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Huang LY, Chiang CC, Li YL, Lai HY, Hsieh YC, Wu YH, Tsai YY. Corneal Complications after COVID-19 Vaccination: A Systemic Review. J Clin Med 2022; 11:jcm11226828. [PMID: 36431307 PMCID: PMC9698276 DOI: 10.3390/jcm11226828] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/17/2022] [Accepted: 11/17/2022] [Indexed: 11/22/2022] Open
Abstract
Multiple vaccines are now being used across the world, and several studies have described cases of corneal graft rejection following the administration of the COVID-19 vaccine. The purpose of this article is to review the corneal adverse event that occurred following COVID-19 vaccine administration. The literature search was conducted in March 2022 using MEDLINE, PubMed, and the Cochrane Database of Systematic Reviews. A total of 27 articles, including 37 cases, have documented corneal adverse events that occurred following COVID-19 vaccination. The mean age was 60 ± 14.9 years (range, 27-83 years). The most common events were acute corneal graft rejection (n = 21, 56.8%), followed by herpes zoster ophthalmicus (n = 11, 29.7%) and herpes simplex keratitis (n = 2, 5.4%). The mean time from vaccination to the event was 10 ± 8.5 days (range, 1-42 days) after the first or second dose of vaccine. All patients with corneal graft rejection, immune-mediated keratolysis, and peripheral ulcerative keratitis (PUK) (n = 24, 64.9%) were managed topically with or without oral corticosteroids. Patients with herpes zoster ophthalmicus and herpes simplex keratitis were managed with oral antiviral agents. Two patients received penetrating keratoplasty due to keratolysis after invalid topical treatment. Disease resolution was noted in 29 patients (78.3%), whereas 3 (8.1%) had persistent corneal edema after graft rejection, 1 (2.7%) had corneal infiltration after HZO, and 4 (10.8%) were not mentioned in the articles. Corneal adverse events could occur after COVID-19 vaccination. After timely treatment with steroids or antiviral agents, most of the events were mild and had a good visual outcome. Administrating or increasing steroids before vaccination may be useful for the prevention of corneal graft rejection. However, the prophylactic use of antiviral treatments in patients with a herpes viral infection history is not recommend.
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Affiliation(s)
- Li-Ying Huang
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404327, Taiwan
| | - Chun-Chi Chiang
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404327, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung 406040, Taiwan
- Department of Optometry, Asia University, Taichung 413305, Taiwan
| | - You-Ling Li
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404327, Taiwan
| | - Hung-Yin Lai
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404327, Taiwan
| | - Yi-Ching Hsieh
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404327, Taiwan
| | - Ying-Hsuen Wu
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404327, Taiwan
| | - Yi-Yu Tsai
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404327, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung 406040, Taiwan
- Department of Optometry, Asia University, Taichung 413305, Taiwan
- Correspondence: ; Tel.: +886-4-22052121 (ext. 1141); Fax: +886-4-22059265
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Boukhvalova MS, Mortensen E, Lopez D, Herold BC, Blanco JCG. Bell's palsy and lip HSV-1 infection: importance of subcutaneous access. JOURNAL OF TRANSLATIONAL SCIENCE 2022; 8:https://www.oatext.com/bells-palsy-and-lip-hsv-1-infection-importance-of-subcutaneous-access.php#Article. [PMID: 36340440 PMCID: PMC9631455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Although HSV-1 has been implicated in facial palsy for a long time, testing and treating for HSV is not routine. The lack of a meaningful demonstration of how HSV-1 would cause facial palsy has limited progress in this field. Herein we demonstrate that the depth of the lip HSV-1 infection defines the course of the disease, with deeper subcutaneous infection allowing virus access to the facial nerve and causing facial palsy. HSV-1 inoculated subcutaneously caused extensive facial paralysis in cotton rats Sigmodon hispidus, while virus inoculated in the same area of the lip by skin surface abrasion did not. Demyelination along the facial nerve (CN VII) accompanied subcutaneous HSV-1 infection and was identified as the possible underlying mechanism of the disease. This causality demonstration is particularly important in light of increased facial palsy outbreaks associated with SARS-CoV-2 infection and SARS-CoV-2 and influenza vaccinations.
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Affiliation(s)
| | | | - Diego Lopez
- Sigmovir Biosystems, Inc., Rockville, MD, USA
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Ocular Adverse Events after Inactivated COVID-19 Vaccination. Vaccines (Basel) 2022; 10:vaccines10060918. [PMID: 35746527 PMCID: PMC9230105 DOI: 10.3390/vaccines10060918] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/03/2022] [Accepted: 06/07/2022] [Indexed: 12/31/2022] Open
Abstract
Purpose: To report the clinical characteristics of ocular adverse events that have occurred, in China, after vaccination with inactivated COVID-19 vaccines. Methods: A retrospective cross-sectional observational study was conducted of ocular disorders that occurred within 15 days from any dose of an inactivated COVID-19 vaccine. Information on gender, age, the interval between the vaccination and ocular symptoms, laterality, duration of the ocular symptoms, primary visual acuity, and clinical diagnosis were retrospectively collected. Results: Twenty-four patients were involved in the study, including 15 females and 9 males, with a mean age of 41 ± 16 years (range of 8−71 years). The patients all denied a prior history of COVID-19 infection. Ocular adverse events occurred after the first dose of vaccine in 18 patients and, after the second or third doses, in six patients. The interval between vaccination with the inactivated COVID-19 vaccine and ocular symptoms was 6 ± 5 days; six patients were bilaterally involved and 18 patients were unilaterally involved. Regarding the diagnosis, 10 patients were diagnosed with white dot syndrome (WDS), 9 patients were diagnosed with uveitis, and 5 patients were diagnosed with retinal vascular disorders. The ages of patients with WDS were younger than those with uveitis or retinal vascular disorders (32 ± 10 vs. 48 ± 18, p < 0.05). For patients diagnosed with WDS, the best-corrected visual acuity (BCVA) was 0.74 ± 0.73 LogMAR. For patients diagnosed with retinal vascular disorders or uveitis, the BCVA was 1.44 ± 1.26 LogMAR. There was no significant difference (p > 0.05). Conclusions: A relationship cannot be established between inactivated COVID-19 vaccines and ocular disorders; therefore, further investigation of the clinical spectrum of ocular adverse events after vaccination with an inactivated COVID-19 vaccine is necessary.
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Singh J, More A, Shetty SB, Chaskar P, Sen A. Herpes simplex virus retinitis following ChAdOx1 nCoV- 19 (Covishield) vaccination for SARS CoV 2: A case report. Ocul Immunol Inflamm 2022; 30:1282-1285. [PMID: 35587646 DOI: 10.1080/09273948.2022.2069127] [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: 10/18/2022]
Abstract
PURPOSE To report a case of herpes simplex virus retinitis following ChadOx1 nCoV-19 (covishield) vaccination. CASE REPORT A 29 year old immunocompetent male presented with unilateral disc edema with adjacent retinitis two days after receiving the first dose of ChAdOx1 nCoV-19 vaccination. Extensive investigations to rule out infective etiology were negative except for polymerase chain reaction (PCR) of the vitreous specimen which was positive for the herpes simplex virus. A diagnosis of herpes simplex (HSV) retinitis post covid vaccination was made. The patient responded well to oral antivirals and steroids. CONCLUSION HSV retinitis is a rare complication following the COVID-19 vaccination.
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Affiliation(s)
- Jayanti Singh
- Vitreo-retina and Uvea Service, Sadguru Netra Chikitsalaya, Chitrakoot, India
| | - Amruta More
- Vitreo-retina and Uvea Service, Sadguru Netra Chikitsalaya, Chitrakoot, India
| | - Sachin B Shetty
- Vitreo-retina and Uvea Service, Sadguru Netra Chikitsalaya, Chitrakoot, India
| | - Priyanka Chaskar
- Microbiology Department, Sadguru Netra Chikitsalaya, Chitrakoot, India
| | - Alok Sen
- Vitreo-retina and Uvea Service, Sadguru Netra Chikitsalaya, Chitrakoot, India
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Al-Dwairi RA, Aleshawi A, Adi S, Abu-Zreig L. Reactivation of Herpes Simplex Keratitis on a Corneal Graft Following SARS-CoV-2 mRNA Vaccination. Med Arch 2022; 76:146-148. [PMID: 35774041 PMCID: PMC9233471 DOI: 10.5455/medarh.2022.76.146-148] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 04/21/2022] [Indexed: 11/03/2022] Open
Abstract
Background Ocular herpes simplex is usually caused by herpes simplex virus type 1 (HSV-1) and less commonly by the type 2 virus (HSV-2). Ocular manifestations of HSV include blepharitis, conjunctivitis, lacrimal system obstruction, corneal involvement, and uveitis. Corneal involvement is one of the causes of loss of vision and can be epithelial herpetic keratitis or stromal herpetic keratitis. Objective A significant population has a colonization of herpes viruses. Under certain circumstances, these viruses can reactivate with a significant ocular morbidity. Globally, COVID-19 vaccines are recommended; however, the vaccine safety data are limited. Case report Herein, we reported a case of herpetic keratitis reactivation that occurred 2 days after receiving SARS-CoV-2 mRNA vaccine. The patient is a 50-year-old man who underwent penetrating keratoplasty (PKP) in 2020 for corneal opacity caused by a previous herpes simplex keratitis in 2013. Herpetic keratitis was treated successfully with topical antiviral acyclovir along with topical moxifloxacin and artificial tears. After treatment, prophylactic oral acyclovir was started. Conclusion Both ophthalmologist and patients should be aware of this phenomenon. Long-term prophylactic antiviral treatment may be recommended for those patients.
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Affiliation(s)
- Rami A Al-Dwairi
- Department of Special Surgery, Division of Ophthalmology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Abdelwahab Aleshawi
- Department of Special Surgery, Division of Ophthalmology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Sharaf Adi
- Department of Special Surgery, Division of Ophthalmology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Laith Abu-Zreig
- Department of Special Surgery, Division of Ophthalmology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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Ortiz-Egea JM, Sánchez CG, López-Jiménez A, Navarro OD. Herpetic anterior uveitis following Pfizer-BioNTech coronavirus disease 2019 vaccine: two case reports. J Med Case Rep 2022; 16:127. [PMID: 35337364 PMCID: PMC8949824 DOI: 10.1186/s13256-022-03350-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 03/01/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To describe two cases of herpetic anterior uveitis after inoculation of the first dose of Pfizer–BioNTech coronavirus disease 2019 vaccine. Methods Case 1: a healthy 92-year-old Caucasian woman developed symptomatic unilateral anterior uveitis for 3 days after Pfizer–BioNTech coronavirus disease 2019 vaccination (Pfizer Inc.). The episode fully resolved with topical and oral antiviral treatment. Case 2: a previously healthy 85-year-old Caucasian woman with left hemicranial signs of herpes zoster infection, associated with herpetic keratouveitis for 3 days after Pfizer–BioNTech coronavirus disease 2019 vaccination. Treatment with topical antibiotics and both oral and topical antiherpetic medication was administered, and she recovered successfully in 5 weeks. Conclusion Clinicians should be aware of the possibility of eye inflammation in the form of herpetic reactivation after coronavirus disease 2019 vaccination.
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Affiliation(s)
- José Manuel Ortiz-Egea
- Ophthalmology Department, Complejo Hospitalario Universitario de Albacete, Albacete, Spain.
| | - Cristina Gómez Sánchez
- Ophthalmology Department, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Andrés López-Jiménez
- Ophthalmology Department, Hospital General Universitario Reina Sofía de Murcia, Murcia, Spain
| | - Olga Diego Navarro
- Ophthalmology Department, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
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Gringeri M, Battini V, Cammarata G, Mosini G, Guarnieri G, Leoni C, Pozzi M, Radice S, Clementi E, Carnovale C. Herpes zoster and simplex reactivation following COVID-19 vaccination: new insights from a vaccine adverse event reporting system (VAERS) database analysis. Expert Rev Vaccines 2022; 21:675-684. [PMID: 35191364 DOI: 10.1080/14760584.2022.2044799] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND A few cases of Herpes Zoster and Simplex reactivation following COVID-19 immunization have been recently described, but the real extent of this suspected adverse event has not been elucidated yet. METHODS We performed a nested case/control study by using the U.S. Vaccine Adverse Event Reporting System database. We carried out a case-level clinical review of all Herpes reactivation cases following the administration of COVID-19 vaccines. For cases and controls, significance was set at P = 0.05, differential risk of reporting was assessed for each vaccine as reporting odds ratio and incidence was estimated based on the total number of vaccine doses administered. RESULTS Of 6,195 cases included in the analysis (5,934 and 273 reporting Herpes Zoster and Herpes Simplex, respectively) over 90% were non-serious. We found a slightly higher risk of reporting both for Zoster (ROR = 1.49) and Simplex (ROR = 1.51) infections following the Pfizer-BioNTech vaccine. The estimated incidence was approximately 0.7/100,000 and 0.03/100,000 for Zoster and Simplex, respectively. CONCLUSIONS The paucity of cases (almost all of non-serious nature) makes the potential occurrence of this adverse effect negligible from clinical standpoints, thus supporting the good safety profile of the COVID-19 vaccination, which remains strongly recommended.
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Affiliation(s)
- Michele Gringeri
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences L. Sacco, "Luigi Sacco" University Hospital, University of Milan, Milano, Italy
| | - Vera Battini
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences L. Sacco, "Luigi Sacco" University Hospital, University of Milan, Milano, Italy
| | - Gianluca Cammarata
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences L. Sacco, "Luigi Sacco" University Hospital, University of Milan, Milano, Italy
| | - Giulia Mosini
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences L. Sacco, "Luigi Sacco" University Hospital, University of Milan, Milano, Italy
| | - Greta Guarnieri
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences L. Sacco, "Luigi Sacco" University Hospital, University of Milan, Milano, Italy
| | - Chiara Leoni
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences L. Sacco, "Luigi Sacco" University Hospital, University of Milan, Milano, Italy
| | - Marco Pozzi
- Scientific Institute, IRCCS E. Medea, Bosisio Parini, LC, Italy
| | - Sonia Radice
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences L. Sacco, "Luigi Sacco" University Hospital, University of Milan, Milano, Italy
| | - Emilio Clementi
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences L. Sacco, "Luigi Sacco" University Hospital, University of Milan, Milano, Italy.,Scientific Institute, IRCCS E. Medea, Bosisio Parini, LC, Italy
| | - Carla Carnovale
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences L. Sacco, "Luigi Sacco" University Hospital, University of Milan, Milano, Italy
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Herpetic Keratitis Preceded by COVID-19 Vaccination. Vaccines (Basel) 2021; 9:vaccines9121394. [PMID: 34960139 PMCID: PMC8707988 DOI: 10.3390/vaccines9121394] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/18/2021] [Accepted: 11/22/2021] [Indexed: 01/14/2023] Open
Abstract
The global Coronavirus Disease 2019 (COVID-19) pandemic has accelerated vaccine development at an unprecedented rate. A large population of people have received COVID-19 vaccines, while the vaccine safety data are limited. Here, we reported two cases of herpetic keratitis that occurred soon after receiving the inactivated COVID-19 vaccines. Case 1 was a 60-year-old woman who underwent penetrating keratoplasty (PKP) one year ago for corneal scarring caused by herpes simplex keratitis (HSK), and case 2 was a 51-year-old man with an unremarkable medical history. Both patients developed herpetic keratitis (HSK and varicella-zoster virus corneal endotheliitis, respectively) soon after receiving the inactivated COVID-19 vaccines (Sinovac). Herpetic keratitis was treated successfully with topical or plus oral antiviral ganciclovir. The short latency time in these two cases suggested that an inactivated COVID-19 vaccine may have a risk of triggering ocular herpes virus reactivation. Both clinicians and patients should be aware of this phenomenon. However, a causal relationship awaits confirmation.
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Richardson-May J, Rothwell A, Rashid M. Reactivation of herpes simplex keratitis following vaccination for COVID-19. BMJ Case Rep 2021; 14:14/9/e245792. [PMID: 34493563 PMCID: PMC8424829 DOI: 10.1136/bcr-2021-245792] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
An 82-year-old man with a history of herpes simplex keratitis 40 years previously presented with recurrence, 1 day following vaccination for novel COVID-19. His condition worsened despite topical treatment with ganciclovir gel. A diagnosis of herpetic stromal keratitis was made, requiring systemic aciclovir, topical prednisolone, moxifloxacin and atropine, and oral doxycycline. He improved clinically on treatment, with some residual corneal scarring. Visual acuity improved from 6/36 corrected at presentation, to 6/24 following treatment. Clearly, public and personal health benefits from vaccination are hugely important and we would not suggest avoiding vaccination in such patients. It is, however, important for ophthalmic providers to be aware of the rare potential for reactivation of herpetic eye disease following vaccination to enable prompt diagnosis and treatment.
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Affiliation(s)
- James Richardson-May
- Ophthalmology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Alice Rothwell
- Ophthalmology, University Hospitals Dorset NHS Foundation Trust, Bournemouth, UK
| | - Mohammed Rashid
- Ophthalmology, University Hospitals Dorset NHS Foundation Trust, Bournemouth, UK
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Shafi A, Nguyen T, Peyvandipour A, Draghici S. GSMA: an approach to identify robust global and test Gene Signatures using Meta-Analysis. Bioinformatics 2019; 36:487-495. [PMID: 31329248 PMCID: PMC7869776 DOI: 10.1093/bioinformatics/btz561] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 12/10/2018] [Accepted: 07/16/2019] [Indexed: 01/31/2023] Open
Abstract
MOTIVATION Recent advances in biomedical research have made massive amount of transcriptomic data available in public repositories from different sources. Due to the heterogeneity present in the individual experiments, identifying reproducible biomarkers for a given disease from multiple independent studies has become a major challenge. The widely used meta-analysis approaches, such as Fisher's method, Stouffer's method, minP and maxP, have at least two major limitations: (i) they are sensitive to outliers, and (ii) they perform only one statistical test for each individual study, and hence do not fully utilize the potential sample size to gain statistical power. RESULTS Here, we propose a gene-level meta-analysis framework that overcomes these limitations and identifies a gene signature that is reliable and reproducible across multiple independent studies of a given disease. The approach provides a comprehensive global signature that can be used to understand the underlying biological phenomena, and a smaller test signature that can be used to classify future samples of a given disease. We demonstrate the utility of the framework by constructing disease signatures for influenza and Alzheimer's disease using nine datasets including 1108 individuals. These signatures are then validated on 12 independent datasets including 912 individuals. The results indicate that the proposed approach performs better than the majority of the existing meta-analysis approaches in terms of both sensitivity as well as specificity. The proposed signatures could be further used in diagnosis, prognosis and identification of therapeutic targets. SUPPLEMENTARY INFORMATION Supplementary data are available at Bioinformatics online.
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Affiliation(s)
- Adib Shafi
- Department of Computer Science, Wayne State University, Detroit, MI 48202, USA
| | - Tin Nguyen
- Department of Computer Science and Engineering, University of Nevada, Reno, NV 89557, USA
| | - Azam Peyvandipour
- Department of Computer Science, Wayne State University, Detroit, MI 48202, USA
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