am Main, Deutschland
| | - G Krahl
- Psychotraumatologie (PZDT), BG Unfallklinik Frankfurt am Main, Frankfurt am Main, Deutschland
| | - Ch Ackermann
- Psychotraumatologie (PZDT), BG Unfallklinik Frankfurt am Main, Frankfurt am Main, Deutschland
| | - S Bultmann
- Sozialgericht Hamburg, Hamburg, Deutschland
| | - R Reimertz
- BG Service- und Rehabilitationszentrum, BG Unfallklinik Frankfurt am Main gGmbH, Akademisches Lehrkrankenhaus, Johann-Wolfgang-Goethe Universität Frankfurt Main, Friedberger Landstr. 430, 60389, Frankfurt am Main, Deutschland
| | - K Dresing
- Klinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie, Universitätsmedizin Göttingen, Göttingen, Deutschland
- Sektion Begutachtung der Deutschen Gesellschaft für Orthopädie und Unfallchirurgie (DGOU), Berlin, Deutschland
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14
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Chaitanuwong P, Moss HE, El Dairi MA. SARS-CoV-2 Infection, Vaccination, and Neuro-Ophthalmic Complications. J Neuroophthalmol 2023; 43:1-4. [PMID: 36790060 PMCID: PMC9924739 DOI: 10.1097/wno.0000000000001812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Affiliation(s)
- Pareena Chaitanuwong
- Ophthalmology Department (PC), Rajavithi Hospital, Ministry of Public Health, Bangkok, Thailand; Department of Ophthalmology (PC), Faculty of Medicine, Rangsit University, Bangkok, Thailand; Department of Ophthalmology (HM) and Neurology and Neurological Sciences (HM), Stanford University School of Medicine, Palo Alto, California; and Department of Ophthalmology (MED), Duke University, Durham, North Carolina
| | - Heather E. Moss
- Ophthalmology Department (PC), Rajavithi Hospital, Ministry of Public Health, Bangkok, Thailand; Department of Ophthalmology (PC), Faculty of Medicine, Rangsit University, Bangkok, Thailand; Department of Ophthalmology (HM) and Neurology and Neurological Sciences (HM), Stanford University School of Medicine, Palo Alto, California; and Department of Ophthalmology (MED), Duke University, Durham, North Carolina
| | - Mays A. El Dairi
- Ophthalmology Department (PC), Rajavithi Hospital, Ministry of Public Health, Bangkok, Thailand; Department of Ophthalmology (PC), Faculty of Medicine, Rangsit University, Bangkok, Thailand; Department of Ophthalmology (HM) and Neurology and Neurological Sciences (HM), Stanford University School of Medicine, Palo Alto, California; and Department of Ophthalmology (MED), Duke University, Durham, North Carolina
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15
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Dong J, Chen R, Zhao H, Zhu Y. COVID-19 and ocular complications: A review of ocular manifestations, diagnostic tools, and prevention strategies. ADVANCES IN OPHTHALMOLOGY PRACTICE AND RESEARCH 2023; 3:33-38. [PMID: 36471811 PMCID: PMC9714126 DOI: 10.1016/j.aopr.2022.11.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 10/18/2022] [Accepted: 11/13/2022] [Indexed: 12/02/2022]
Abstract
Background The novel severe acute respiratory syndrome coronavins 2 (SARS-CoV-2) led to the severe Corona Virus Disease 2019 (COVID-19) outbreak that started in December 2019 in China and caused enormous health and economic problems worldwide. Over time, SARS-CoV-2 has demonstrated the capacity for mutation. As the most prevalent new coronavirus variety worldwide, the Omicron variant has supplanted the Delta variant. The COVID-19 primarily damages the immune system and the lungs, but it can also harm other organs secondarily, depending on the patients' co-existing conditions. Main Text COVID-19 is associated with ophthalmic manifestations such as conjunctival congestion, tear overflow, and conjunctival edema, with the majority of eye complications occurring in patients with severe infection. The virus may make a patient more susceptible to thrombotic conditions that affect venous and arterial circulation. Meanwhile, it can lead to efferent complications and mucormycosis which is more common in patients with diabetes or who have critical or severe SARS-CoV-2 infection. Significantly, there are a number of ocular side effects following the COVID-19 vaccination, such as herpetic keratitis and facial nerve palsy, which have been reported. These side effects may be caused by the vaccinations' propensity to trigger autoimmune symptoms or thromboembolic events. At present, large-scale nucleic acid testing mainly relies on nasopharyngeal swabs and throat swabs. Tear samples and conjunctival swabs may be helpful samples for the diagnosis of ocular SARS-CoV-2 infection. The eye could be a new route of infection, and finding ways such as effective environmental disinfection, scientific administrative control management, qualified personal protection and other measures to protect the eyes could further reduce the risk of infection. Conclusions This review aims to sum up the ocular complications of COVID-19, the possible pathogenesis, and preventive strategies to protect ophthalmology practitioners and patients by reviewing the currently available literature on the topic.
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Affiliation(s)
- Jilian Dong
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Ruida Chen
- Eye Department, Affiliated Dongyang Hospital, Wenzhou Medical University, Dongyang, China
- Eye Center, Affiliated Second Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Hanhe Zhao
- Eye Center, Affiliated Second Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yirui Zhu
- Eye Center, Affiliated Second Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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16
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Vohra SB, Kumar CM. International survey of ophthalmic anaesthesia service provision, protection of anaesthesia providers and patients during COVID-19 pandemic: a wake-up call. Eye (Lond) 2023; 37:548-553. [PMID: 35220400 PMCID: PMC8881697 DOI: 10.1038/s41433-022-01979-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 01/25/2022] [Accepted: 02/08/2022] [Indexed: 11/09/2022] Open
Abstract
AIMS This international survey was conducted to study the impact of Covid-19 pandemic on the provision and practices of ophthalmic anaesthesia, evaluate the methods employed by parent ophthalmic units for safeguarding their anaesthesia providers and patients during lockdown, and to assess pandemic's effect on anaesthesia providers as individuals. The study was done with the hope that the results will help in protecting patients and safeguarding precious human resource by better management if this pandemic was to continue or there was to be another pandemic. METHODS An anonymous questionnaire survey was distributed electronically between December 2020-January 2021 to the practicing ophthalmic anaesthesia providers in different parts of the world. RESULTS The survey identified that apart from reducing elective operating services, the ophthalmic units were ill prepared for the pandemic and the overall management was lacklustre. There was a definite lack of effective peri-operative patient screening, and, streaming processes. Measures for personal protection of staff were not optimal especially during regional/local ophthalmic anaesthesia. Severity of the pandemic, sudden job plan changes, and redeployment to intensive care units/acute covid wards had an adverse psychological impact on the affected staff. CONCLUSION Ophthalmic anaesthesia services worldwide have had poor attentiveness to the life-threatening menace and reality of Covid-19 pandemic. A review of the institutional practices to address correctible deficiencies is urgently required. Robust, mandatory, elective, timely preventative strategies need to be implemented to protect patients, and, the precious ophthalmic workforce from potential adverse physical and psychological injuries.
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Affiliation(s)
- Shashi B Vohra
- Department of Anaesthesia, Critical Care and Pain Management, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham Midland Eye Centre, City Hospital, Dudley Road, Birmingham, B18 7QH, UK.
| | - Chandra M Kumar
- Newcastle University, Gelang Patah, Johor, Malaysia
- Department of Anaesthesia, Khoo Teck Puat Hospital, Yishun Central 90, Singapore, 768828, Singapore
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17
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Makino Antunes AC, Aldred A, Tirado Moreno GP, de Souza Ribeiro JA, Brandão PE, Barone GT, Conselheiro JDA, Goulart AC, Desuó IC, Gomes G. Potential of using facial thermal imaging in patient triage of flu-like syndrome during the COVID-19 pandemic crisis. PLoS One 2023; 18:e0279930. [PMID: 36652420 PMCID: PMC9847904 DOI: 10.1371/journal.pone.0279930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 12/16/2022] [Indexed: 01/19/2023] Open
Abstract
The screening of flu-like syndrome is difficult due to nonspecific symptoms or even oligosymptomatic presentation and became even more complex during the Covid-19 pandemic. However, an efficient screening tool plays an important role in the control of highly contagious diseases, allowing more efficient medical-epidemiological approaches and rational management of global health resources. Infrared thermography is a technique sensitive to small alterations in the skin temperature which may be related to early signs of inflammation and thus being relevant in the detection of infectious diseases. Thus, the objective of this study was to evaluate the potential of facial thermal profiles as a risk evaluator of symptoms and signs of SARs diseases, using COVID-19 as background disease. A total of 136 patients were inquired about the most common symptoms of COVID-19 infection and were submitted to an infrared image scanning, where the temperatures of 10 parameters from different regions of the face were captured. We used RT-qPCR as the ground truth to compare with the thermal parameters, in order to evaluate the performance of infrared imaging in COVID-19 screening. Only 16% of infected patients had fever at the hospital admission, and most infrared thermal variables presented values of temperature significantly higher in infected patients. The maximum eye temperature (MaxE) showed the highest predictive value at a cut-off of >35.9°C (sn = 71.87%, sp = 86.11%, LR+ = 5.18, LR- = 0.33, AUC = 0.850, p < 0.001). Our predictive model reached an accuracy of 86% for disease detection, indicating that facial infrared thermal scanning, based on the combination of different facial regions and the thermal profile of the face, has potential to act as a more accurate diagnostic support method for early COVID-19 screening, when compared to classical infrared methods, based on a single spot with the maximum skin temperature of the face.
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Affiliation(s)
- Ana Carolina Makino Antunes
- Department of General Surgery, Hospital Universitário, Universidade de São Paulo, São Paulo, São Paulo, Brasil
| | - Alexandre Aldred
- Predikta Soluções em Pesquisa Ltda, São Paulo, São Paulo, Brasil
| | - Gabriela Pinheiro Tirado Moreno
- Department of Internal Medicine, The Veterinary Teaching Hospital, School of Veterinary Medicine and Animal Science of University of São Paulo, São Paulo, São Paulo, Brasil
| | | | - Paulo Eduardo Brandão
- Department of Preventive Veterinary Medicine and Animal Health, School of Veterinary Medicine, University of São Paulo, São Paulo, São Paulo, Brasil
| | - Gisely Toledo Barone
- Department of Preventive Veterinary Medicine and Animal Health, School of Veterinary Medicine, University of São Paulo, São Paulo, São Paulo, Brasil
| | - Juliana de Amorin Conselheiro
- Department of Preventive Veterinary Medicine and Animal Health, School of Veterinary Medicine, University of São Paulo, São Paulo, São Paulo, Brasil
| | - Alessandra C. Goulart
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, São Paulo, Brasil
- Department of Internal Medicine, Hospital Universitário, Universidade de São Paulo, São Paulo, São Paulo, Brasil
| | - Ivan Cesar Desuó
- Predikta Soluções em Pesquisa Ltda, São Paulo, São Paulo, Brasil
| | - Guilherme Gomes
- Predikta Soluções em Pesquisa Ltda, São Paulo, São Paulo, Brasil
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18
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Therapeutic Exercise Interventions through Telerehabilitation in Patients with Post COVID-19 Symptoms: A Systematic Review. J Clin Med 2022; 11:jcm11247521. [PMID: 36556137 PMCID: PMC9785416 DOI: 10.3390/jcm11247521] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 12/06/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
The worldwide incidence of COVID-19 has generated a pandemic of sequelae. These sequelae require multidisciplinary rehabilitative work to address the multisystemic symptoms that patients will present with now and in the future. The aim of the present systematic review is to analyze the current situation of telerehabilitation in patients with COVID-19 sequelae and its effectiveness. Searches were conducted on the following databases: PubMed, Scopus, PEDro, and Web of Science (WOS). There was no complete homogeneity among the five selected articles, so we differentiated two clinical subgroups for the clustering of outcome measures: (group one) patients with post-discharge symptoms and (group two) patients with permanent symptoms or “long COVID-19” defined as persistent symptoms > 2 months. For group one, post-discharge sequelae, improvements were obtained in cardiovascular parameters, and physical test studies in group two presented very favorable results in all the cardiorespiratory measures and physical tests evaluated. Telerehabilitation through therapeutic exercise based on mixed protocols of aerobic, respiratory, and low-load strength exercises appear to be an effective and safe strategy for the recovery of short- and long-term post-COVID-19 sequelae.
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19
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Abstract
The German Society of Pneumology initiated 2021 the AWMF S1 guideline Long COVID/Post-COVID. In a broad interdisciplinary approach, this S1 guideline was designed based on the current state of knowledge.The clinical recommendations describe current Long COVID/Post-COVID symptoms, diagnostic approaches, and therapies.In addition to the general and consensus introduction, a subject-specific approach was taken to summarize the current state of knowledge.The guideline has an explicit practical claim and will be developed and adapted by the author team based on the current increase in knowledge.
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20
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COVID-19 Vaccine-Associated Optic Neuropathy: A Systematic Review of 45 Patients. Vaccines (Basel) 2022; 10:vaccines10101758. [PMID: 36298623 PMCID: PMC9609672 DOI: 10.3390/vaccines10101758] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 10/15/2022] [Accepted: 10/19/2022] [Indexed: 11/20/2022] Open
Abstract
We provide a systematic review of published cases of optic neuropathy following COVID-19 vaccination. We used Ovid MEDLINE, PubMed, and Google Scholar. Search terms included: “COVID-19 vaccination”, “optic neuropathy”, “optic neuritis”, and “ischemic optic neuropathy”. The titles and abstracts were screened, then the full texts were reviewed. Sixty eyes from forty-five patients (28 females) were included. Eighteen eyes from fourteen patients (31.1%) were diagnosed with anterior ischemic optic neuropathy (AION), while 34 eyes from 26 patients (57.8%) were diagnosed with optic neuritis (ON). Other conditions included autoimmune optic neuropathy and Leber hereditary optic neuropathy. Fifteen patients (33.3%) had bilateral involvement. The mean age of all patients was 47.4 ± 17.1 years. The mean age of AION patients was 62.9 ± 12.2 years and of ON patients was 39.7 ± 12.8 years (p < 0.001). The mean time from vaccination to ophthalmic symptoms was 9.6 ± 8.7 days. The mean presenting visual acuity (VA) was logMAR 0.990 ± 0.924. For 41 eyes with available follow-up, the mean presenting VA was logMAR 0.842 ± 0.885, which improved to logMAR 0.523 ± 0.860 at final follow-up (p < 0.001). COVID-19 vaccination may be associated with different forms of optic neuropathy. Patients diagnosed with ON were more likely to be younger and to experience visual improvement. More studies are needed to further characterize optic neuropathies associated with COVID-19 vaccination.
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21
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Roy B, Runa SA. SARS-CoV-2 infection and diabetes: Pathophysiological mechanism of multi-system organ failure. World J Virol 2022; 11:252-274. [PMID: 36188734 PMCID: PMC9523319 DOI: 10.5501/wjv.v11.i5.252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/25/2022] [Accepted: 08/01/2022] [Indexed: 02/05/2023] Open
Abstract
Since the discovery of the coronavirus disease 2019 outbreak, a vast majority of studies have been carried out that confirmed the worst outcome of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in people with preexisting health conditions, including diabetes, obesity, hypertension, cancer, and cardiovascular diseases. Likewise, diabetes itself is one of the leading causes of global public health concerns that impose a heavy global burden on public health as well as socio-economic development. Both diabetes and SARS-CoV-2 infection have their independent ability to induce the pathogenesis and severity of multi-system organ failure, while the co-existence of these two culprits can accelerate the rate of disease progression and magnify the severity of the disease. However, the exact pathophysiology of multi-system organ failure in diabetic patients after SARS-CoV-2 infection is still obscure. This review summarized the organ-specific possible molecular mechanisms of SARS-CoV-2 and diabetes-induced pathophysiology of several diseases of multiple organs, including the lungs, heart, kidneys, brain, eyes, gastrointestinal system, and bones, and sub-sequent manifestation of multi-system organ failure.
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Affiliation(s)
- Bipradas Roy
- Department of Physiology, Wayne State University, Detroit, MI 48201, United States
- Division of Hypertension and Vascular Research, Department of Internal Medicine, Henry Ford Health System, Detroit, MI 48202, United States
| | - Sadia Afrin Runa
- Department of Biotechnology and Genetic Engineering, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj 8100, Bangladesh
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22
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Akbari M, Dourandeesh M. Update on overview of ocular manifestations of COVID-19. Front Med (Lausanne) 2022; 9:877023. [PMID: 36177323 PMCID: PMC9513125 DOI: 10.3389/fmed.2022.877023] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 08/08/2022] [Indexed: 01/08/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) has become the most critical health crisis at present, and research is continued about the exact pathophysiology, presentations, and complications of this pandemic. It influences several organs, and many studies have addressed the organs, the involvement of which during the COVID-19 results in patients' death. One of the important organs that can be involved during COVID-19, which is also a transmission route of the disease, is the eye. According to the evidence, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can have ocular manifestations and complications. According to the literature, conjunctivitis is the most common presentation, which can develop at any stage of COVID-19 (during and even after the disease), and the major pathophysiology of the eye involvement during the disease is attributed to the direct effect of the virus on the eyes, tissue damage caused by inflammation, underlying diseases, and the adverse effect of the medications prescribed. There are also reports of life-threatening complications, such as rhino-orbital cerebral mucormycosis, which require urgent treatment and are associated with a great mortality rate. Ocular manifestations may also be the presentation of a life-threatening event, such as stroke; therefore, it is necessary to pay great attention to the ocular manifestations during COVID-19. In this review, after about 2 years of the pandemic started, we present a narrative review on ocular manifestations during COVID-19, categorized into three main categories; ophthalmic, orbital, and neuro-ophthalmological manifestations with a detailed description of the presenting symptoms, risk factor, diagnostic, and therapeutic strategies suggested for each.
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Affiliation(s)
- Mitra Akbari
- Eye Research Center, Department of Eye, Amiralmomenin Hospital, School of Medicine, Guilan University of Medical Science, Rasht, Iran
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Cazzato G, Cascardi E, Colagrande A, Foti C, Stellacci A, Marrone M, Ingravallo G, Arezzo F, Loizzi V, Solimando AG, Parente P, Maiorano E, Cormio G, Vacca A, Resta L. SARS-CoV-2 and Skin: New Insights and Perspectives. Biomolecules 2022; 12:1212. [PMID: 36139051 PMCID: PMC9496354 DOI: 10.3390/biom12091212] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/22/2022] [Accepted: 08/29/2022] [Indexed: 12/15/2022] Open
Abstract
The SARS-CoV-2 pandemic has disrupted global health systems and brought the entire globe to its knees. Although born as a disease of the respiratory system, COVID-19 can affect different parts of the body, including the skin. Reports of ongoing skin manifestations of COVID-19 have gradually multiplied, pushing researchers to investigate the etiopathogenic mechanisms underlying these phenomena in more depth. In an attempt to investigate the possible association between SARS-CoV-2, ACE2, TMPRSS2 and skin manifestations, we performed immunohistochemical investigations of the ACE2 receptor and TMPRSS2 in nine skin samples from SARS-CoV-2-positive patients compared to a cohort of healthy controls. Furthermore, after consulting public databases regarding ACE2 mRNA expression in various cell populations resident in the skin, we conducted a literature review aimed at outlining the current state of this topic. We did not find statistically different immuno-expression of ACE2 and TMPRSS2 between the group of SARS-CoV-2-positive patients (nine skin biopsies) and the control group. Regarding ACE2, major immunolabeling was present in the epidermal keratinocytes and, rarely, in the fibroblasts and in the adenomeres of the eccrine sweat glands. Regarding the immune expression of TMPRSS2, we found no significant differences between the two groups, with a weak immune staining only in some skin cytotypes. From the review of the literature, we isolated 35 relevant articles according to the inclusion criteria adopted. ACE2 appears to be a target of SARS-CoV-2, although, other receptor molecules may potentially be implicated, such as TMPRSS2. Future studies with large cases and different molecular investigative methods are needed to further elucidate the mechanisms underlying the skin manifestations of SARS-CoV-2.
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Affiliation(s)
- Gerardo Cazzato
- Section of Molecular Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Eliano Cascardi
- Department of Medical Sciences, University of Turin, 10124 Turin, Italy
- Pathology Unit, FPO-IRCCS Candiolo Cancer Institute, Str. Provinciale 142 lm 3.95, 10060 Candiolo, Italy
| | - Anna Colagrande
- Section of Molecular Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Caterina Foti
- Section of Dermatology, Department of Biomedical Sciences and Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Alessandra Stellacci
- Section of Legal Medicine, Department of Interdisciplinary Medicine, Bari Policlinico Hospital, University of Bari, 70124 Bari, Italy
| | - Maricla Marrone
- Section of Legal Medicine, Department of Interdisciplinary Medicine, Bari Policlinico Hospital, University of Bari, 70124 Bari, Italy
| | - Giuseppe Ingravallo
- Section of Molecular Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Francesca Arezzo
- Section of Gynecology and Obstetrics, Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Vera Loizzi
- Section of Gynecology and Obstetrics, Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Antonio Giovanni Solimando
- Section of Internal Medicine, Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Paola Parente
- Pathology Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, 71100 San Giovanni Rotondo, Italy
| | - Eugenio Maiorano
- Section of Molecular Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Gennaro Cormio
- Oncology Unit IRCCS Istituto Tumori Giovanni Paolo II and Department of Interdisciplinary Medicine (DIM), University of Bari, 70124 Bari, Italy
| | - Angelo Vacca
- Section of Internal Medicine, Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Leonardo Resta
- Section of Molecular Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy
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Trott M, Driscoll R, Pardhan S. The prevalence of sensory changes in post-COVID syndrome: A systematic review and meta-analysis. Front Med (Lausanne) 2022; 9:980253. [PMID: 36091707 PMCID: PMC9452774 DOI: 10.3389/fmed.2022.980253] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
Post-COVID syndrome can be defined as symptoms of COVID-19 that persist for longer than 12 weeks, with several studies reporting persistent symptoms relating to the sensory organs (eyes, ears, and nose). The aim of this systematic review was to examine the prevalence of persistent anosmia, hyposmia, ageusia, and hypogeusia, as well as eye/vision and ear/hearing related long-COVID symptoms. Authors searched the electronic databases from inception to November 2021. Search terms included words related to long-COVID, smell, taste, eyes/vision, and ears/hearing, with all observational study designs being included. A random effects meta-analysis was undertaken, calculating the prevalence proportions of anosmia, hyposmia, ageusia, and hypogeusia, respectively. From the initial pool, 21 studies met the inclusion criteria (total n 4,707; median n per study 125; median age = 49.8; median percentage female = 59.2%) and 14 were included in the meta-analysis The prevalence of anosmia was 12.2% (95% CI 7.7–16.6%), hyposmia 29.9% (95% CI 19.9–40%), ageusia 11.7% (95% CI 6.1–17.3%), and hypogeusia 31.2% (95% 16.4–46.1%). Several eye/vision and ear/hearing symptoms were also reported. Considering that changes in the sensory organs are associated with decreases in quality of life, future research should examine the etiology behind the persistent symptoms.
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Affiliation(s)
- Mike Trott
- Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, United Kingdom
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
- *Correspondence: Mike Trott,
| | - Robin Driscoll
- Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, United Kingdom
| | - Shahina Pardhan
- Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, United Kingdom
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Pandrea I, Brooks K, Desai RP, Tare M, Brenchley JM, Apetrei C. I've looked at gut from both sides now: Gastrointestinal tract involvement in the pathogenesis of SARS-CoV-2 and HIV/SIV infections. Front Immunol 2022; 13:899559. [PMID: 36032119 PMCID: PMC9411647 DOI: 10.3389/fimmu.2022.899559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 07/25/2022] [Indexed: 01/08/2023] Open
Abstract
The lumen of the gastrointestinal (GI) tract contains an incredibly diverse and extensive collection of microorganisms that can directly stimulate the immune system. There are significant data to demonstrate that the spatial localization of the microbiome can impact viral disease pathogenesis. Here we discuss recent studies that have investigated causes and consequences of GI tract pathologies in HIV, SIV, and SARS-CoV-2 infections with HIV and SIV initiating GI pathology from the basal side and SARS-CoV-2 from the luminal side. Both these infections result in alterations of the intestinal barrier, leading to microbial translocation, persistent inflammation, and T-cell immune activation. GI tract damage is one of the major contributors to multisystem inflammatory syndrome in SARS-CoV-2-infected individuals and to the incomplete immune restoration in HIV-infected subjects, even in those with robust viral control with antiretroviral therapy. While the causes of GI tract pathologies differ between these virus families, therapeutic interventions to reduce microbial translocation-induced inflammation and improve the integrity of the GI tract may improve the prognoses of infected individuals.
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Affiliation(s)
- Ivona Pandrea
- Department of Pathology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Kelsie Brooks
- Barrier Immunity Section, Laboratory of Viral Diseases, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States
| | - Rahul P. Desai
- Department of Pathology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
- Division of Infectious Diseases, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Minali Tare
- Department of Pathology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
- Division of Infectious Diseases, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jason M. Brenchley
- Barrier Immunity Section, Laboratory of Viral Diseases, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States
| | - Cristian Apetrei
- Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
- Division of Infectious Diseases, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
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Updates on Coronavirus-Related Ocular Manifestations: From the Past to COVID-19 Pandemic. ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2022. [DOI: 10.5812/pedinfect-117176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Context: Coronaviruses are the largest RNA viruses associated with some ocular manifestations. There are various contradictory reports about the ocular manifestations of coronaviruses in humans. Different ocular tissues can affect coronavirus-associated infectious diseases. Evidence Acquisition: All manuscripts were collected from PubMed, Google Scholar, and other relevant databases. All searches were done by specific keywords, including "coronavirus," "ocular disease," and "eye." Results: There are various contradictory reports about the ocular effects of coronaviruses in humans. Different ocular tissues are involved in coronavirus-associated infectious diseases. The ductal connection between the upper respiratory tract and eye mucosa through the nasolacrimal duct can be an entrance to respiratory viruses, such as coronaviruses. The coronavirus can infect the retina, conjunctiva, cornea, and uvea of the eye. The primary SARS-CoV-2 receptor, ACE2, is mainly expressed in the posterior tissues of the eye, such as the retina and RPE. Feline CoV, SARS-CoV, MERS-CoV, and infectious bronchitis virus (IBV) are responsible for conjunctiva involvement in coronavirus-related ocular pathogenesis. Also, various studies are held on COVID-19 and the impact of the conjunctiva on diagnosis and medical complications. Given that the cornea has an acceptable expression of ACE2 and TMPRSS2 genes compared to lung tissue, some studies were done on the impact of the cornea in COVID-19. Feline infectious peritonitis virus (FIPV) is also related to uvea complications. The experiments of human and animal models on the effects of coronaviruses on the retina and cornea in the event of various epidemics of coronaviruses and new and unknown ocular complications can be of great help to future studies. Conclusions: Given the importance of investigating the pathogenesis and other routes of SARS-CoV-2 infection, especially in areas other than the respiratory tract, this report attempts to highlight the importance of eye infections caused by the virus, its role in maintaining the virus transmission chain, and its impact on public health.
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Abstract
The coronavirus disease 2019 (COVID-19) is now known to be associated with several ocular manifestations. The literature thoroughly discussed those that affect adults, with a lesser focus in the pediatric age group. We aim to outline the various pediatric ocular manifestations described in the literature. The manifestations may be divided into isolated events attributed to COVID-19 or occurring in the new multisystem inflammatory syndrome in children (MIS-C), a novel entity associated by COVID-19 infection. Ocular manifestations have virtually affected all ages. They manifested in neonates, infants, children, and adolescents. Episcleritis, conjunctivitis, optic neuritis, cranial nerve palsies, retinal vein occlusion, retinal vasculitis, retinal changes, orbital myositis, orbital cellulitis were reported in the literature with this emerging viral illness. Conjunctivitis was the most common ocular manifestation in MIS-C in nearly half of the patients. Other ocular manifestations in MIS-C were anterior uveitis, corneal epitheliopathy, optic neuritis, idiopathic intracranial hypertension, and retinitis. The clinical outcome was favorable, and children regain their visual ability with minimal or no deficits in most of the cases. Further follow-up may be warranted to better understand the long-term effects and visual prognosis.
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Affiliation(s)
- Muhannad A Alnahdi
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada,College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia,Department of Ophthalmology, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia,Muhannad A Alnahdi, Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.
| | - Maan Alkharashi
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia,Department of Ophthalmology, Boston Children's Hospital, Boston, Massachusetts,Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
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Furdova A, Vesely P, Trnka M, Novakova E, Stubna M, Furda R, Branikova L, Pridavkova Z. Conjunctival Swab Findings in 484 COVID-19 Patients in Four Hospital Centers in Slovakia. Vision (Basel) 2022; 6:vision6030046. [PMID: 35893763 PMCID: PMC9330891 DOI: 10.3390/vision6030046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 11/16/2022] Open
Abstract
Since 2020, the COVID-19 (Coronavirus Disease 2019) has quickly become a worldwide health problem. Ophthalmologists must deal with symptoms as well. For the positive detection in the conjunctival sac swab in COVID-19 patients hospitalized in Slovakia during March 2021 in four hospital centers, we used a test based on a polymerase chain reaction (PCR). In a group of 484 patients, 264 males (55%) and 220 females (45%) with clinical symptoms were identified with COVID-19 as a clinical diagnosis. The PCR test swab results from the conjunctival sac taken on the same day were positive in 58 patients (12%), 31 males (with a mean age of 74.6 ± 13.59 years) and 27 females (with a mean age of 70.63 ± 14.17 years); negative in 417 patients (86%); and 9 patients (2%) had an unclear result. The cycle threshold values comparing the nasopharynx and conjunctiva were also different in the group of all patients divided by age and gender. In COVID-19 patients the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was detectable using PCR test in the nasopharynx but also in the conjunctival sac swab, where the positivity rate was only 12%.
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Affiliation(s)
- Alena Furdova
- Department of Ophthalmology, Faculty of Medicine, Comenius University, 826 01 Bratislava, Slovakia;
- Correspondence: ; Tel.: +421-248-234607
| | - Pavol Vesely
- Department of Ophthalmology, Faculty of Medicine, Comenius University, 826 01 Bratislava, Slovakia;
- VESELY Eye Clinic, 826 00 Bratislava, Slovakia
| | - Michal Trnka
- Department of Medical Physics, Biophysics, Informatics and Telemedicine, Faculty of Medicine, Comenius University, 821 01 Bratislava, Slovakia;
| | - Elena Novakova
- Department of Microbiology and Immunology, Jessenius Faculty of Medicine, Comenius University, 036 01 Martin, Slovakia;
| | - Michal Stubna
- Department of Ophthalmology, Faculty Hospital, 010 01 Zilina, Slovakia;
| | - Robert Furda
- Department of Information Systems, Faculty of Management, Comenius University, 820 05 Bratislava, Slovakia;
| | - Lubica Branikova
- Department of Ophthalmology, Faculty Hospital, 940 62 Nove Zamky, Slovakia;
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Baj J, Forma A, Teresińska B, Tyczyńska M, Zembala J, Januszewski J, Flieger J, Buszewicz G, Teresiński G. How Does SARS-CoV-2 Affect Our Eyes-What Have We Learnt So Far about the Ophthalmic Manifestations of COVID-19? J Clin Med 2022; 11:3379. [PMID: 35743449 PMCID: PMC9225256 DOI: 10.3390/jcm11123379] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/21/2022] [Accepted: 06/08/2022] [Indexed: 12/03/2022] Open
Abstract
The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has become a worldwide threat resulting in a pandemic in 2020. SARS-CoV-2 infection manifests itself as coronavirus disease 2019 (COVID-19) that is evidenced in a vast number of either specific or nonspecific symptoms. Except for typical (but nonspecific) symptoms such as fever, dry cough, or muscle weakness, the infected patients might also present atypical symptoms including neurological, dermatological, or ophthalmic manifestations. This paper summarizes the current state of knowledge regarding the onset, progression, and types of ophthalmic symptoms induced by SARS-CoV-2 infection recognized amongst the infected patients.
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Affiliation(s)
- Jacek Baj
- Chair and Department of Anatomy, Medical University of Lublin, 20-090 Lublin, Poland; (M.T.); (J.J.)
| | - Alicja Forma
- Chair and Department of Forensic Medicine, Medical University of Lublin, 20-090 Lublin, Poland; (B.T.); (G.B.); (G.T.)
| | - Barbara Teresińska
- Chair and Department of Forensic Medicine, Medical University of Lublin, 20-090 Lublin, Poland; (B.T.); (G.B.); (G.T.)
| | - Magdalena Tyczyńska
- Chair and Department of Anatomy, Medical University of Lublin, 20-090 Lublin, Poland; (M.T.); (J.J.)
| | - Julita Zembala
- Department of Ophthalmology, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | - Jacek Januszewski
- Chair and Department of Anatomy, Medical University of Lublin, 20-090 Lublin, Poland; (M.T.); (J.J.)
| | - Jolanta Flieger
- Department of Analytical Chemistry, Medical University of Lublin, 20-093 Lublin, Poland;
| | - Grzegorz Buszewicz
- Chair and Department of Forensic Medicine, Medical University of Lublin, 20-090 Lublin, Poland; (B.T.); (G.B.); (G.T.)
| | - Grzegorz Teresiński
- Chair and Department of Forensic Medicine, Medical University of Lublin, 20-090 Lublin, Poland; (B.T.); (G.B.); (G.T.)
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Pereira A, Murtaza F, Kaplan AJ, Yan P. Initial anterior uveitis event associated with recent novel SARS-CoV-2 (COVID-19) infection in the setting of HLA-B27. Am J Ophthalmol Case Rep 2022; 26:101565. [PMID: 35531263 PMCID: PMC9054730 DOI: 10.1016/j.ajoc.2022.101565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 04/22/2022] [Accepted: 04/25/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose To describe an atypical ocular manifestation following SARS-CoV-2 infection. Observations A 27-year old previously healthy male with no past ocular history presented with pain, photophobia and red eye in his left eye (OS). His only notable mention on review of systems was a positive SARS-CoV-2 infection three weeks prior. Slit lamp examination demonstrated fine inferior keratic precipitates (KPs) in the inferior cornea and 3+ anterior chamber cells OS. There was no vitritis or chorioretinal lesions. The patient was diagnosed with his first event of acute anterior uveitis. Standard ocular inflammatory panel returned positive for HLA-B27. The postulated mechanism of initial anterior uveitis attack in the setting of COVID-19 infection was dysregulation of inflammatory cells and mediators in a patient with baseline elevated risk for ocular inflammation. Conclusions and Importance It is crucial to investigate patients for HLA-B27 following initial anterior uveitis event if infected by SARS-CoV-2, as patients with HLA-B27 are at baseline higher risk of ocular inflammatory dysregulation.
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Affiliation(s)
- Austin Pereira
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Fahmeeda Murtaza
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Alexander J. Kaplan
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Kensington Vision and Research Center, University of Toronto, Toronto, Ontario, Canada
| | - Peng Yan
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Kensington Vision and Research Center, University of Toronto, Toronto, Ontario, Canada
- Corresponding author.Kensington Eye Institute, 340 College Street #501, Toronto, Ontario, M5T 3A9, Canada.
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31
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Binotti W, Hamrah P. COVID-19-related Conjunctivitis Review: Clinical Features and Management. Ocul Immunol Inflamm 2022; 31:778-784. [PMID: 35394858 DOI: 10.1080/09273948.2022.2054432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE The ongoing coronavirus disease-2019 (COVID-19) pandemic has greatly impacted theworld. 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. METHODS Literature review was conducted in the PubMed, Google Scholar and EMBASE databases using keywords such as "coronavirus", COVID-19", "SARS-CoV-2", "conjunctivitis", "ocular surface", "eye" and "ophthalmology". RESULTS The ocular surface may serve as an entry point and reservoir for the virus. Frequency of hand-eye contact was an independent risk factor for COVID-19-related conjunctivitis. Therefore, appropriate protective eyewear or face shields are recommended, especially for health-care workers. Bilateral conjunctival sampling within 9 days of symptom onset provides a higher positive yield rate. 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. CONCLUSION 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.
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Affiliation(s)
- William Binotti
- Center for Translational Ocular Immunology, Tufts Medical Center, Department of Ophthalmology, Tufts University School of Medicine, Boston, Massachusetts, USA.,Cornea Service, New England Eye Center, Tufts Medical Center, Department of Ophthalmology, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Pedram Hamrah
- Center for Translational Ocular Immunology, Tufts Medical Center, Department of Ophthalmology, Tufts University School of Medicine, Boston, Massachusetts, USA.,Cornea Service, New England Eye Center, Tufts Medical Center, Department of Ophthalmology, Tufts University School of Medicine, Boston, Massachusetts, USA
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32
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Gaur A, Sarkar P. Eye: The Hard-hit Victim of COVID-19 Pandemic. J Ophthalmic Vis Res 2022; 17:290-295. [PMID: 35765644 PMCID: PMC9185198 DOI: 10.18502/jovr.v17i2.10805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 12/28/2021] [Indexed: 11/24/2022] Open
Abstract
The COVID-19 pandemic has brought the entire world to a standstill. Wearing of mask and time-to-time sanitization have become a customary daily practice. Additionally, as the outdoor activities and movements have been curtailed, concept of work from home is being widely adopted. Hence, the screen exposure time has considerably increased. All these conditions have directly or indirectly impacted the health of eye. This article emphasizes on the repercussions of this pandemic on eye health. It also focuses on the precautions that may be taken to prevent them as well as some solutions to manage them.
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Affiliation(s)
- Aman Gaur
- Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi
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Loffredo L, Fallarino A, Paraninfi A, Pacella F, Pacella E, Oliva A, Violi F. Different rates of conjunctivitis in COVID-19 eastern and western hospitalized patients: a meta-analysis. Intern Emerg Med 2022; 17:925-928. [PMID: 34750658 PMCID: PMC8575664 DOI: 10.1007/s11739-021-02880-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 10/26/2021] [Indexed: 01/08/2023]
Affiliation(s)
- Lorenzo Loffredo
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
| | - Alessia Fallarino
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Aurora Paraninfi
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Fernanda Pacella
- Department of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Elena Pacella
- Department of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Alessandra Oliva
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Francesco Violi
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
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Andrade SA, Lima RE, Varotti FDP, Abdelwahab O, Lwaleed BA. COVID-19 pandemic: multilevel dental technical guidelines based on new scientific evidence. EINSTEIN-SAO PAULO 2022; 20:eAE6307. [PMID: 35293431 PMCID: PMC8909155 DOI: 10.31744/einstein_journal/2022ae6307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 12/17/2020] [Indexed: 11/06/2022] Open
Abstract
The COVID-19 pandemic imposed restrictive measures on dentistry in different regions of the world, ranging from stoppage of care to only permission for urgent and emergency dental services. Thus, new biosafety guidelines for resuming activities, whether in single dental offices, large clinics or dental education activities, are urgently required. In this sense, herein, guidelines that incorporate common points of the main protocols found in the literature for the resumption of dental activities at their different levels, whether in the scope of care or education, are presented. Furthermore, we present the incorporation of measures that allow an increase in the level of biosafety, such as the control of the dental team, the inclusion in the history of conjunctivitis as a possible alert for COVID-19, and the use of the pulse oximeter to assess the risk of silent hypoxemia, which may indicate a complication of COVID-19. In addition, new perspectives for directing research and innovation for biosafety in dentistry are discussed.
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Ocular Complications Following Vaccination for COVID-19: A One-Year Retrospective. Vaccines (Basel) 2022; 10:vaccines10020342. [PMID: 35214800 PMCID: PMC8875181 DOI: 10.3390/vaccines10020342] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/16/2022] [Accepted: 02/18/2022] [Indexed: 12/24/2022] Open
Abstract
Vaccination efforts as a mitigation strategy in the corona virus disease 2019 (COVID-19) pandemic are fully underway. A vital component of understanding the optimal clinical use of these vaccines is a thorough investigation of adverse events following vaccination. To date, some limited reports and reviews have discussed ocular adverse events following COVID-19 vaccination, but a systematic review detailing these reports with manifestations and clinical courses as well as proposed mechanisms has yet to be published. This comprehensive review one-year into vaccination efforts against COVID-19 is meant to furnish sound understanding for ophthalmologists and primary care physicians based on the existing body of clinical data. We discuss manifestations categorized into one of the following: eyelid, orbit, uveitis, retina, vascular, neuro-ophthalmology, ocular motility disorders, and other.
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36
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Toader M, Branisteanu D, Glod M, Esanu I, Branisteanu C, Capsa MS, Dimitriu A, Nicolescu A, Pinzariu A, Branisteanu D. Mucocutaneous lesions associated with SARS‑CoV‑2 infection (Review). Exp Ther Med 2022; 23:258. [PMID: 35251324 PMCID: PMC8892620 DOI: 10.3892/etm.2022.11183] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 11/10/2021] [Indexed: 01/08/2023] Open
Abstract
The ongoing COVID-19 pandemic, declared by the World Health Organisation in March 2020, with the emergence of new, possibly more contagious and more virulent strains, remains a research subject, with the complex systemic involvement better described and understood, but also with a variety of skin and mucosal lesions described in the literature. Mucocutaneous lesions associated with SARS-CoV-2 infection are still under investigation, due to their polymorphic clinical aspect and incompletely understood pathogenic mechanism. The cutaneous inflammatory, exanthematous and purpuric rashes, erythemato-purpuric enanthems, oral ulcers, lichenoid oral lesions, conjunctivitis, conjunctival pseudomembranes, or corneal lesions have been described in patients with COVID-19. Several classifications have been proposed based on the clinical pattern, histological findings, and possible pathogenic mechanisms. The pathogenic mechanism, the diagnostic criteria, the prognostic importance of these lesions are still being debated. The diverse clinical aspects of dermatological manifestations render the diagnosis difficult. However, several clinical patterns strongly associated with COVID-19, such as chilblains, papulovesicular exanthems, and febrile rash require increased awareness and changes to the investigation protocols for these conditions, to include testing for SARS-CoV-2. In the present review, the mucocutaneous findings associated with the novel coronavirus infection, reported thus far in the literature, was provided.
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Affiliation(s)
- Mihaela Toader
- Department of Oral Dermatology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Daniel Branisteanu
- Department of Ophthalmology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Mihai Glod
- Department of Surgery, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Irina Esanu
- Department of Internal Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | | | - Maria-Stefana Capsa
- Department of Dermatology, ‘Railway Clinical Hospital’, 700506 Iasi, Romania
| | - Andreea Dimitriu
- Department of Dermatology, ‘Arcadia’ Hospitals and Medical Centers, 700620 Iasi, Romania
| | - Alin Nicolescu
- Department of Dermatology, Roma Medical Center for Diagnosis and Treatment, 011773 Bucharest, Romania
| | - Alin Pinzariu
- Department of Physiology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Daciana Branisteanu
- Department of Dermatology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
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37
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Karakus S, Foster J, Dai X, Gonzales A, Zhu X, Eberhart C, Hsu W. Prevalence of SARS-CoV-2 in Conjunctival Swab Samples Among Patients Presenting with Conjunctivitis During the COVID-19 Pandemic. Clin Ophthalmol 2022; 16:127-133. [PMID: 35046637 PMCID: PMC8763262 DOI: 10.2147/opth.s343793] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/14/2021] [Indexed: 01/08/2023] Open
Abstract
Purpose To investigate the prevalence of SARS-CoV-2-associated conjunctivitis among patients presenting with conjunctivitis to ophthalmology clinics in the absence of respiratory symptoms suggesting COVID-19 during the first year of the pandemic. Patients and Methods This prospective, observational, cross-sectional study enrolled patients aged 18 years and older who presented with acute conjunctivitis between May 2020 and May 2021. After reviewing demographics, ocular and systemic symptoms, a slit lamp examination was performed. Five samples were collected (conjunctival swab from each eye, nasal swab from each nostril, and a nasopharyngeal swab) in separate tubes for a reverse transcription-polymerase chain reaction test for SARS-CoV-2. Patients were called at 1 and 2 weeks to follow up on their ocular and systemic symptoms and collect information about conjunctival adenovirus test results and COVID-19 test results if performed outside of the study. Results A total of 36 patients were enrolled. The most common ocular symptom was redness (35/36, 97%), and 14 patients (39%) had symptoms in both eyes at the time of the presentation. SARS-CoV-2 RNA was not detected in any samples collected during the study visit (95% confidence interval [CI] from 0 to 0.08). None of the study participants were diagnosed with COVID-19 following conjunctivitis during the 2-week follow-up period. We found that 25 patients had a conjunctival adenovirus test done on the day of their study visit, 9 of which reported positive results. Conclusion Our data suggest that it may not be valuable to obtain routine testing of SARS-CoV-2 in patients presenting with conjunctivitis in the absence of COVID-19.
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Affiliation(s)
- Sezen Karakus
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - James Foster
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Xi Dai
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Anthony Gonzales
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Xi Zhu
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Biology, Public Health Studies, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Charles Eberhart
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - William Hsu
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Molecular and Cell Biology, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD, USA
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38
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Zhang L, Guo X, Jiang H, Zhao N, Cheng W, Xu W, Liu S. Decreased incidence of acute hemorrhagic conjunctivitis associated with enhanced public health intervention during the COVID-19 epidemic in China, 2020. Arch Virol 2022; 167:577-581. [PMID: 35039974 PMCID: PMC8763440 DOI: 10.1007/s00705-021-05282-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 09/13/2021] [Indexed: 11/29/2022]
Abstract
Outbreaks of acute hemorrhagic conjunctivitis (AHC) are associated with a high disease burden. In this study, we investigated the association between enhanced public health intervention and the incidence of AHC during the COVID-19 pandemic in China. A total of 212,526 AHC cases were reported in China during 2015–2020. The overall yearly incidence rate and number of AHC cases decreased by 23.08% and 22.15%, respectively, during the COVID-19 epidemic, compared with the previous 5 years (all p < 0.001). Significant reductions in AHC incidence were found both during the emergency period and after the relaxation of emergency measures in 2020 compared to the previous 5 years (22.22% and 28.00% reduction, respectively; p < 0.001). Enhanced public health initiatives during the COVID-19 pandemic in China were therefore associated with lower transmission of pathogens causing AHC.
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Affiliation(s)
- Li Zhang
- Eye Center of the Second Affiliated Hospital, Medical School of Zhejiang University, Hangzhou, 310009, Zhejiang, China
| | - Xiangyu Guo
- School of Statistics, Renmin University of China, Beijing, 100872, China
| | - Hui Jiang
- Beijing Chest Hospital, Capital Medical University, Beijing, 101149, China.,Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, 101149, China
| | - Na Zhao
- Collaborative Innovation Center of Recovery and Reconstruction of Degraded Ecosystem in Wanjiang Basin Co-founded by Anhui Province and Ministry of Education, School of Ecology and Environment, Anhui Normal University, Wuhu, 241002, Anhui, China
| | - Wei Cheng
- Department of Infectious Diseases, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang, China
| | - Wangli Xu
- School of Statistics, Renmin University of China, Beijing, 100872, China.
| | - Shelan Liu
- Department of Infectious Diseases, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang, China.
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Mocanu V, Bhagwani D, Sharma A, Borza C, Rosca CI, Stelian M, Bhagwani S, Haidar L, Kshtriya L, Kundnani NR, Horhat FR, Horhat R. COVID-19 and the Human Eye: Conjunctivitis, a Lone COVID-19 Finding - A Case-Control Study. Med Princ Pract 2022; 31:66-73. [PMID: 34986482 PMCID: PMC8995668 DOI: 10.1159/000521808] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 12/26/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES COVID-19 has varied clinical manifestations, from asymptomatic to severe cases, and conjunctivitis is one of them, but sometimes a lone initial symptom is found to be present. The aim of this study was to identify the prevalence of conjunctivitis as the first symptom in COVID-19 patients in a primary healthcare unit. METHODOLOGY A retrospective study was conducted, analyzing the presenting complains/symptoms and results of COVID-19-confirmatory tests. RESULTS Out of the 672 cases that were sent for RT-PCR testing, only 121 (18%) were found to be positive. Among these, 2.67% patients had both conjunctivitis and COVID-19, 77.77% patients had unilateral eye affected, while 22.22% had bilateral conjunctivitis of varying degrees. Fifteen patients diagnosed to have both acute conjunctivitis and COVID-19 presented other symptoms associated with COVID-19 infection. Three patients had only acute conjunctivitis during their entire course of COVID-19. CONCLUSIONS Conjunctivitis is a symptom of COVID-19 and may be the first sign of the infection, until the onset of the classical manifestations; such patients may continue to be a viral reservoir. Physicians should not miss unilateral conjunctivitis as it can be the only presenting complaint of COVID-19 during the initial phase, which might worsen if undetected and can aid in the spread of the contagion.
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Affiliation(s)
- Valeria Mocanu
- Department of Ophthalmology, EYE-ENT Senzory-Tumoral Research Centre, Victor Babeș University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | | | - Abhinav Sharma
- Department of Cardiology, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania
- Department of Occupational Medicine, Municipal Emergency University Hospital, Arad, Romania
- Family Physician Clinic, Teremia Mare, Romania
| | - Claudia Borza
- Department of Functional Science, Discipline of Physiopathology, Center for Translational Research and Systems Medicine, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Ciprian Ilie Rosca
- Family Physician Clinic, Teremia Mare, Romania
- Department of Internal Medicine, Centre for Advanced Research in Cardiovascular Pathology and Hemostasis, “Victor Babes“ University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - Morariu Stelian
- Department of Occupational Medicine, Municipal Emergency University Hospital, Arad, Romania
- Department of Occupational Medicine, Vasile Goldis West University, Arad, Romania
| | | | - Laura Haidar
- Department of Functional Sciences, Physiology, Centre of Immuno-Physiology and Biotechnologies, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | | | - Nilima Rajpal Kundnani
- Family Physician Clinic, Teremia Mare, Romania
- Department of Functional Sciences, Physiology, Centre of Immuno-Physiology and Biotechnologies, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
- Shreeji Clinic, Ahmedabad, India
- *Nilima Rajpal Kundnani,
| | - Florin-Raul Horhat
- Department of Functional Science, Medical Informatics and Biostatistics, “Victor Babeș“ University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - Raluca Horhat
- Department of Functional Science, Biophysics, “Victor Babeș“ University of Medicine and Pharmacy Timisoara, Timisoara, Romania
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Abstract
Purpose : To report a case of anterior ischemic optic neuropathy (AION) following COVID-19 vaccination and provide a systematic review of all published cases of optic neuropathy following COVID-19 vaccination. Methods : A systematic literature search was performed using PubMed and Ovid MEDLINE for cases of optic neuropathy following COVID-19 vaccination. Terms used in the search included “COVID-19 vaccination”, “optic neuropathy”, “optic neuritis”, and “ischemic optic neuropathy”. Titles and abstracts were initially screened then full texts of eligible studies were reviewed for data extraction. Only cases published in the English language, peer reviewed, and that included details on optic nerve involvement were included. All study types were eligible for inclusion. Results : Including our patient, a total of 10 patients (8 females) were identified as developing optic neuropathy following COVID-19 vaccination. Five patients (50.0%) were diagnosed with AION, while 4 (40.0%) were diagnosed with optic neuritis. One patient was diagnosed with papillitis and neuroretinitis. Three patients (30.0%) had bilateral involvement. Mean age of patients was 48.5±19.7 years. Mean time from vaccination to onset of ophthalmic symptoms was 6.5±6.4 days. Median (IQR) presenting visual acuity was logMAR 0.3 (0-1). For the 8 eyes which had both presenting and final follow-up visual acuity, median (IQR) presenting vision was logMAR 0.2 (0-0.7) and at final follow-up was logMAR 0 (0-0.05) (P=0.184). Conclusion : COVID-19 vaccination may result in optic neuropathy in the form of optic neuritis and ischemic optic neuropathy. Further studies are needed to determine the incidence, management, and prognosis of optic neuropathies associated with COVID-19 vaccination.
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Soltani S, Zandi M, Ahmadi SE, Zarandi B, Hosseini Z, Akhavan Rezayat S, Abyadeh M, Pakzad I, Malekifar P, Pakzad R, Mozhgani SH. Pooled Prevalence Estimate of Ocular Manifestations in COVID-19 Patients: A Systematic Review and Meta-Analysis. IRANIAN JOURNAL OF MEDICAL SCIENCES 2022; 47:2-14. [PMID: 35017772 PMCID: PMC8743370 DOI: 10.30476/ijms.2021.89475.2026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 04/22/2021] [Accepted: 06/05/2021] [Indexed: 01/08/2023]
Abstract
Background There are reports of ocular tropism due to respiratory viruses such as severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Various studies have shown ocular manifestation in coronavirus disease-2019 (COVID-19) patients. We aimed to identify ophthalmic manifestations in COVID-19 patients and establish an association between ocular symptoms and SARS-CoV-2 infection. Methods A systematic search of Medline, Scopus, Web of Science, Embase, and Cochrane Library was conducted for publications from December 2019 to April 2021. The search included MeSH terms such as SARS-CoV-2 and ocular manifestations. The pooled prevalence estimate (PPE) with 95% confidence interval (CI) was calculated using binomial distribution and random effects. The meta-regression method was used to examine factors affecting heterogeneity between studies. Results Of the 412 retrieved articles, 23 studies with a total of 3,650 COVID-19 patients were analyzed. The PPE for any ocular manifestations was 23.77% (95% CI: 15.73-31.81). The most prevalent symptom was dry eyes with a PPE of 13.66% (95% CI: 5.01-25.51). The PPE with 95% CI for conjunctival hyperemia, conjunctival congestion/conjunctivitis, and ocular pain was 13.41% (4.65-25.51), 9.14% (6.13-12.15), and 10.34% (4.90-15.78), respectively. Only two studies reported ocular discomfort and diplopia. The results of meta-regression analysis showed that age and sample size had no significant effect on the prevalence of any ocular manifestations. There was no significant publication bias in our meta-analysis. Conclusion There is a high prevalence of ocular manifestations in COVID-19 patients. The most common symptoms are dry eyes, conjunctival hyperemia, conjunctival congestion/conjunctivitis, ocular pain, irritation/itching/burning sensation, and foreign body sensation.
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Affiliation(s)
- Saber Soltani
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Research Center for Clinical Virology, Department of Virology, Tehran University of Medical Sciences, Tehran, Iran
| | - Milad Zandi
- Department of Hematology and Blood Banking, School of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran.,Hepatitis Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Seyed-Esmaeil Ahmadi
- Department of Hematology and Blood Banking, School of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Bahman Zarandi
- Department of Hematology and Blood Banking, School of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Zeinab Hosseini
- Hepatitis Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Sara Akhavan Rezayat
- Department of Health Economics and Management, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Abyadeh
- Cell Science Research Center, Department of Molecular Systems Biology, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Iraj Pakzad
- Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran.,Department of Microbiology, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Pooneh Malekifar
- Department of Epidemiology, School of Public Health, Tehran University Medical Sciences, Tehran, Iran
| | - Reza Pakzad
- 0Department of Epidemiology, Faculty of Health, Ilam University Medical Sciences, Ilam, Iran.,1Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Sayed-Hamidreza Mozhgani
- 2Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.,3Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
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42
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Marchenko NR, Kasparova EA, Budnikova EA, Makarova MA. [Anterior eye segment damage in coronavirus infection (COVID-19)]. Vestn Oftalmol 2021; 137:142-148. [PMID: 34965080 DOI: 10.17116/oftalma2021137061142] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Conjunctivitis may appear as the first symptom of the coronavirus infection (COVID-19). In isolated cases, the lesion of the conjunctiva evokes a systemic infectious process. Currently, the conjunctiva is not considered as an area of long-term reproduction of coronavirus, and its damage is caused by hyperproduction of pro-inflammatory cytokines (especially IL-6); development of iridocyclitis and keratoconjunctivitis is also possible. Most often, local corticosteroids are used to treat these processes, although their use requires caution due to the risk of activating secondary infection (herpetic bacterial, fungal), which often develops as a result of immunodeficiency caused both by COVID-19 and the massive corticosteroid and antibiotic therapy employed when the course of the disease is severe. The severe condition of patients, the lung ventilation, and the prone position all contribute to corneal erosions, exposure keratopathy, pseudomonas aeruginosa keratitis and angle-closure glaucoma attacks. The risk of transmission of coronavirus infection during keratoplasty is estimated as minimal.
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Affiliation(s)
| | | | | | - M A Makarova
- Research Institute of Eye Diseases, Moscow, Russia
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Guemes-Villahoz N, Burgos-Blasco B, Perez-Garcia P, Fernández-Vigo JI, Morales-Fernandez L, Donate-Lopez J, Ramos-Amador JT, Garcia-Feijoo J. Retinal and peripapillary vessel density increase in recovered COVID-19 children by optical coherence tomography angiography. J AAPOS 2021; 25:325.e1-325.e6. [PMID: 34687877 PMCID: PMC8527103 DOI: 10.1016/j.jaapos.2021.06.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/13/2021] [Accepted: 06/22/2021] [Indexed: 01/08/2023]
Abstract
PURPOSE To evaluate retinal vascular changes in children who have recovered from coronavirus disease (COVID-19) using optical coherence tomography angiography (OCTA) and to compare the results with age-matched healthy children. METHODS In this cross-sectional case-control study, children 6-18 years of age with laboratory-confirmed SARS-CoV-2 infection were compared with historic healthy controls. All participants underwent ophthalmological examination, including fundus photography and OCTA of the macular region and optic disk. COVID-19 children were examined 4-8 weeks after COVID-19 diagnoses. Demographic data, medical history, and COVID-19 symptoms were noted. OCTA parameters in the superficial capillary plexus (SCP) were analyzed according to ETDRS sectors and peripapillary quadrants. RESULTS A total of 72 patients were included: 27 recovered COVID-19 children and 45 controls. Mean age for cases was 11.96 ± 3.8 years (18 females [66%]); for controls, 11.02 ± 2.0 years (29 females [64%]). Macular OCTA of the SCP showed a significant increase in retinal vessel density (VD) in recovered COVID-19 children compared with healthy controls in the inner ring (P = 0.001). Macular perfusion density (mPD) was also increased in the inner ring (P = 0.001). Peripapillary OCTA evidenced a significant higher flux index (FI) in all four quadrants (P < 0.001). CONCLUSIONS Recovered COVID-19 children present increased retinal VD, mPD, and peripapillary FI shortly after recovery. Since the retinal vasculature is considered a unique window to assess microvascular changes, these findings may represent a potential in vivo biomarker of vascular abnormalities in COVID-19 children in other organs.
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Affiliation(s)
- Noemi Guemes-Villahoz
- Ophthalmology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
| | - Barbara Burgos-Blasco
- Ophthalmology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Pilar Perez-Garcia
- Ophthalmology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Jose Ignacio Fernández-Vigo
- Ophthalmology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Laura Morales-Fernandez
- Ophthalmology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Juan Donate-Lopez
- Ophthalmology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | | | - Julian Garcia-Feijoo
- Ophthalmology Department, Hospital Clínico San Carlos, Departamento de Inmunología, Oftalmología y ORL, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Oftared, Madrid, Spain
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Bontzos G, Gkiala A, Karakosta C, Maliotis N, Detorakis ET. COVID-19 in Ophthalmology. Current Disease Status and Challenges during Clinical Practice. MAEDICA 2021; 16:668-680. [PMID: 35261670 PMCID: PMC8897783 DOI: 10.26574/maedica.2020.16.4.668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Purpose: The novel coronavirus disease 2019 (COVID-19) has raised a global public health concern. The purpose of this review is to summarize the evidence currently available on COVID-19 for its ocular implications and manifestations from both pathogenetic and clinical standpoints. Methods: For this narrative review, more than 100 relevant scientific articles were considered from various databases (PubMed, Google Scholar, and Science Direct) using keywords such as coronavirus outbreak, COVID-19, ophthalmology, ocular symptoms. Results:Daily healthcare both from patient and physician perspective, as well as on some guidelines regarding prevention and management have dramatically changed over the last few months. Although COVID-19 infection mainly affects the respiratory system as well as the gastrointestinal, cardiovascular, and urinary systems, it may cause a wide spectrum of ocular manifestations. Various challenges have to be faced to minimize exposure for both patients and physicians. Conclusion:The risk of COVID-19 infection should be considered and medical care should be prioritized for urgent cases. Appropriate management for patients with chronic cases that may result in adverse outcomes should not be neglected, while patients that can be monitored remotely should be identified.
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Affiliation(s)
- Georgios Bontzos
- Department of Ophthalmology, 'Korgialenio-Benakio' General Hospital, 11526 Athens, Greece
| | - Anastasia Gkiala
- Department of Ophthalmology, 'Korgialenio-Benakio' General Hospital, 11526 Athens, Greece
| | - Christina Karakosta
- Department of Ophthalmology, 'Korgialenio-Benakio' General Hospital, 11526 Athens, Greece
| | - Neofytos Maliotis
- Department of Ophthalmology, General Hospital of Nikaia "Agios Panteleimon", 18454 Athens, Greece
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45
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Lin TP, Ko CN, Zheng K, Lai KH, Wong RL, Lee A, Zhang S, Huang SS, Wan KH, Lam DS. COVID-19: Update on Its Ocular Involvements, and Complications From Its Treatments and Vaccinations. Asia Pac J Ophthalmol (Phila) 2021; 10:521-529. [PMID: 34839344 PMCID: PMC8673850 DOI: 10.1097/apo.0000000000000453] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 10/10/2021] [Indexed: 01/08/2023] Open
Abstract
ABSTRACT The coronavirus disease 2019 (COVID-19) came under the attention of the international medical community when China first notified the World Health Organization of a pneumonia outbreak of then-unknown etiology in Wuhan in December 2019. Since then, COVID-19 caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has appalled the world by spreading at a pandemic speed. Although ophthalmologists do not directly engage in the clinical care of COVID-19 patients, the ophthalmology community has become aware of the close ties between its practice and the pandemic. Not only are ophthalmologists at heightened risk of SARS-CoV-2 exposure due to their physical proximity with patients in routine ophthalmic examinations, but SARS-CoV-2 possesses ocular tropism resulting in ocular complications beyond the respiratory tract after viral exposure. Furthermore, patients could potentially suffer from adverse ocular effects in the therapeutic process. This review summarized the latest literature to cover the ophthalmic manifestations, effects of treatments, and vaccinations on the eye to aid the frontline clinicians in providing effective ophthalmic care to COVID-19 patients as the pandemic continues to evolve.
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Affiliation(s)
- Timothy P.H. Lin
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong
| | | | - Ke Zheng
- C-MER (Beijing) Dennis Lam Eye Hospital, Beijing, China
| | - Kenny H.W. Lai
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong
- C-MER International Eye Care Group, Hong Kong
| | - Raymond L.M. Wong
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong
- C-MER International Eye Care Group, Hong Kong
| | - Allie Lee
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | | | - Suber S. Huang
- Retina Center of Ohio, Cleveland, OH, US
- Bascom Palmer Eye Institute, Miami, FL, US
| | - Kelvin H. Wan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong
| | - Dennis S.C. Lam
- C-MER International Eye Research Center of The Chinese University of Hong Kong (Shenzhen), China
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Chen Y, Li L, Zhang Q, Liu H, Huang Y, Lin S, Yin G, Xie Q. Epidemiology, methodological quality, and reporting characteristics of systematic reviews and meta-analyses on coronavirus disease 2019: A cross-sectional study. Medicine (Baltimore) 2021; 100:e27950. [PMID: 34964777 PMCID: PMC8615445 DOI: 10.1097/md.0000000000027950] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 11/02/2021] [Indexed: 02/05/2023] Open
Abstract
During the coronavirus disease 2019 (COVID-19) pandemic, convenient accessibility and rapid publication of studies related to the ongoing pandemic prompted shorter preparation time for studies. Whether the methodological quality and reporting characteristics of published systematic reviews (SRs)/meta-analyses are affected during the specific pandemic condition is yet to be clarified. This study aimed to evaluate the epidemiology, methodological quality, and reporting characteristics of published SRs/meta-analyses related to COVID-19.The Ovid Medline, Ovid Embase, Cochrane Library, and Web of Science electronic databases were searched to identify published SRs/meta-analyses related to the COVID-19 pandemic. Study screening, data extraction, and methodology quality assessment were performed independently by 2 authors. The methodology quality of included SRs/meta-analyses was evaluated using revised version of a measurement tool to assess SRs, and the reporting characteristics were assessed based on the preferred reporting items for SRs and meta-analyses guidelines.A total of 47 SRs/meta-analyses were included with a low to critically low methodological quality. The median number of days from the date of literature retrieval to the date that the study was first available online was 21 days; due to the limited time, only 7 studies had study protocols, and the studies focused on a wide range of COVID-19 topics. The rate of compliance to the preferred reporting items for SRs and meta-analyses checklists of reporting characteristics ranged from 14.9% to 100%. The rate of compliance to the items of protocol and registration, detailed search strategy, and assessment of publication bias was less than 50%.SRs/meta-analyses on COVID-19 were poorly conducted and reported, and thus, need to be substantially improved.
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Affiliation(s)
- Yuehong Chen
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Ling Li
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Qiuping Zhang
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Huan Liu
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Yupeng Huang
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Sang Lin
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Geng Yin
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Qibing Xie
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
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Stadnytskyi V, Anfinrud P, Bax A. Breathing, speaking, coughing or sneezing: What drives transmission of SARS-CoV-2? J Intern Med 2021; 290:1010-1027. [PMID: 34105202 PMCID: PMC8242678 DOI: 10.1111/joim.13326] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 05/05/2021] [Indexed: 12/19/2022]
Abstract
The SARS-CoV-2 virus is highly contagious, as demonstrated by numerous well-documented superspreading events. The infection commonly starts in the upper respiratory tract (URT) but can migrate to the lower respiratory tract (LRT) and other organs, often with severe consequences. Whereas LRT infection can lead to shedding of virus via breath and cough droplets, URT infection enables shedding via abundant speech droplets. Their viral load can be high in carriers with mild or no symptoms, an observation linked to the abundance of SARS-CoV-2-susceptible cells in the oral cavity epithelium. Expelled droplets rapidly lose water through evaporation, with the smaller ones transforming into long-lived aerosol. Although the largest speech droplets can carry more virions, they are few in number, fall to the ground rapidly and therefore play a relatively minor role in transmission. Of more concern is small speech aerosol, which can descend deep into the LRT and cause severe disease. However, since their total volume is small, the amount of virus they carry is low. Nevertheless, in closed environments with inadequate ventilation, they can accumulate, which elevates the risk of direct LRT infection. Of most concern is the large fraction of speech aerosol that is intermediate-sized because it remains suspended in air for minutes and can be transported over considerable distances by convective air currents. The abundance of this speech-generated aerosol, combined with its high viral load in pre- and asymptomatic individuals, strongly implicates airborne transmission of SARS-CoV-2 through speech as the primary contributor to its rapid spread.
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Affiliation(s)
- V Stadnytskyi
- From the, Laboratory of Chemical Physics, NIDDK, National Institutes of Health, Bethesda, MD, USA
| | - P Anfinrud
- From the, Laboratory of Chemical Physics, NIDDK, National Institutes of Health, Bethesda, MD, USA
| | - A Bax
- From the, Laboratory of Chemical Physics, NIDDK, National Institutes of Health, Bethesda, MD, USA
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Rodríguez-Ares T, Lamas-Francis D, Treviño M, Navarro D, Cea M, López-Valladares MJ, Martínez L, Gude F, Touriño R. SARS-CoV-2 in Conjunctiva and Tears and Ocular Symptoms of Patients with COVID-19. Vision (Basel) 2021; 5:vision5040051. [PMID: 34698308 PMCID: PMC8544743 DOI: 10.3390/vision5040051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 12/23/2022] Open
Abstract
This study investigates the presence of SARS-CoV-2 in conjunctival secretions and tears and evaluates ocular symptoms in a group of patients with COVID-19. We included 56 hospitalized patients with COVID-19 in this cross-sectional cohort study. Conjunctival secretions and tears were collected using flocked swabs and Schirmer strips for SARS-CoV-2 reverse-transcriptase polymerase chain reaction (RT-PCR). Assessment of ocular surface manifestations included an OSDI (Ocular Surface Disease Index) questionnaire. Patients had been admitted to hospital for an average of 2.4 days (range 0–7) and had shown general symptoms for an average of 7.1 days (range 1–20) prior to ocular testing. Four (7.1%) of 56 conjunctival swabs and four (4%) of 112 Schirmer strips were positive for SARS-CoV-2. The mean E-gene cycle threshold values (Ct values) were 31.2 (SD 5.0) in conjunctival swabs and 32.9 (SD 2.7) in left eye Schirmer strips. Overall, 17 (30%) patients presented ocular symptoms. No association was found between positive ocular samples and ocular symptoms. This study shows that SARS-CoV-2 can be detected on the conjunctiva and tears of patients with COVID-19. Contact with the ocular surface may transmit the virus and preventive measures should be taken in this direction.
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Affiliation(s)
- Teresa Rodríguez-Ares
- Department of Ophthalmology, University Hospital of Santiago de Compostela, 15706 Santiago de Compostela, Spain; (T.R.-A.); (M.J.L.-V.); (L.M.); (R.T.)
- Faculty of Medicine, University of Santiago de Compostela, 15705 Santiago de Compostela, Spain;
| | - David Lamas-Francis
- Department of Ophthalmology, University Hospital of Santiago de Compostela, 15706 Santiago de Compostela, Spain; (T.R.-A.); (M.J.L.-V.); (L.M.); (R.T.)
- Correspondence:
| | - Mercedes Treviño
- Department of Microbiology, University Hospital of Santiago de Compostela, 15705 Santiago de Compostela, Spain; (M.T.); (D.N.); (M.C.)
| | - Daniel Navarro
- Department of Microbiology, University Hospital of Santiago de Compostela, 15705 Santiago de Compostela, Spain; (M.T.); (D.N.); (M.C.)
| | - María Cea
- Department of Microbiology, University Hospital of Santiago de Compostela, 15705 Santiago de Compostela, Spain; (M.T.); (D.N.); (M.C.)
| | - María Jesús López-Valladares
- Department of Ophthalmology, University Hospital of Santiago de Compostela, 15706 Santiago de Compostela, Spain; (T.R.-A.); (M.J.L.-V.); (L.M.); (R.T.)
| | - Laura Martínez
- Department of Ophthalmology, University Hospital of Santiago de Compostela, 15706 Santiago de Compostela, Spain; (T.R.-A.); (M.J.L.-V.); (L.M.); (R.T.)
| | - Francisco Gude
- Faculty of Medicine, University of Santiago de Compostela, 15705 Santiago de Compostela, Spain;
- Clinical Epidemiology Service, University Hospital of Santiago de Compostela, 15706 Santiago de Compostela, Spain
| | - Rosario Touriño
- Department of Ophthalmology, University Hospital of Santiago de Compostela, 15706 Santiago de Compostela, Spain; (T.R.-A.); (M.J.L.-V.); (L.M.); (R.T.)
- Faculty of Medicine, University of Santiago de Compostela, 15705 Santiago de Compostela, Spain;
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Gijs M, Veugen JMJ, Wolffs PFG, Savelkoul PHM, Tas J, van Bussel BCT, de Kruif MD, Henry RMA, Webers CAB, Dickman MM, Nuijts RMMA. In-Depth Investigation of Conjunctival Swabs and Tear Fluid of Symptomatic COVID-19 Patients, an Observational Cohort Study. Transl Vis Sci Technol 2021; 10:32. [PMID: 34673905 PMCID: PMC8543390 DOI: 10.1167/tvst.10.12.32] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 09/15/2021] [Indexed: 01/08/2023] Open
Abstract
Purpose The putative presence of SARS-CoV-2 in ocular specimen puts healthcare workers at risk. We thoroughly examined conjunctival swabs and tear fluid in a large cohort of COVID-19 patients. Methods A total of 243 symptomatic laboratory-confirmed COVID-19 patients were included in this observational multicenter study. Conjunctival swabs were analyzed by reverse transcription polymerase chain reaction for detection of SARS-CoV-2 RNA. Next-generation sequencing and phylogenetic analysis were performed to identify viral strains and to determine tissue tropism. Schirmer tear samples from 43 hospitalized COVID-19 patients and 25 healthy controls were analyzed by multiplex cytokine immunoassays. Results Viral SARS-CoV-2 RNA was detected in conjunctival swabs from 17 (7.0%) of 243 COVID-19 patients. Conjunctival samples were positive for viral SARS-CoV-2 RNA as long as 12 days after disease onset. Cycle threshold (Ct) values for conjunctival swabs (mean 34.5 ± 5.1) were significantly higher than nasopharyngeal swabs (mean 16.7 ± 3.6). No correlation between Ct values of conjunctival and nasopharyngeal swabs was observed. The majority of positive conjunctival samples were detected only once and primarily during the first visit. Next-generation sequencing analysis revealed that the virus strain found in the conjunctiva was most often identical to the one found in the nasopharynx. Tear cytokine levels IL-1β and IL-6 were elevated in COVID-19 patients compared to healthy controls. Conclusions Conjunctival samples that were positive for SARS-CoV-2 RNA contained the same viral strain as the nasopharynx. Translational Relevance The presence of SARS-CoV-2 viral RNA and elevated cytokines in tear fluid confirm the involvement of the ocular surface in COVID-19 disease.
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Affiliation(s)
- Marlies Gijs
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
- School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands
| | - Judith M. J. Veugen
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
- School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands
- Department of Medical Microbiology, Maastricht University Medical Center, Maastricht, the Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Petra F. G. Wolffs
- Department of Medical Microbiology, Maastricht University Medical Center, Maastricht, the Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Paul H. M. Savelkoul
- Department of Medical Microbiology, Maastricht University Medical Center, Maastricht, the Netherlands
- Department of Medical Microbiology and Infection Control, Amsterdam Infection and Immunity Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Jeanette Tas
- School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands
- Department of Intensive Care Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Bas C. T. van Bussel
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
- Department of Intensive Care Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Martijn D. de Kruif
- Department of Pulmonary Medicine, Zuyderland Medical Center, Heerlen, the Netherlands
| | - Ronald M. A. Henry
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Carroll A. B. Webers
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
- School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands
| | - Mor M. Dickman
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
- School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands
| | - Rudy M. M. A. Nuijts
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
- School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands
- Department of Ophthalmology, Zuyderland Medical Center, Heerlen, the Netherlands
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50
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Sarkar D, Soni D, Nagpal A, Khurram F, Karkhur S, Verma V, Mohan RR, Sharma B. Ocular manifestations of RT-PCR-confirmed COVID-19 cases in a large database cross-sectional study. BMJ Open Ophthalmol 2021; 6:e000775. [PMID: 34584962 PMCID: PMC8460530 DOI: 10.1136/bmjophth-2021-000775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 08/21/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To evaluate ocular manifestations of reverse transcriptase (RT)-PCR-confirmed SARS-CoV-2-infected patients in a validated comparative model, and additionally to evaluate the correlation between severity of COVID-19 and ocular manifestations. METHODS AND ANALYSIS In a prospective cross-sectional study, a total of 2400 subjects were enrolled over a period of 8 months. To eliminate bias of identical ocular symptom profile in other non-COVID-19 respiratory infections and to acquire a comparative model, 1200 COVID-19 RT-PCR-positive patients (group 1) and 1200 RT-PCR-negative patients (group 2) were included. Data collection included use of a prestructured tool and 'Google-forms', along with stratification of patients into 'mild, moderate, and severe' categories. Study subjects were evaluated for ocular manifestations by clinical examination and laboratory work-up. Univariate and multivariate logistic regression analyses were performed. RESULTS 144 (12%) patients in group 1 had ocular symptoms as compared with 24 (2%) patients in group 2 (p<0.001). Ocular manifestations (symptoms and signs) comprising burning sensation (6.7%, p<0.001), foreign body sensation and irritation (7.0%, p<0.001), and conjunctival signs (2.7%, p<0.001) were found statistically significant in group 1 as compared with group 2. Ocular involvement increased in proportion to severity of COVID-19: mild (5.3%), moderate (24.6%) and severe (58.8%) (p=0.0006). CONCLUSION The frequency of occurrence of ocular manifestations was higher in group 1 as opposed to group 2. Furthermore, the presence of ocular manifestations carried a direct correlation with severity of systemic disease and presence of comorbidities.
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Affiliation(s)
- Deepayan Sarkar
- Department of Ophthalmology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Deepak Soni
- Department of Ophthalmology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Aniza Nagpal
- Department of Ophthalmology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Fazil Khurram
- Department of Ophthalmology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Samendra Karkhur
- Department of Ophthalmology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Vidhya Verma
- Department of Ophthalmology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Rajiv R Mohan
- Department of Ophthalmology, College of Veterinary Medicine and Mason Eye Institute, School of Medicine, University of Missouri, Columbia, Missouri, USA
| | - Bhavana Sharma
- Department of Ophthalmology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
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