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Kimpel J, Rössler A, Bante D, Borena W, von Laer D, Zehetner C, Rauchegger T, Seiwald S, Falkensammer B. Detection of infectious SARS-CoV-2 in ocular samples is linked to viral load in the nasopharynx. Front Cell Infect Microbiol 2024; 14:1332157. [PMID: 38500504 PMCID: PMC10946250 DOI: 10.3389/fcimb.2024.1332157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/05/2024] [Indexed: 03/20/2024] Open
Abstract
Introduction SARS-CoV-2 is known to infect respiratory tissue cells. However, less is known about infection of ocular tissue and potential infectivity of lacrimal fluid. With this study, we want to compare viral loads in eye and nasopharyngeal swabs and analyze these for infectious virus. Methods Between May 2020 and April 2021 ocular and nasopharyngeal swabs were collected from 28 SARS-CoV-2 infected patients treated on the corona virus disease 2019 (COVID-19)-ward of the University Hospital of Innsbruck, Austria. Samples with PCR detectable SARS-CoV-2 were analyzed via whole genome sequencing and an attempt was made to isolate infectious virus. Results At the time point of sample collection, 22 individuals were still PCR positive in nasopharyngeal samples and in 6 of these patients one or both ocular samples were additionally positive. CT-values in eyes were generally higher compared to corresponding nasopharyngeal samples and we observed a tendency for lower CT-values, i.e. increased viral load, in nasopharyngeal swabs of individuals with at least one infected eye, compared to those where ocular samples were PCR negative. Ocular and nasopharyngeal sequences from the same patient were assigned to the same variant, either the D614G or the Alpha variant. Infectious virus was successfully isolated from 9 nasopharyngeal swabs, however only from one of the seven PCR positive ocular samples. Conclusion We could detect SARS-CoV-2 in eyes of some of the infected patients albeit at lower levels compared to nasopharyngeal swabs. However, our results also indicate that lacrimal fluid might be infectious in patients with high viral load.
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Affiliation(s)
- Janine Kimpel
- Institute of Virology, Medical University of Innsbruck, Innsbruck, Austria
| | - Annika Rössler
- Institute of Virology, Medical University of Innsbruck, Innsbruck, Austria
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - David Bante
- Institute of Virology, Medical University of Innsbruck, Innsbruck, Austria
| | - Wegene Borena
- Institute of Virology, Medical University of Innsbruck, Innsbruck, Austria
| | - Dorothee von Laer
- Institute of Virology, Medical University of Innsbruck, Innsbruck, Austria
| | - Claus Zehetner
- Department of Ophthalmology, Medical University of Innsbruck, Innsbruck, Austria
| | - Teresa Rauchegger
- Department of Ophthalmology, Medical University of Innsbruck, Innsbruck, Austria
| | - Stefanie Seiwald
- Department of Internal Medicine III, Medical University of Innsbruck, Innsbruck, Austria
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Bansal R, Bora I, Kanta P, Singh MP, Angrup A, Suri V, Mohindra R, Jaswal S, Meena SC, Bhalla A, Malhotra P, Gupta V, Ray P. Cycle threshold values of SARS-CoV-2 RNA in conjunctival swabs and nasopharyngeal secretions: a comparative study from a tertiary care center in India. Int Ophthalmol 2024; 44:29. [PMID: 38329577 DOI: 10.1007/s10792-024-02976-3] [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: 03/07/2023] [Accepted: 10/29/2023] [Indexed: 02/09/2024]
Abstract
PURPOSE To detect the viral RNA load of SARS-CoV-2 in conjunctival swabs of COVID-19 patients, and compare with nasopharyngeal swabs. METHODS Conjunctival swabs of COVID-19 patients (with PCR positive nasopharyngeal swabs) were subjected to quantitative reverse transcription-polymerase chain reaction (RT-PCR) for detection of SARS-CoV-2 RNA. The cycle threshold (Ct) values of Open Reading Frame 1 (ORF 1 Ab gene) and nucleoprotein (N gene) PCRs were used to assess the viral RNA load, and compare them with the baseline values of nasopharyngeal swabs. RESULTS Of 93 patients, 17 (18.27%) demonstrated SARS-CoV-2 RNA in conjunctival swabs. Baseline nasopharyngeal swabs were collected at a median of 2 days; while, the conjunctival swabs were collected at median 7 days, from onset of illness (p < 0.001). Despite a significant delay in conjunctival swab collection than nasopharyngeal swabs, the Ct values (ORF or N gene PCRs) were comparable between nasopharyngeal swab and conjunctival swab samples. Subsequently, during the recovery period, in four of these 17 patients (with conjunctival swab positivity), when the second nasopharyngeal swab was 'negative', the conjunctival swab was 'positive'. CONCLUSION The conjunctival swabs demonstrated SARS-CoV-2 RNA in 17 (18.27%) of 93 COVID-19 patients. Our results may suggest a delayed or a prolonged shedding of the virus/viral RNA on the ocular surface than in nasopharyngeal mucosa.
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Affiliation(s)
- Reema Bansal
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
| | - Ishani Bora
- Department of Virology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Poonam Kanta
- Department of Virology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Mini P Singh
- Department of Virology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Archana Angrup
- Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Vikas Suri
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ritin Mohindra
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sanjay Jaswal
- Department of Anesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Shyam Charan Meena
- Department of Anesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ashish Bhalla
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Pankaj Malhotra
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Vishali Gupta
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Pallab Ray
- Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Poças IM, Lino P, Silva C, Mendonça P, Cunha JP, Barroqueiro O, Carvalho F, Nicho I, Castelhano M, Condado P, Carmo R, Almeida J, Prieto I, Camacho P. Ocular repercussions in COVID-19 patients: structural changes of the retina and choroid. Strabismus 2023; 31:271-280. [PMID: 38053303 DOI: 10.1080/09273972.2023.2278639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
BACKGROUND Neurotropic capabilities of SARS-COVs allow viruses to reach the central nervous system by hematogenous neuronal dissemination. The human retina, as an extension of the Central Nervous System, may have some neurodegenerative and/or vascular modifications related to COVID-19. OBJECTIVES To evaluate choroidal and inner neural layers in participants previously recovered from COVID-19 compared to the control group using optical coherence tomography. METHODS With a cross-sectional approach, the sample (n = 96), constituted by patients who have recovered from COVID-19 (n = 56) and healthy participants control group (n = 40) were ophthalmologically characterized. The neurodegenerative and vascular histological assessment was performed using SD-OCT and the mean thickness was measured in Early Treatment Diabetic Retinopathy Study (ETDRS) subfields. Retinal nerve fiber layer, Ganglion cell layer and subfoveal choroidal thickness were obtained through semi-automatic measurement. RESULTS A total of 40 controls (27 women [67.5%]) and 56 COVID-19 participants (34 women [60.8%]) were included in this first report. There were retinal thickness significant differences in nearly all inner ETDRS subfields: nasal 3 mm (p = .025), I3 (p = .049), and temporal 3 mm (p = .009). Also, a decrease in neural layers was found in the nasal 3 mm (p = .049) and temporal 3 mm (p = .029) during ganglion cell layer assessment. The peripapillary retinal nerve fiber layer thickness was thinner in the COVID-19 group in superior temporal (p = .019), nasal (p = .002), inferior temporal (p = .046) and global (p = .014). Concerning the subfoveal choroidal measurement, an increase was observed in the COVID-19 group (p = .002). CONCLUSION Participants who had recovered from COVID-19 showed a non-glaucomatous neuropathy trend pattern. We found differences closer to the classic description of the "bow-tie" observed in other neurological as compressive neuropathies at the chiasma location. OCT assessment also showed an increase in choroidal thickness as a result of vascular changes.
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Affiliation(s)
- Ilda Maria Poças
- Departamento das Ciências da Terapia e Reabilitação, Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Lisbon, Portugal
| | - Pedro Lino
- Departamento de Oftalmologia, Hospital Professor Doutor Fernando Fonseca, EPE, Amadora, Portugal
| | - Carina Silva
- Departamento das Ciências Exatas, da Vida Sociais e Humanas, Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Lisboa, Portugal
- H&TRC- Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Lisboa, Portugal
| | - Paula Mendonça
- H&TRC- Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Lisboa, Portugal
- Departamento das Ciências do Diagnóstico, Terapêutica e Saúde Pública, Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Lisboa, Portugal
| | - João Paulo Cunha
- Departamento das Ciências da Terapia e Reabilitação, Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Lisbon, Portugal
- Departamento de Oftalmologia, Hospital Cuf Cascais, Cascais Municipality, Portugal
| | - Olga Barroqueiro
- Departamento de Oftalmologia, Hospital Professor Doutor Fernando Fonseca, EPE, Amadora, Portugal
| | - Francisca Carvalho
- Departamento de Oftalmologia, Hospital Cuf Cascais, Cascais Municipality, Portugal
| | - Inês Nicho
- Departamento de Oftalmologia, Hospital Professor Doutor Fernando Fonseca, EPE, Amadora, Portugal
| | - Mariana Castelhano
- Departamento de Oftalmologia, Hospital Cuf Cascais, Cascais Municipality, Portugal
| | - Patrícia Condado
- Departamento de Oftalmologia, Hospital Professor Doutor Fernando Fonseca, EPE, Amadora, Portugal
| | - Rita Carmo
- Departamento de Oftalmologia, Hospital Professor Doutor Fernando Fonseca, EPE, Amadora, Portugal
| | - Júlio Almeida
- Departamento de Oftalmologia, Hospital Professor Doutor Fernando Fonseca, EPE, Amadora, Portugal
| | - Isabel Prieto
- Departamento de Oftalmologia, Hospital Professor Doutor Fernando Fonseca, EPE, Amadora, Portugal
| | - Pedro Camacho
- Departamento das Ciências da Terapia e Reabilitação, Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Lisbon, Portugal
- H&TRC- Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Lisboa, Portugal
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Rishi E, Thomas J, Fashina T, Kim L, Yeh S. Emerging Pathogenic Viral Infections of the Eye. Annu Rev Vis Sci 2023; 9:71-89. [PMID: 37018917 DOI: 10.1146/annurev-vision-100820-010504] [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] [Indexed: 04/07/2023]
Abstract
Global health security threats and the public health impact resulting from emerging infectious diseases including the ongoing COVID-19 pandemic and recent Ebola virus disease outbreaks continuously emphasize the need for a comprehensive approach to preparedness, management of disease outbreaks, and health sequelae associated with emergent pathogens. A spectrum of associated ophthalmic manifestations, along with the potential persistence of emerging viral pathogens in ocular tissues, highlight the importance of an ophthalmic approach to contributing to efforts in the response to public health emergencies from disease outbreaks. This article summarizes the ophthalmic and systemic findings, epidemiology, and therapeutics for emerging viral pathogens identified by the World Health Organization as high-priority pathogens with epidemic potential.
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Affiliation(s)
- Ekta Rishi
- Department of Ophthalmology and Visual Sciences, Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, Nebraska, USA; , ,
| | | | - Tolulope Fashina
- Department of Ophthalmology and Visual Sciences, Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, Nebraska, USA; , ,
| | - Lucas Kim
- Mercer University School of Medicine, Augusta, Georgia, USA;
| | - Steven Yeh
- Department of Ophthalmology and Visual Sciences, Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, Nebraska, USA; , ,
- Global Center for Health Security, University of Nebraska Medical Center, Omaha, Nebraska, USA
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Singh K, Pattebahadur R, Shete V, Bang P, Mishra M, Gade N. The Characteristics of Ocular Findings and the Presence of SARS-CoV-2 in the Tears of Coronavirus Disease 2019 Patients. Cureus 2023; 15:e44589. [PMID: 37795067 PMCID: PMC10545887 DOI: 10.7759/cureus.44589] [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: 09/01/2023] [Indexed: 10/06/2023] Open
Abstract
Purpose The purpose of the study is to observe the characteristics of ocular manifestations in coronavirus disease 2019 (COVID-19) patients and to analyze the presence of severe acute respiratory syndrome coronavirus 2 ribonucleic acid (SARS-CoV-2 RNA) in the tears of patients with moderate-to-severe COVID-19. Material and methods We conducted this prospective cross-sectional study from February to June 2021 at the All India Institute of Medical Sciences, one of the tertiary eye care centers in Nagpur, India. The study included confirmed COVID-19 patients based on real-time reverse transcription-polymerase chain reaction (RT-PCR) nasopharyngeal swabs, whether or not the patients exhibited ocular symptoms. We recorded detailed information regarding the patients' history, including demographic profile, ocular symptoms, systemic symptoms, and radiologic findings. We collected ocular samples within 48 hours of collecting naso-oropharyngeal samples from the patients' eyes. We used conjunctival swabs to obtain tear samples, which we then placed in viral transport media (VTM) for cold chain transportation to the microbiology department. We performed RT-PCR on the tear samples to detect the presence of the SARS-CoV-2 virus. Result We included 40 patients in the study, with 26 (65%) classified as having moderate COVID-19, six (15%) classified as having severe COVID-19, and the remaining having mild COVID-19. Out of the 40 patients, five (12%) tested positive for SARS-CoV-2 in the tear sample using RT-PCR, seven (17%) exhibited ocular signs and symptoms, and only one tested positive for SARS-CoV-2 in their tears. The ocular manifestations observed in COVID-19 patients included dry eye, conjunctivitis (including conjunctival hyperemia and epiphora), and lid edema. Notably, we detected a positive COVID-19 tear sample in patients both with and without ocular symptoms. Conclusion Limited reports have focused on ocular involvement in patients with COVID-19. However, our study demonstrates the detection of SARS-CoV-2 in conjunctival swabs from confirmed COVID-19 patients, albeit with a lower positivity rate. Despite the low prevalence of the virus found in tears, there is a potential risk of transmission through ocular routes. It is noteworthy that we observed a COVID-19-positive tear sample in patients with and without ocular symptoms. Therefore, it is important to consider the possibility of ocular transmission even in the absence of ocular manifestations. Medical personnel should take careful precautions during ocular examinations of patients diagnosed with COVID-19 to minimize the risk of transmission.
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Affiliation(s)
- Kanishk Singh
- Ophthalmology, All India Institute of Medical Sciences, Nagpur, IND
| | | | - Vishal Shete
- Microbiology, All India Institute of Medical Sciences, Nagpur, IND
| | - Puja Bang
- Ophthalmology, All India Institute of Medical Sciences, Nagpur, IND
| | - Meena Mishra
- Microbiology, All India Institute of Medical Sciences, Nagpur, IND
| | - Neeta Gade
- Microbiology, All India Institute of Medical Sciences, Nagpur, IND
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Paez-Escamilla M, Caplash S, Kalra G, Odden J, Price D, Marroquin OC, Koscumb S, Commiskey P, Indermill C, Finkelstein J, Gushchin AG, Coca A, Friberg TR, Eller AW, Gallagher DS, Harwick JC, Waxman EL, Chhablani J, Bonhomme G, Prensky C, Anetakis AJ, Martel JN, Massicotte E, Ores R, Girmens JF, Pearce TM, Sahel JA, Dansingani K, Westcott M, Errera MH. Challenges in posterior uveitis-tips and tricks for the retina specialist. J Ophthalmic Inflamm Infect 2023; 13:35. [PMID: 37589912 PMCID: PMC10435440 DOI: 10.1186/s12348-023-00342-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 04/07/2023] [Indexed: 08/18/2023] Open
Abstract
PURPOSE Posterior uveitis is a common chorioretinal pathology affecting all ages worldwide and is a frequent reason for referral to the retina clinic. The spectrum of etiologies for uveitis is very broad and includes infectious and auto-immune diseases. Inflammation can be confined to the eye or may be a part of systemic disease. A useful outline is therefore proposed to aid in the correct diagnosis of these challenging entities. The situation is further complicated by the fact that many neoplastic conditions resemble features of posterior uveitis; they are known as "masqueraders of uveitis". Here, we summarize different posterior uveitides that present with rare findings, along with masqueraders that can be difficult to distinguish. These conditions pose a diagnostic dilemma resulting in delay in treatment because of diagnostic uncertainty. METHODS An extensive literature search was performed on the MEDLINE/PUBMED, EBSCO and Cochrane CENTRAL databases from January 1985 to January 2022 for original studies and reviews of predetermined diagnoses that include posterior uveitic entities, panuveitis and masquerade syndromes. RESULTS We described conditions that can present as mimickers of posterior uveitis (i.e., immune check-points inhibitors and Vogt-Koyanagi-Harada-like uveitis; leukemia and lymphoma associated posterior uveitis), inflammatory conditions that present as mimickers of retinal diseases (i.e., Purtscher-like retinopathy as a presentation of systemic lupus erythematosus; central serous chorioretinopathy masquerading inflammatory exudative retinal detachment), and uveitic conditions with rare and diagnostically challenging etiologies (i.e., paradoxical inflammatory effects of anti-TNF-α; post vaccination uveitis; ocular inflammation after intravitreal injection of antiangiogenic drugs). CONCLUSION This review of unique posterior uveitis cases highlights the overlapping features of posterior uveitis (paradoxical inflammatory effects of anti -TNF α and uveitis; Purtscher-like retinopathy as a presentation of systemic lupus erythematosus, …) and the nature of retinal conditions (ischemic ocular syndrome, or central retinal vein occlusion, amyloidosis, inherited conditions like retinitis pigmentosa, autosomal dominant neovascular inflammatory vitreoretinopathy (ADNIV), etc.…) that may mimic them is represented. Careful review of past uveitis history, current medications and recent vaccinations, detailed examination of signs of past or present inflammation, eventually genetic testing and/ or multimodal retinal imaging (like fluorescein angiography, EDI-OCT, OCT-angiography for lupus Purtscher-like retinopathy evaluation, or ICG for central serous retinopathy, or retinal amyloid angiopathy) may aid in correct diagnosis.
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Affiliation(s)
- Manuel Paez-Escamilla
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Sonny Caplash
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Gagan Kalra
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jamie Odden
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Danielle Price
- Clinical Analytics, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Stephen Koscumb
- Clinical Analytics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Patrick Commiskey
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Chad Indermill
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jerome Finkelstein
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Anna G Gushchin
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Andreea Coca
- Department of Rheumatology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Thomas R Friberg
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Andrew W Eller
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Denise S Gallagher
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jean C Harwick
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Evan L Waxman
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jay Chhablani
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Gabrielle Bonhomme
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Colin Prensky
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Alexander J Anetakis
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Joseph N Martel
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Erika Massicotte
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Raphaelle Ores
- Department of Ophthalmology, McGill University Campus Outaouais, Gatineau, QC, Canada
| | | | - Thomas M Pearce
- Division of Neuropathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Jose-Alain Sahel
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kunal Dansingani
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Mark Westcott
- Department of Uveitis, Moorfields Eye Hospital, NHS Foundation Trust, London, UK
| | - Marie-Helene Errera
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
- UPMC Eye Center, University of Pittsburgh School of Medicine, 203 Lothrop Street, Pittsburgh, PA, 15213, USA.
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Ali A, Waqar M, Akram A, Rafique S, Rehman G, Idrees M, Halim SA, Waqas M, Uddin J, Gojayev A, Khan A, Al-Harrasi A. Seroprevalence of SARS-CoV-2: Insights into the epidemiology of the pandemic. J Infect Public Health 2023; 16:1256-1261. [PMID: 37300952 DOI: 10.1016/j.jiph.2023.05.036] [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: 03/31/2023] [Revised: 05/18/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023] Open
Abstract
AIM This study aimed to assess the seroprevalence of SARS-CoV-2 and disease symptoms in Malakand, Pakistan. MATERIALS & METHOD 623 samples with suspected SARS-CoV-2 were collected from different regions of Malakand and analyzed to detect SARS-CoV-2 IgG antibodies using ELISA. RESULTS 306 (49.1%) 0 f 623 patients were anti-SARS-CoV-2 IgG reactive, with a higher prevalence in males (75%) than females (25%). In this study, we enrolled two groups, subjects working in a non-medical setting and subjects working in a medical setting. Clinical symptoms were statistically linked with SARS-CoV-2. Four weeks of follow-up analysis of IgG titers in health care workers showed an increase in IgG antibodies titer. CONCLUSION This study gives insights into the community-based spread of SARS-CoV-2 infection, associated immunity, and herd immunity in the studied population. This study can provide insights to the government about early vaccination of this population as most of the population is not yet vaccinated.
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Affiliation(s)
- Amjad Ali
- Department of Biotechnology and Genetic Engineering, Hazara University Mansehra, Khyber Pakhtunkhwa, Pakistan
| | - Muhammad Waqar
- Genome Centre for Molecular Based Diagnostics & Research (GCMBDR) Lahore, Lahore, Pakistan; Department of Biotechnology Quaid-e-Azam University Islamabad, Pakistan
| | - Ayesha Akram
- Molecular Virology laboratory Centre for Applied Molecular Biology (CAMB), University of the Punjab, 87-West Canal Bank Road Thokar Niaz Baig, Lahore, Pakistan
| | - Shazia Rafique
- Division of Molecular Virology, Centre of Excellence in Molecular Biology (CEMB), University of the Punjab, 87-West Canal Bank Road Thokar Niaz Baig, Lahore, Pakistan
| | - Gauhar Rehman
- Category-D Hospital Talash Dir Lower, Malakand Division, Khyber Pakhtunkhwa, Pakistan
| | - Muhammad Idrees
- Genome Centre for Molecular Based Diagnostics & Research (GCMBDR) Lahore, Lahore, Pakistan; Division of Molecular Virology, Centre of Excellence in Molecular Biology (CEMB), University of the Punjab, 87-West Canal Bank Road Thokar Niaz Baig, Lahore, Pakistan; Vice Chancellor of University of Peshawar, Khyber Pakhtunkhwa, Pakistan.
| | - Sobia Ahsan Halim
- Natural and Medical Sciences Research Center, University of Nizwa, Birkat-Al-Mou, 616, PO Box 33, Nizwa, Sultanate of Oman
| | - Muhammad Waqas
- Department of Biotechnology and Genetic Engineering, Hazara University Mansehra, Khyber Pakhtunkhwa, Pakistan; Natural and Medical Sciences Research Center, University of Nizwa, Birkat-Al-Mou, 616, PO Box 33, Nizwa, Sultanate of Oman
| | - Jalal Uddin
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Khalid University, Abha 62529, Kingdom of Saudi Arabia
| | - Anar Gojayev
- School of Education, General Education Program, ADA University, Ahmadbey Aghaoghlu str. 11, Baku AZ1008, Azerbaijan
| | - Ajmal Khan
- Natural and Medical Sciences Research Center, University of Nizwa, Birkat-Al-Mou, 616, PO Box 33, Nizwa, Sultanate of Oman.
| | - Ahmed Al-Harrasi
- Natural and Medical Sciences Research Center, University of Nizwa, Birkat-Al-Mou, 616, PO Box 33, Nizwa, Sultanate of Oman.
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8
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Habot-Wilner Z, Neri P, Okada AA, Agrawal R, Xin Le N, Cohen S, Fischer N, Kilmartin F, Coman A, Kilmartin D. COVID Vaccine-Associated Uveitis. Ocul Immunol Inflamm 2023:1-8. [PMID: 37145198 DOI: 10.1080/09273948.2023.2200858] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
PURPOSE Following the pandemic of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2, different vaccines were developed and approved by the main medical authorities under emergency protocol regulations. Although highly effective and well-tolerated in most patients, vaccines can uncommonly cause ocular adverse effects. In this article, the current evidence related to vaccine-associated uveitis is reviewed. METHODS A literature review of uveitis post various SARS-CoV-2 vaccinations. RESULTS Uveitis was reported following various forms of vaccinations but was more commonly seen following the Pfizer mRNA vaccine which is the most used vaccination worldwide. In western countries, the most common uveitis is mild anterior uveitis, developing within a week of first or subsequent vaccination with good resolution following appropriate topical steroid therapy in most cases. Posterior uveitis and particularly Vogt-Koyanagi-Harada disease was more prevalent in Asia. Uveitis may develop among known uveitis patients and those with other autoimmune diseases. CONCLUSION Uveitis following Covid vaccinations is uncommon and has a good prognosis.
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Affiliation(s)
- Zohar Habot-Wilner
- Division of Ophthalmology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Piergiorgio Neri
- The Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
- Cleveland Lerner College of Medicine, Case Western University, Cleveland, Ohio, USA
- College of Medicine and Health Science, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Annabelle A Okada
- Kyorin Eye Center, Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan
| | - Rupesh Agrawal
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
- Singapore Eye Research Institute, Singapore
- Lee Kong Chian School of Medicine, Singapore
- Eye ACP Program, Duke NUS Medical School, Antimicrobials and Anti-infectives, Singapore Eye Research Institute, Singapore
| | - Ng Xin Le
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
| | - Shai Cohen
- Division of Ophthalmology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Naomi Fischer
- Department of Ophthalmology, Wolfson Medical Center, Holon, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Amy Coman
- University College Dublin Medical School, Dublin, Ireland
- Department of Ophthalmology, Royal Victoria Eye & Ear Hospital, Dublin, Ireland
| | - Dara Kilmartin
- University College Dublin Medical School, Dublin, Ireland
- Department of Ophthalmology, Royal Victoria Eye & Ear Hospital, Dublin, Ireland
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9
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Arslanoglu Aydin E, Ozdel S, Cakar Ozdal P, Bagrul İ, Baglan E, Tuncez S, Bulbul M. Changing face of non-infectious pediatric uveitis in the pre-pandemic and pandemic periods: a comparison study. Postgrad Med 2023; 135:418-423. [PMID: 36851832 DOI: 10.1080/00325481.2023.2184092] [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: 02/24/2023]
Abstract
OBJECTIVE Our aim in this study was to reveal the clinical features of pediatric uveitis in the pandemic period and to compare it with the pre-pandemic era. METHODS This retrospective study included 187 children diagnosed with uveitis between the 11th of March 2017 and the 11th of March 2022. The patients were divided into two groups based on the date of diagnosis as follows; Group 1: Patients diagnosed in the pre-pandemic period (11th March 2017-11th March 2020); Group 2: Patients diagnosed in the pandemic period (12th March 2020-11th March 2022). Demographic data, characteristics of uveitis, underlying diseases, systemic treatment modalities, and complications were compared between the two groups. RESULTS A total of 187 (pre-pandemic 71, and pandemic 114) pediatric uveitis patients were recruited to the study. Fifty one percent (51%) of the patients were female. The number of patients diagnosed with uveitis increased approximately twice during the pandemic period compared to the pre-pandemic period. The frequency of anterior uveitis was found to be significantly higher in the pandemic period than in the pre-pandemic period (p = 0.037). It was mostly presented as symptomatic uveitis. There was a decrease in the diagnosis of JIA-related uveitis. ANA positivity increased in the pandemic period (p = 0.029). The response to treatment was better and the complication rate decreased in the pandemic period. CONCLUSION The present study involved a large number of pediatric patients with uveitis. There are some differences in the characteristics of pediatric uveitis cases comparing the pandemic period and the pre-pandemic period. This increased frequency and changing clinical features of pediatric uveitis seems to be a result of COVID-19 infection.
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Affiliation(s)
- Elif Arslanoglu Aydin
- Department of Pediatric Rheumatology, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Semanur Ozdel
- Department of Pediatric Rheumatology, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Pinar Cakar Ozdal
- Service of Uveitis and Retinal Diseases, Ankara Ulucanlar Eye Research Hospital, Ankara, Turkey
| | - İlknur Bagrul
- Department of Pediatric Rheumatology, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Esra Baglan
- Department of Pediatric Rheumatology, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Serife Tuncez
- Department of Pediatric Rheumatology, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Mehmet Bulbul
- Department of Pediatric Nephrology and Rheumatology, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
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10
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Ozturk M, Kumova D, Alacam S, Erdogan H, Onder F. Detection of coronavirus in tear samples of hospitalized patients with COVID-19. Int Ophthalmol 2023; 43:451-462. [PMID: 35859082 PMCID: PMC9299406 DOI: 10.1007/s10792-022-02442-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 07/07/2022] [Indexed: 01/08/2023]
Abstract
PURPOSE To assess the presence of viral RNA in conjunctival secretions and tears of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected patients in terms of a possible ocular transmission route and also to examine whether a difference between the patients with and without ocular surface positivity existed. METHODS A prospective cross-sectional study of 70 consecutive patients who were hospitalized in Haseki Training and Research Hospital with SARS-CoV-2 from February 1 to April 1, 2021, was performed. Tears and conjunctival secretions were collected within 24 h of nasopharyngeal sample collection and examined for SARS-CoV-2 using reverse transcription real-time polymerase chain reaction (qPCR). The clinical data, results of blood tests and nasopharyngeal and conjunctival swabs, and CT findings were evaluated for all patients. RESULTS Seventy patients (37 males, 33 females) were included in this study. Tear-conjunctival samples from eight patients (11.42%) yielded positive PCR results although these eight patients had no eye symptoms or conjunctivitis. In patients with positive conjunctival PCR results, cycle threshold values for conjunctival samples were higher than those for nasopharyngeal samples. All findings (except gender) were similar between patients with either positive or negative conjunctival swab samples. All patients with positive conjunctival swab samples were male; however, the male ratio in patients with negative conjunctival swab samples was only 46.77%. CONCLUSION In our study, the rate of conjunctival swab PCR positivity was 11.42%. It appears that even in the absence of ocular symptoms, SARS-CoV-2 virus may be present on the ocular surface; therefore, the ocular surface may be a significant viral transmission route.
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Affiliation(s)
- Mine Ozturk
- Department of Ophthalmology, Haseki Training and Research Hospital, University of Health Sciences, Millet Street, 34096, Istanbul, Turkey.
| | - Deniz Kumova
- Department of Ophthalmology, Haseki Training and Research Hospital, University of Health Sciences, Millet Street, 34096 Istanbul, Turkey
| | - Sema Alacam
- Division of Virology, Department of Medical Microbiology, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Hatice Erdogan
- Department of Medical Microbiology, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Feyza Onder
- Department of Ophthalmology, Haseki Training and Research Hospital, University of Health Sciences, Millet Street, 34096 Istanbul, Turkey
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11
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Loskutov IA, Korsakova NV, Lyakhova EA, Poromov AA, Pshenichnaya NY, Maleev VV. [Ophthalmic manifestations of COVID-19]. Vestn Oftalmol 2023; 139:81-88. [PMID: 37942601 DOI: 10.17116/oftalma202313905181] [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] [Indexed: 11/10/2023]
Abstract
In March 2020 the World Health Organization (WHO) declared a pandemic of the novel coronavirus infection (COVID-19) caused by the SARS-CoV-2 respiratory virus. The high spread rate of the virus and the severity of the course of the disease are of great clinical and epidemiological significance, making it relevant for ophthalmologists to study the mechanisms of how SARS-CoV-2 infects ocular structures, as well as possible clinical manifestations of the infection in the organ of vision. This review contains analysis, systematization, and generalization of epidemiological and clinical data on SARS-CoV-2 ocular lesions and was carried out with the data found in scientific abstract databases. The article presents main clinical ophthalmic manifestations of COVID-19, lists the utilized schemes of etiotropic and symptomatic therapy, recommended preventive measures, and considers the possible ophthalmic complications after vaccination against COVID-19.
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Affiliation(s)
- I A Loskutov
- Moscow Regional Research Clinical Institute named after M.F. Vladimirsky, Moscow, Russia
| | - N V Korsakova
- Chuvash State University named after I.N. Ulyanov, Cheboksary, Russia
- Cheboksary branch of S.N. Fedorov National Medical Research Center "MNTK "Eye Microsurgery", Cheboksary, Russia
| | | | - A A Poromov
- I. Mechnikov Research Institute of Vaccines and Sera, Moscow, Russia
| | - N Yu Pshenichnaya
- Central Research Institute of Epidemiology, Moscow, Russia
- National Medical Research Center for Phthisiopulmonology and Infectious Diseases, Moscow, Russia
| | - V V Maleev
- Central Research Institute of Epidemiology, Moscow, Russia
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12
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Kurysheva NI, Pererva OA, Nikitina AD. Eye damage in COVID-19. Part 1: Involvement of the eye in SARS-CoV-2 virus transmission and anterior segment complications. RUSSIAN OPHTHALMOLOGICAL JOURNAL 2022. [DOI: 10.21516/2072-0076-2022-15-4-156-165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In COVID-19, eye damage may develop at any stage of the disease. Viral ribonucleic acid has been found in ocular tissues, but the role of the eye as a route of infection is yet to be substantiated. Ophthalmic manifestations may be a typical feature of COVID-19 infection or they may develop several weeks after recovery. Ophthalmologists should be aware of possible relationships of an ophthalmic pathology with SARS-CoV-2 in order to obtain targeted case history, detect the specific signs, prescribe the necessary tests and thereby reduce the spread of the infection. These relationships are also important for early diagnosis and treatment of complications that threaten the patients’ life and vision. The first part of the review focuses on the possible involvement of the eye in SARS-CoV-2 infection and the spread of infection. Clinical manifestations of the anterior segment damage are considered.
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Affiliation(s)
- N. I. Kurysheva
- Medical Biological University of Innovations and Continuing Education — A.I. Burnazyan Medical Biophysical Center; Ophthalmological Center, Federal Medical and Biological Agency
| | - O. A. Pererva
- Medical Biological University of Innovations and Continuing Education — A.I. Burnazyan Medical Biophysical Center; Ophthalmological Center, Federal Medical and Biological Agency
| | - A. D. Nikitina
- Medical Biological University of Innovations and Continuing Education — A.I. Burnazyan Medical Biophysical Center; Ophthalmological Center, Federal Medical and Biological Agency
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13
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Gavrilova TV, Sergienko AP, Chereshneva MV. COVID-19-associated retinovasculitis in the late stage of HIV infection: a clinical case. RUSSIAN OPHTHALMOLOGICAL JOURNAL 2022. [DOI: 10.21516/2072-0076-2022-15-4-121-125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
A clinical case of retinovasculitis with coronavirus infection COVID-19 involving a female patient in the late stage of HIV infection is reported. The patient had no antiretroviral therapy. Clinical features of eye changes, their severity and dynamics influenced by the ophthalmic therapy were revealed. A relationship between the course of COVID-19 and the state of immunodeficiency causes by HIV was found. As a result of the long disease duration and the complications, the patient died.
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Affiliation(s)
| | | | - M. V. Chereshneva
- Institute of Immunology and Physiology, Ural Branch, Russian Academy of Sciences
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14
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Ocular tropism of SARS-CoV-2 in animal models with retinal inflammation via neuronal invasion following intranasal inoculation. Nat Commun 2022; 13:7675. [PMID: 36509737 PMCID: PMC9743116 DOI: 10.1038/s41467-022-35225-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 11/22/2022] [Indexed: 12/14/2022] Open
Abstract
Although ocular manifestations are reported in patients with COVID-19, consensus on ocular tropism of SARS-CoV-2 is lacking. Here, we infect K18-hACE2 transgenic mice with SARS-CoV-2 using various routes. We observe ocular manifestation and retinal inflammation with production of pro-inflammatory cytokines in the eyes of intranasally (IN)-infected mice. Intratracheal (IT) infection results in dissemination of the virus from the lungs to the brain and eyes via trigeminal and optic nerves. Ocular and neuronal invasions are confirmed using intracerebral (IC) infection. Notably, the eye-dropped (ED) virus does not cause lung infection and becomes undetectable with time. Ocular and neurotropic distribution of the virus in vivo is evident in fluorescence imaging with an infectious clone of SARS-CoV-2-mCherry. The ocular tropic and neuroinvasive characteristics of SARS-CoV-2 are confirmed in wild-type Syrian hamsters. Our data can improve the understanding regarding viral transmission and clinical characteristics of SARS-CoV-2 and help in improving COVID-19 control procedures.
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15
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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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16
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Conjunctival Swabs Reveal Higher Detection Rate Compared to Schirmer Strips for SARS-CoV-2 RNA Detection in Tears of Hospitalized COVID-19 Patients. J Clin Med 2022; 11:jcm11236929. [PMID: 36498504 PMCID: PMC9737489 DOI: 10.3390/jcm11236929] [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] [Received: 10/29/2022] [Revised: 11/15/2022] [Accepted: 11/20/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose: To determine the prevalence of SARS-CoV-2 in tear samples and to investigate whether it correlates with ocular findings and patients’ prognosis in Brazil. Methods: Tears were collected using Schirmer strips (SS) and conjunctival swabs (CS) from patients hospitalized with laboratory-confirmed SARS-CoV-2 infection. Samples were analyzed using qRT-PCR. Demographic and clinical data, ocular symptoms, and Schirmer tests (ST) were collected from patients. Charlson Comorbidity Index (CCI) was used to rate comorbidities, and patients were monitored until hospital discharge or death. Results: There were 61 hospitalized patients, 33 of which were diagnosed with COVID-19. Within the confirmed COVID-19 patients, SARS-CoV-2 was detected in 18.2% (n = 6) of CS and 12.1% (n = 4) of SS samples. Subjective and objective parameters for dry eye syndrome (e.g., ST COVID-19: 8.3 ± 6.4mm, non-COVID-19: 8.9 ± 6.6mm, p > 0.05) were comparable between COVID-19 (n = 33) and non-COVID-19 patients (n = 28). Among the 16 COVID-19 patients exhibiting ocular symptoms, only tearing was reported significantly more frequently when tear samples were positive for SARS-CoV-2 (p < 0.05). Strikingly, patients whose tears tested positive for SARS-CoV-2 had significantly inferior CCI (pos.: 34.0 ± 31.8%, neg.: 67.6 ± 36.4%, p < 0.05) and higher mortality rates (pos.: 50.0%, neg.: 7.4%, p < 0.01). Conclusions: SARS-CoV-2 was detected with a prevalence of 18.2% on the ocular surface. Decreased CCI and increased mortality rate in the positive tear group suggests that viral detection may relate to prognosis and highlight the need of personal protective measures for healthcare professionals. Most of the patients, regardless of COVID-19 diagnosis, had low tear production and eye discomfort, possibly pointing to the need for artificial tear use during hospitalization.
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17
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Zhu R, Yu ZY, Han L. Insights on the possibility of SARS-CoV-2 transmission through the eyes. Int J Ophthalmol 2022; 15:1857-1863. [PMID: 36404966 PMCID: PMC9631193 DOI: 10.18240/ijo.2022.11.18] [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: 04/03/2022] [Accepted: 08/26/2022] [Indexed: 12/12/2022] Open
Abstract
A novel coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or 2019-nCOV), causing coronavirus disease 2019 (COVID-19), has rapidly spread to most countries and regions worldwide since it broke out at the end of 2019. Epidemic of the virus produces a tremendous pressure on the global health systems. With progressive insight into SARS-CoV-2, the role of eye tissue has attracted wide attention in the spread of COVID-19. Whether SARS-CoV-2 can enter the human body through eyes and cause infection? The fact that unprotected exposure of the eyes to 2019-nCoV might have allowed the virus to infect the body implies that 2019-nCOV can invade eye tissue and set foot in organism. Facing the severe challenge of preventing spread of the COVID-19, combined with the high-risk environment of ophthalmology, it is crucial to investigate ocular tropism of coronavirus. This paper explores the possibility of coronavirus transmission through the eye from aspects of probable mechanisms, clinical cases, detection of coronavirus; and puts forward precautions for ophthalmologists and nurses. Consequently, this review reveals our understanding of ocular tropism of coronavirus and contributes to determining risk of ocular transmission, raising awareness of necessary eye protection among medical workers and reducing further prevalence of SARS-CoV-2.
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Affiliation(s)
- Rui Zhu
- Department of Ophthalmology, the Fourth Affiliated Hospital of China Medical University, Shenyang 110005, Liaoning Province, China
- Eye Hospital of China Medical University, Shenyang 110005, Liaoning Province, China
- Key Lens Research Laboratory of Liaoning Province, Shenyang 110005, Liaoning Province, China
- China Medical University, Shenyang 110122, Liaoning Province, China
| | - Zi-Yan Yu
- Department of Ophthalmology, the Fourth Affiliated Hospital of China Medical University, Shenyang 110005, Liaoning Province, China
- Eye Hospital of China Medical University, Shenyang 110005, Liaoning Province, China
- Key Lens Research Laboratory of Liaoning Province, Shenyang 110005, Liaoning Province, China
| | - Lin Han
- Department of Ophthalmology, the Fourth Affiliated Hospital of China Medical University, Shenyang 110005, Liaoning Province, China
- Eye Hospital of China Medical University, Shenyang 110005, Liaoning Province, China
- Key Lens Research Laboratory of Liaoning Province, Shenyang 110005, Liaoning Province, China
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18
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Clinical Experience of an American Academic Ophthalmology Department During the COVID-19 Pandemic. Qual Manag Health Care 2022; 31:267-273. [PMID: 35142730 PMCID: PMC9528806 DOI: 10.1097/qmh.0000000000000358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVES To describe the experience of a large American academic ophthalmology department from the start of the COVID-19 pandemic to the early recovery phase in Summer 2020. METHODS Retrospective review; description of approaches taken by our academic medical center and department regarding supply chain issues, protection of doctors and staff, elimination of nonurgent care, calls for staff and faculty deployment, and reopening. Comparison of surgical and clinic volumes in suburban locations versus the main campus; analysis of volumes compared with pre-pandemic periods. RESULTS At our medical center, screening and precautions (such as the mask policy) continued to evolve from March through August 2020. Ophthalmologists were not allowed to use N95 respirators except in rare circumstances. Surgical and clinic volume dropped at both urban and suburban locations, but surgery rebounded more quickly at suburban surgery centers once elective procedures resumed. Mandates from administration were not always attainable. CONCLUSIONS During respiratory pandemics such as COVID-19, medical centers should adopt protective measures that are consistent across inpatient and outpatient sectors and consistent with other institutions. Our department's large presence outside the urban center where the main hospital is located allowed faster return of clinical care overall. In the event of another pandemic, a central budget rather than individual divisional budgets should be used for purchase of protective equipment for health care workers of an academic center. Because outpatient care provides important continuity of care and keeps patients away from emergency departments and hospitals, perhaps outpatient care does not have to be curtailed to the extent it was in Spring-Summer 2020, provided that outpatient health care workers have sufficient staff and equipment and the above measures are in place.
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19
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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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20
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Çetinkaya T, Kurt MM. Optical biometric measurements in patients with previous COVID-19 treatment. SPEKTRUM DER AUGENHEILKUNDE 2022; 37:1-7. [PMID: 35909991 PMCID: PMC9315324 DOI: 10.1007/s00717-022-00526-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/22/2022] [Indexed: 12/03/2022]
Abstract
Background We aimed to compare optical biometric measurements using optical biometry in patients with previously received COVID-19 treatment and a control group. Methods In this cross-sectional study, patients with previously received COVID-19 treatment formed the COVID-19 group and age- and sex-matched healthy participants formed the control group. Optical biometric measurements including keratometry, corneal astigmatism, astigmatic axis, central corneal thickness, anterior chamber depth, and axial length were made using a Nidek optical biometer (AL-Scan; Nidek Co., Ltd., Japan). Results Measurements of keratometry (p = 0.79), corneal astigmatism (p = 0.41), axial length (p = 0.96), anterior chamber depth (p = 0.59), and central corneal thickness (p = 0.37) were similar between the COVID-19 and control groups. The astigmatic axis type taken from 2.4 mm of the cornea showed significant difference between the two groups (p = 0.02, χ2), while the measurements taken from 3.3 mm of the cornea were similar (p = 0.10, χ2). In the subgroup analysis, axial length, anterior chamber depth, and central corneal thickness measurements were found to be statistically significantly higher in male patients of the COVID-19 group (p = 0.02; p = 0.001; p = 0.02, t test). Conclusion The changes in optical biometric measurements found in our study were due to the fact that COVID-19 is more frequent and severe in males, SARS-CoV‑2 can attach to the cornea via ACE‑2 receptors, and favipiravir can reach the aqueous humor. To our knowledge, there is no study on this subject to date, and therefore more research is needed to shed light on this topic.
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Affiliation(s)
- Tugba Çetinkaya
- Department of Ophthalmology, Gazi State Hospital, 55070 İlkadım/Samsun, Turkey
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21
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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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22
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Chakrabartty I, Khan M, Mahanta S, Chopra H, Dhawan M, Choudhary OP, Bibi S, Mohanta YK, Emran TB. Comparative overview of emerging RNA viruses: Epidemiology, pathogenesis, diagnosis and current treatment. Ann Med Surg (Lond) 2022; 79:103985. [PMID: 35721786 PMCID: PMC9188442 DOI: 10.1016/j.amsu.2022.103985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 02/06/2023] Open
Abstract
From many decades, emerging infections have threatened humanity. The pandemics caused by different CoVs have already claimed and will continue to claim millions of lives. The SARS, Ebola, MERS epidemics and the most recent emergence of COVID-19 pandemic have threatened populations across borders. Since a highly pathogenic CoV has been evolved into the human population in the twenty-first century known as SARS, scientific advancements and innovative methods to tackle these viruses have increased in order to improve response preparedness towards the unpredictable threat posed by these rapidly emerging pathogens. Recently published review articles on SARS-CoV-2 have mainly focused on its pathogenesis, epidemiology and available treatments. However, in this review, we have done a systematic comparison of all three CoVs i.e., SARS, MERS and SARS-CoV-2 along with Ebola and Zika in terms of their epidemiology, virology, clinical features and current treatment strategies. This review focuses on important emerging RNA viruses starting from Zika, Ebola and the CoVs which include SARS, MERS and SARS-CoV-2. Each of these viruses has been elaborated on the basis of their epidemiology, virulence, transmission and treatment. However, special attention has been given to SARS-CoV-2 and the disease caused by it i.e., COVID-19 due to current havoc caused worldwide. At the end, insights into the current understanding of the lessons learned from previous epidemics to combat emerging CoVs have been described. The travel-related viral spread, the unprecedented nosocomial outbreaks and the high case-fatality rates associated with these highly transmissible and pathogenic viruses highlight the need for new prophylactic and therapeutic actions which include but are not limited to clinical indicators, contact tracing, and laboratory investigations as important factors that need to be taken into account in order to arrive at the final conclusion. Recently published review articles on SARS-CoV-2 have mainly focused on its pathogenesis, epidemiology and available treatments. The pandemics caused by different CoVs have already claimed and will continue to claim millions of lives. This review focuses on important emerging RNA viruses starting from Zika, Ebola and the CoVs which include SARS, MERS and SARS-CoV-2. Globally, numerous studies and researchers have recently started fighting this virus.
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Affiliation(s)
- Ishani Chakrabartty
- Department of Applied Biology, School of Biological Sciences, University of Science and Technology Meghalaya (USTM), 9th Mile, Techno City, Baridua, Ri-Bhoi 793101, Meghalaya, India
| | - Maryam Khan
- Department of Biochemistry, Faculty of Life Sciences, Aligarh Muslim University, Aligarh, 202002, U.P, India
| | - Saurov Mahanta
- National Institute of Electronics and Information Technology (NIELIT), Guwahati Centre Guwahati, 781008, Assam, India
| | - Hitesh Chopra
- Chitkara College of Pharmacy, Chitkara University, Rajpura, Punjab, India
| | - Manish Dhawan
- Department of Microbiology, Punjab Agricultural University, Ludhiana, 141004, Punjab, India.,Trafford College, Altrincham, Manchester, WA14 5PQ, UK
| | - Om Prakash Choudhary
- Department of Veterinary Anatomy and Histology, College of Veterinary Sciences and Animal Husbandry, Central Agricultural University (I), Selesih, Aizawl, India
| | - Shabana Bibi
- Department of Biosciences, Shifa Tameer-e-Millat University, Islamabad, Pakistan.,Yunnan Herbal Laboratory, College of Ecology and Environmental Sciences, Yunnan University, Kunming, 650091, China
| | - Yugal Kishore Mohanta
- Department of Applied Biology, School of Biological Sciences, University of Science and Technology Meghalaya (USTM), 9th Mile, Techno City, Baridua, Ri-Bhoi 793101, Meghalaya, India
| | - Talha Bin Emran
- Department of Pharmacy, BGC Trust University Bangladesh, Chittagong, 4381, Bangladesh.,Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka, 1207, Bangladesh
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Aktürk Acar F, Esenülkü MC, Hekimoğlu B. Retinal Findings of Hospitalized Neonates Recovered from COVID-19 Infection: A Prospective, Observational, Descriptive Study. J Trop Pediatr 2022; 68:6588092. [PMID: 35583305 PMCID: PMC9129200 DOI: 10.1093/tropej/fmac036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE Coronavirus disease 2019 (COVID-19) that is caused by severe acute respiratory syndrome coronavirus 2 can cause microvascular alterations that can lead to irreversible complications in multiple tissues and organs. Detrimental effects of COVID-19 on retinal structure have recently been reported in adult population. However, literature data about neonatal population is very scarce. Thus, we aimed to assess possible retinal changes of neonates recovered from COVID-19 infection in this prospective, observational, descriptive study. METHODS The neonates recovered from COVID-19 infection were included to the study between 01 September 2020 and 30 April 2021. Their initial ophthalmological examination was made after a negative real-time reverse transcription-polymerase chain reaction obtained and all patients were re-examined 1 month later. All examinations were performed by same retina specialist using a binocular indirect ophthalmoscopy. RESULTS A total of 15 neonates [9 (60%) male, 6 (40%) female, mean gestational age of 38.9 ± 0.9 weeks (ranging from 37 to 40 week)] were evaluated in the study. The mean age at the time of hospitalization was 17.5 ± 8.7 days (ranging from 2 to 29 days), and the mean duration of hospitalization was 12.5 ± 6.2 days (ranging from 4 to 27 days). Except for one patient with bilateral avascular area in Zone-III, no further retinal manifestation related to COVID-19 was found in the study. CONCLUSION COVID-19 infection can cause retinal damage in neonates. Therefore, these patients should be closely monitored for signs of ocular involvement.
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Affiliation(s)
- Filiz Aktürk Acar
- Division of Neonatology, Department of Pediatrics, Health Sciences University, Kanuni Training and Research Hospital, Trabzon 61000, Turkey,Correspondence: Filiz Aktürk Acar, Division of Neonatology, Department of Pediatrics, Health Sciences University, Kanuni Training and Research Hospital, Trabzon 61000, Turkey. Tel: +90 462 230 23 00. E-mail <>
| | - Mahmut Cenap Esenülkü
- Department of Ophthalmology, Health Sciences University, Kanuni Training and Research Hospital, Trabzon 61000, Turkey
| | - Berna Hekimoğlu
- Division of Neonatology, Department of Pediatrics, Health Sciences University, Kanuni Training and Research Hospital, Trabzon 61000, Turkey
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24
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Ung L, Chodosh J. COVID-19 and the eye: alternative facts The 2022 Bowman Club, David L. Easty lecture. BMJ Open Ophthalmol 2022; 7:bmjophth-2022-001042. [PMID: 35675203 PMCID: PMC9114314 DOI: 10.1136/bmjophth-2022-001042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 04/18/2022] [Indexed: 01/08/2023] Open
Abstract
In addition to catastrophic loss of life, and dramatic and unwanted alterations to the daily lives of those left behind, the COVID-19 pandemic has fostered the publication and dissemination of an unprecedented quantity of peer-reviewed medical and scientific publications on a single subject. In particular, the ophthalmic literature is now replete with clinical and laboratory studies on putative eye involvement by SARS-CoV-2, the aetiologic agent of COVID-19. In this review, we critically appraise the published literature on COVID-19, and suggest that the quality of scientific peer review and editorial decision-making also suffered during the COVID-19 pandemic.
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Affiliation(s)
- Lawson Ung
- Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard University T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - James Chodosh
- Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
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25
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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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26
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Yartsev VD, Atkova EL. [The role of local antiseptics in the prevention of coronavirus infection during endonasal interventions on the lacrimal ducts]. Vestn Otorinolaringol 2022; 87:75-80. [PMID: 35274896 DOI: 10.17116/otorino20228701175] [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: 11/17/2022]
Abstract
In connection with the pandemic of coronavirus infection, it is urgent to develop measures to prevent the intraoperative spread of coronavirus particles and infection of the operating room staff. OBJECTIVE Generalization and analysis of available data concerning local antiseptic therapy for the prevention of coronavirus infection during endonasal interventions on the lacrimal tract. MATERIAL AND METHODS The search for literature sources was carried out using MEDLINE search engines and the Russian Science Citation Index for queries with the keywords "COVID-19", "coronavirus infection", "antiseptics", "protocol for otorhinolaryngological operations", "dacryosurgical operations" and similar in various combinations. RESULTS It has been shown that during endonasal operations on the lacrimal tract, the number of risk factors for infection increases, since these procedures are aerosol-generating, and contact occurs not only with the nasal mucosa, but also with the lacrimal fluid, in which the coronavirus is also replicated. The data on the effectiveness of various antiseptics are summarized, the analysis of the possibility of their use in preoperative preparation for endonasal interventions on the lacrimal tract from the point of view of efficacy and safety is carried out. Information is provided on the proprietary protocol for the use of antiseptics to prevent the spread of coronavirus infection during endonasal dacryocystorhinostomy. It is shown that the preventive use of local disinfectants reduces the number of viral particles on the nasal mucosa, which leads to a decrease in contamination of the surrounding space. Among the available and studied antiseptics, the most suitable is povidone-iodine, which can be used in concentrations up to 1.25% to irrigate the nasal mucosa before surgery with an exposure of 30-60 sec. When performing operations on the lacrimal pathways, it is also advisable to carry out antiseptic treatment of the conjunctival cavity with a 5% solution of povidone-iodine and rinse the lacrimal pathways before the operation with povidone-iodine in a concentration of 0.4%. CONCLUSION To date, information has been obtained that makes it advisable to use antiseptics before performing endonasal aerosol-generating interventions, in particular endonasal dacryocystorhinostomies and recanalization of the tear ducts.
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Affiliation(s)
- V D Yartsev
- Research Institute of Eye Diseases, Moscow, Russia
| | - E L Atkova
- Research Institute of Eye Diseases, Moscow, Russia
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27
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Babushkin AE, Saitova GR, Matyukhina EN. [Viral conjunctivitis as the first sign of COVID-19 infection (clinical observation)]. Vestn Oftalmol 2022; 138:52-56. [PMID: 35234421 DOI: 10.17116/oftalma202213801152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The article presents a case of complicated viral conjunctivitis. Conjunctivitis was the initial sign of the new coronavirus infection (COVID-19) in the patient. The disease had a fairly long course and led to symmetrical scarring in the form of partial external symblepharon and dry eye syndrome. Ophthalmologists should be aware about this disease and its complications. Early treatment with corticosteroids in combination with symptomatic therapy can contribute to prevention of the development of conjunctival scarring. In addition to conjunctival scarring, this disease can possibly potentiate the development of keratitis, optic neuritis, and uveitis.
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28
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Sweet AN, André NM, Stout AE, Licitra BN, Whittaker GR. Clinical and Molecular Relationships between COVID-19 and Feline Infectious Peritonitis (FIP). Viruses 2022; 14:481. [PMID: 35336888 PMCID: PMC8954060 DOI: 10.3390/v14030481] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/09/2022] [Accepted: 02/21/2022] [Indexed: 01/08/2023] Open
Abstract
The emergence of severe acute respiratory syndrome 2 (SARS-CoV-2) has led the medical and scientific community to address questions surrounding the pathogenesis and clinical presentation of COVID-19; however, relevant clinical models outside of humans are still lacking. In felines, a ubiquitous coronavirus, described as feline coronavirus (FCoV), can present as feline infectious peritonitis (FIP)-a leading cause of mortality in young cats that is characterized as a severe, systemic inflammation. The diverse extrapulmonary signs of FIP and rapidly progressive disease course, coupled with a closely related etiologic agent, present a degree of overlap with COVID-19. This paper will explore the molecular and clinical relationships between FIP and COVID-19. While key differences between the two syndromes exist, these similarities support further examination of feline coronaviruses as a naturally occurring clinical model for coronavirus disease in humans.
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Affiliation(s)
- Arjun N. Sweet
- Department of Microbiology & Immunology and Feline Health Center, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA; (A.N.S.); (N.M.A.); (A.E.S.)
- Division of Nutritional Sciences, College of Human Ecology, Cornell University, Ithaca, NY 14853, USA
| | - Nicole M. André
- Department of Microbiology & Immunology and Feline Health Center, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA; (A.N.S.); (N.M.A.); (A.E.S.)
| | - Alison E. Stout
- Department of Microbiology & Immunology and Feline Health Center, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA; (A.N.S.); (N.M.A.); (A.E.S.)
| | - Beth N. Licitra
- Department of Microbiology & Immunology and Feline Health Center, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA; (A.N.S.); (N.M.A.); (A.E.S.)
| | - Gary R. Whittaker
- Department of Microbiology & Immunology and Feline Health Center, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA; (A.N.S.); (N.M.A.); (A.E.S.)
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Ahmad W, Shabbiri K. Two years of SARS-CoV-2 infection (2019-2021): structural biology, vaccination, and current global situation. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2022; 34:5. [PMID: 35043040 PMCID: PMC8759062 DOI: 10.1186/s43162-021-00092-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 12/03/2021] [Indexed: 11/10/2022] Open
Abstract
The deadly SARS-CoV-2 virus has infected more than 259,502,031 confirmed cases with 5,183,003 deaths in 223 countries during the last 22 months (Dec 2019-Nov 2021), whereas approximately 7,702,859,718, vaccine doses have been administered (WHO: https://covid19.who.int/) as of the 24th of Nov 2021. Recent announcements of test trial completion of several new vaccines resulted in the launching of immunization for the common person around the globe highlighting a ray of hope to cope with this infection. Meanwhile, genetic variations in SARS-CoV-2 and third layer of infection spread in numerous countries emerged as a stronger prototype than the parental. New and parental SARS-CoV-2 strains appeared as a risk factor for other pre-existing diseases like cancer, diabetes, neurological disorders, kidney, liver, heart, and eye injury. This situation requires more attention and re-structuring of the currently developed vaccines and/or drugs against SARS-CoV-2 infection. Although a decline in COVID-19 infection has been reported globally, an increase in COVID-19 cases in the subcontinent and east Mediterranean area could be alarming. In this review, we have summarized the current information about the SARS-CoV-2 biology, its interaction and possible infection pathways within the host, epidemiology, risk factors, economic collapse, and possible vaccine and drug development.
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Affiliation(s)
- Waqar Ahmad
- Department of Biochemistry, College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates
- The University of Queensland, Brisbane, Australia
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30
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Gaikwad R, Thikeker M, Kalantri R. A clinical study of ocular findings among patients with COVID-19 at a tertiary care center in Western Maharashtra, India. DELTA JOURNAL OF OPHTHALMOLOGY 2022. [DOI: 10.4103/djo.djo_58_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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31
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Dhiman R, Rakheja V, Saxena R. An Ophthalmologist's Insight Into The Viral Pandemics. JOURNAL OF OPTOMETRY 2022; 15:35-43. [PMID: 33422421 PMCID: PMC8045749 DOI: 10.1016/j.optom.2020.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 06/12/2023]
Abstract
In recent past, major pandemics and epidemics have occurred due to the emergence and resurgence of the novel strains of viruses like Influenza [HINI-A "Spanish Flu", H1N1-Novel A "Swine flu"], Corona [Middle East Respiratory Syndrome (MERS), Severe acute respiratory syndrome (SARS-CoV-1, SARS-CoV-2)] and Ebola virus [Ebola virus disease]. These infectious diseases may have several ocular manifestations and rarely might be the presenting symptom of the underlying disease. The eyes can act as a portal of entry and/or route of viral transmission for these pathogens. Therefore, an ophthalmologist/optometrist needs to act with ample preparedness and responsibility. Establishing a standard of care in ophthalmic practice by modifying the conventional examination techniques and adopting tele-ophthalmology model to triage the patients can control the community spread of the disease. This article aims to elucidate the ocular manifestations in these pandemics and measures that should be adopted in ophthalmic practice to prevent the disease transmission.
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Affiliation(s)
- Rebika Dhiman
- Department of Ophthalmology, Dr R P Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India.
| | - Vaishali Rakheja
- Department of Ophthalmology, Dr R P Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Rohit Saxena
- Department of Ophthalmology, Dr R P Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India.
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Navarčík R, Popov I, Valašková J, Horkovičová K. SARS-COV-2 PANDEMIC FROM THE OPHTHALMOLOGIST`S PERSPECTIVE. A REVIEW. CESKA A SLOVENSKA OFTALMOLOGIE : CASOPIS CESKE OFTALMOLOGICKE SPOLECNOSTI A SLOVENSKE OFTALMOLOGICKE SPOLECNOSTI 2022; 78:217-332. [PMID: 35105149 DOI: 10.31348/2022/1] [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: 06/14/2023]
Abstract
In December 2019, a novel coronavirus (CoV) epidemic, caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) emerged from China. Coronaviruses belong to enveloped ssRNA viruses and are classified into four genera: Alpha coronavirus, Beta coronavirus, Gamma coronavirus and Delta coronavirus. It is assumed that SARS-CoV-2 is spread primarily during a personal contact via bigger respiratory droplets. These droplets with viruses can be directly inhaled by other people or can lend on the surfaces with the possibility of further spreading. The ocular surface has been suggested as one of possible infection entries. Human eye has its own renin-angiotensin system with present ACE2 receptors, which bind the virus through spike protein. The most common symptoms of the SARS-CoV-2 infection are fever, cough and dyspnoea. Several clinical entities, such as conjunctivitis, anterior uveitis, retinitis, and optic neuritis have been associated with this infection. The most common ophthalmologic symptom associated with COVID-19 disease is conjunctivitis. Some studies indicate that eye symptoms are commonly present in patients with severe COVID-19 pneumonia and that it is possible to detect viral RNA from the conjunctival sac of these patients. In ophthalmologic praxis, we manage not only the therapy of the eye structures` inflammation in relation with this infection, but also the overall management of the visits and the supervision of the patients who are at risk and positive for coronavirus. Ophthalmologists could potentially have a higher risk of SARS-CoV-2 infection due to personal communication with the patients, frequent exposure to tears and eye secrets and the use of devices. We would like to provide an ophthalmologist`s perspective on this topic.
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Kumar A, Anuranjani L. Incidence and association of ocular manifestations with the disease severity in COVID-19 patients of northern region of India. Taiwan J Ophthalmol 2022; 12:312-316. [PMID: 36248072 PMCID: PMC9558480 DOI: 10.4103/tjo.tjo_12_22] [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: 10/08/2021] [Accepted: 02/14/2022] [Indexed: 11/24/2022] Open
Abstract
PURPOSE: Our study aims to find the incidence of ocular manifestations and to investigate the relation of ocular manifestations with the disease severity among coronavirus disease 2019 (COVID-19) patients. MATERIAL AND METHODS: Our study is a cross-sectional study done between May 15, 2020, and April 15, 2021, at Hind Institute of Medical Sciences, Lucknow, India. All COVID-19 patients who got admitted to our center between May 15, 2020, and April 15, 2021, were included in our study. We included 261 patients in our study. Diagnosis of COVID-19 was made by testing the nasal and pharyngeal swabs by (reverse transcriptase-polymerase chain reaction [RT-PCR]). An RT-PCR test positive was the criteria for admission in the COVID ward. Statistical analyses were performed using the Mann–Whitney U-test, Chi-square test, and Kolmogorov–Smirnov test. P < 0.01 was considered statistically significant. RESULTS: We included 261 patients in our study. Out of 261 patients, ocular manifestations were found in 43 (16.4%) patients. The patients with ocular manifestations had higher neutrophil counts, erythrocyte sedimentation rate (ESR), procalcitonin (PCT), C-reactive protein (CRP), and D-dimer values (P < 0.001). Patients with ocular manifestations were relatively more symptomatic concerning fever and myalgia. CONCLUSION: The incidence of ocular manifestations in COVID-19 patients was 16.4%. Ocular manifestation was significantly associated with raised neutrophil counts, CRP, ESR, PCT, and D-dimer values. Ocular manifestation was also significantly associated with higher body temperature and higher mean age. The findings of the study are suggestive of more severe disease in patients of COVID-19 with ocular manifestations.
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A clinical case of central retinal artery occlusion after pneumonia caused by SARS-CoV-2 (COVID-19). ACTA BIOMEDICA SCIENTIFICA 2021. [DOI: 10.29413/abs.2021-6.6-1.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
In domestic and foreign medical periodical literature, highlighting the problem of ophthalmopathology against the background of coronavirus infection, the lesion of the anterior segment of the eye is most often described. It is extremely hard to find reports about pathology of the retina, optic nerve or central parts of the visual analyzer. However, it is widely acknowledged that there is a high risk of developing coagulopathy against the background of COVID-19 infection, which leads to occlusion and thrombosis of retinal vessels, ischemic neuropathies. The problem of irreversible loss of vision due to circulatory disorders of the retinal vessels was urgent even before the wide spread of coronavirus infection due to the high prevalence of atherosclerosis, hypertension and type 1 and 2 diabetes in the population. Also, it is widely known that occlusions and thrombosis of retinal vessels can be formidable harbingers of the developing life-threatening conditions. Knowledge about the high risk of vascular ophthalmopatology against the background of a previous COVID-19 infection by the primary echelon ophthalmologists, early diagnostics and treatment of ischemic conditions of the posterior segment of the eye will reduce the frequency of irreversible vision loss due to these diseases, secondary neovascular glaucoma cases, and will also help to send patients to the multidisciplinary hospitals in a timely manner for the prevention of fatal complications of coagulopathy. The article provides a brief overview of foreign literary sources regarding the history of outbreaks of coronavirus infection in the world, as well as possible ways of damage to the organ of vision by the coronavirus. A clinical case of damage to the vascular bed of the retina in both eyes due to coagulopathy against the background of pneumonia caused by COVID-19 is presented, which is actual due to the low illumination of similarly cases.
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Sacchi M, Lizzio RAU, Villani E, Tagliabue E, Monsellato G, Pajardi G, Luccarelli S, Nucci P. Prevalence of SARS-CoV-2 amongst ophthalmologists throughout the first and second waves of the pandemic. Medicine (Baltimore) 2021; 100:e28192. [PMID: 34918674 PMCID: PMC8677999 DOI: 10.1097/md.0000000000028192] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 11/18/2021] [Indexed: 01/08/2023] Open
Abstract
The study aims to investigate the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among ophthalmology unit staff throughout the first and second waves of the outbreak, in order to verify the effectiveness of the measures adopted in containing the contagion.A retrospective observational study was conducted involving staff members, who received a naso/oropharyngeal swab when complaining of SARS-CoV-2 symptoms and once a month as a screening measure. They were tested for SARS-CoV-2 antibodies as a screening measure during the first and the second wave. Clinical activities performed during the outbreak were compared with those performed during the same period in 2019 and correlated with the number of coronavirus disease-2019 eye care workers.Analysis included 25 workers. Clinical infection was 0% and 12% whereas the prevalence of SARS-CoV-2 antibodies ranged from 4% to 8% in the first and second wave, respectively. The increase in the prevalence of SARS-CoV-2 infection between the first and the second wave was not significant (1/25 vs 3/25, P = .6092). Clinical activities significantly decreased during the first wave compared with the same period in 2019 (3256 vs 10,075, P < .0001, -68% to 2019), but increased during the second wave (8208 vs 3256, P < .0001, +152% to the first wave).Despite the increase in routine activities during the second wave, we did not observe a significant increase in SARS-CoV-2 prevalence. Strict protection measures seemed to contain the rate of contagion among the ophthalmology unit members even in a high-volume clinical setting in one of the most affected area by the coronavirus disease-2019 outbreak.
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Affiliation(s)
- Matteo Sacchi
- Eye Clinic, San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy
| | | | - Edoardo Villani
- Eye Clinic, San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - Elena Tagliabue
- Value-based Healthcare Unit, IRCCS Multimedica, Milan, Italy
| | | | - Giorgio Pajardi
- Plastic and Hand Surgery Clinic, San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy
| | | | - Paolo Nucci
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
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Alam MS, Mistry S, Das S, Mukherjee S, Kumar A, Rao GS. Surgical performance and the positivity rate for novel coronavirus (severe acute respiratory syndrome coronavirus 2) in an ophthalmic setup during the coronavirus disease 2019 pandemic. Oman J Ophthalmol 2021; 14:162-168. [PMID: 34880577 PMCID: PMC8597822 DOI: 10.4103/ojo.ojo_61_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/30/2021] [Accepted: 07/01/2021] [Indexed: 12/15/2022] Open
Abstract
AIM: To describe, the impact of ongoing coronavirus disease 2019 (COVID-19) pandemic on ophthalmic surgeries at a tertiary eye care center of East India during and after the lockdown, and the positivity rate for novel coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]). MATERIALS AND METHODS: A retrospective study of all ophthalmic surgeries performed during and after lockdown from April 1, 2020 to August 31, 2020, with comparison to the corresponding period in the previous year (2019) was done. Eligible patients were tested for novel coronavirus (SARS-CoV-2) preoperatively as per the institutional protocols. RESULTS: A total of 569 surgeries were performed during the study period compared to 3458 performed in 2019, (P = 0.00001). The maximum number of surgeries were performed in June (191, 33.57%) and July (189, 33.22%) and in the subspecialty of vitreo-retina (337, 59.23%) followed by cataract (101, 17.75%). The most common vitreoretinal procedures were intravitreal injections (223, 66.17%) and retinal detachment surgery (56, 16.62%). Emergency surgeries performed were 30 (5.275%) compared to 76 (2.20%) during the same duration in the previous year (P = 0.00004). Ninety-four (16.52%) cases were screened for COVID-19. A total of 10 (10.64%) cases tested positive for SARS-CoV-2. Only one of these cases was symptomatic. CONCLUSION: There was a drastic decline in the number of both elective and emergency surgeries during and after the lockdown period of the COVID-19 pandemic when compared to the corresponding previous year duration. The maximum number of surgeries was performed in the vitreoretinal subspecialty. The positivity rate for SARS CoV-2 amongst the patients tested was 10.64% and most of these patients were asymptomatic.
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Affiliation(s)
- Md Shahid Alam
- Aditya Birla Sankara Nethralaya, Kolkata, West Bengal, India.,A Unit of Medical Research Foundation, Chennai, Tamil Nadu, India
| | - Suraj Mistry
- Aditya Birla Sankara Nethralaya, Kolkata, West Bengal, India.,A Unit of Medical Research Foundation, Chennai, Tamil Nadu, India
| | - Sudipta Das
- Aditya Birla Sankara Nethralaya, Kolkata, West Bengal, India.,A Unit of Medical Research Foundation, Chennai, Tamil Nadu, India
| | - Suchetna Mukherjee
- Aditya Birla Sankara Nethralaya, Kolkata, West Bengal, India.,A Unit of Medical Research Foundation, Chennai, Tamil Nadu, India
| | - Amitabh Kumar
- Aditya Birla Sankara Nethralaya, Kolkata, West Bengal, India.,A Unit of Medical Research Foundation, Chennai, Tamil Nadu, India
| | - Girish Shiva Rao
- Sankara Nethralaya, Medical Research Foundation, Chennai, Tamil Nadu, India
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Abstract
Since the outbreak in late December 2019, the coronavirus disease 2019 (COVID-19) pandemic has spread across the globe, causing great damage to human life and property. A lot of researchers around the world have devoted themselves to the study of its origin, pathogenic mechanism, and transmission route, and this article gives a summary. First, both humans and animals can act as the host of coronavirus. In indoor environments, the virus may exist in aerosols, droplets, saliva, etc., from the nose and mouth connected to the respiratory system, as well as feces, urine, etc., from the digestive and urinary systems. In addition, other substances, such as breast milk, eye feces, and blood, released from the host can carry viruses. The virus transmitted indoors is affected by indoor machinery, natural forces, and human activities, and spreads in different distances. Second, the virus spreads outdoors through three kinds of media: solid, liquid, and gas, and is affected by their survival time, the temperature, and humidity in the environment.
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Wasfy T, Eldesouky MA, Serag Y, Elbedewy HA. Concurrent and Post COVID-19 Ophthalmological Implications. Clin Ophthalmol 2021; 15:4467-4473. [PMID: 34819718 PMCID: PMC8608288 DOI: 10.2147/opth.s336600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 10/22/2021] [Indexed: 01/08/2023] Open
Abstract
Background and Aim COVID-19 infection is a respiratory disease but it can have ophthalmological manifestations as well. This study aimed to investigate the ophthalmological implications of COVID-19 either during the course of the disease or after recovery. Methods A retrospective study included the records of 425 COVID-19 patients, proved by positive PCR swabs. The records were collected from three isolation hospitals in Gharbeya Governorate, Egypt. Results The mean age of the studied group was 41.73 ± 13.59, and 216 (50.8%) of them were males. One hundred and thirty one (30.8%) patients had ophthalmological manifestations. Among the entire patients, the most common ophthalmological presentation was conjunctivitis in 111 patients (26.1%), followed by neuro-retinal affection in 9 (2.1%), secondary fungal orbital cellulitis in 6 (1.4%), episcleritis in 3 (0.7%) and keratitis in 2 (0.5%) patients. All of the observed ophthalmological implications occurred either during the course of the disease (concurrent) or after recovery, except for the fungal orbital cellulitis which occurred only after recovery. Conclusion COVID-19 could cause different eye manifestations. Recovery from the main disease does not guarantee eye safety, especially in high-risk patients.
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Affiliation(s)
- Tamer Wasfy
- Ophthalmology Department, Tanta University, Tanta, Egypt
| | | | - Yasser Serag
- Ophthalmology Department, Tanta University, Tanta, Egypt
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Daryabari SH, Asadollah A, Moghadam FA, Dorostkar R, Bahramifar A, Aghamollaei H. Detection of COVID-19 in tears of ICU-admitted patients with SARS-CoV-2 infection. Int Ophthalmol 2021; 42:723-727. [PMID: 34762278 PMCID: PMC8581600 DOI: 10.1007/s10792-021-01938-3] [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: 11/06/2020] [Accepted: 06/18/2021] [Indexed: 11/30/2022]
Abstract
Purpose Upon the outbreak of 2019, novel coronavirus (COVID-19) pandemic confirmed the cases surpassed 20 million. Despite a few reports identified the association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with ocular manifestations, it may assess the ocular symptoms of patients with the COVID-19 by ophthalmologists facilitate the diagnosis and prevent transmission. Methods A total of 60 patients with the COVID-19 admitted to Baghiatallah hospital from March 2020 to May 2020 were retrospectively reviewed and analyzed for the ocular manifestations, blood tests, and reverse transcriptase-polymerase chain reaction (RT-PCR) for SARS-CoV-2 using nasopharyngeal and conjunctival swabs. Results Among 60 included patients with clinically confirmed COVID-19, the median age 58.36 years (IQR: 30–88 years), 27 (45%) were male. Furthermore, 29 (48%) and 5 (8%) patients yielded positive for SARS-CoV-2 on RT-PCR from nasopharyngeal swabs and conjunctival specimens, respectively. Among 60 patients, 10 (16%) and 3 (5%), respectively, had the ocular manifestations and positive results for SARS-CoV-2 on RT-PCR from conjunctival and nasopharyngeal swabs. Conclusion Although the positive rate of tear RT-PCR rate is not noticeable as nasopharyngeal swabs yet, COVID-19 transmission through the eyes is biologically plausible.
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Affiliation(s)
| | - Atieh Asadollah
- Baghiatollah University of Medical Sciences, Tehran, Islamic Republic of Iran
| | | | - Ruhollah Dorostkar
- Baghiatollah University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Ali Bahramifar
- Baghiatollah University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Hossein Aghamollaei
- Baghiatollah University of Medical Sciences, Tehran, Islamic Republic of Iran
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40
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Kaye AD, Cornett EM, Brondeel KC, Lerner ZI, Knight HE, Erwin A, Charipova K, Gress KL, Urits I, Urman RD, Fox CJ, Kevil CG. Biology of COVID-19 and related viruses: Epidemiology, signs, symptoms, diagnosis, and treatment. Best Pract Res Clin Anaesthesiol 2021; 35:269-292. [PMID: 34511219 PMCID: PMC7723419 DOI: 10.1016/j.bpa.2020.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 02/06/2023]
Abstract
Coronaviruses belong to the family Coronaviridae order Nidovirales and are known causes of respiratory and intestinal disease in various mammalian and avian species. Species of coronaviruses known to infect humans are referred to as human coronaviruses (HCoVs). While traditionally, HCoVs have been a significant cause of the common cold, more recently, emergent viruses, including severe acute respiratory syndrome coronavirus (SARS-CoV-2) has caused a global pandemic. Here, we discuss coronavirus disease (COVID-19) biology, pathology, epidemiology, signs and symptoms, diagnosis, treatment, and recent clinical trials involving promising treatments.
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Affiliation(s)
- Alan D Kaye
- LSU Health Shreveport, 1501 Kings Highway, Shreveport LA 71103, USA.
| | - Elyse M Cornett
- Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport LA 71103, USA.
| | - Kimberley C Brondeel
- University of Texas Medical Branch, 301 University Blvd, Galveston TX 77555, USA.
| | - Zachary I Lerner
- LSU Health Sciences Center New Orleans, 1901 Perdido Street, New Orleans, LA 70112, USA.
| | - Haley E Knight
- Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA.
| | - Abigail Erwin
- LSU Health Sciences Center New Orleans, 1901 Perdido Street, New Orleans, LA 70112, USA.
| | - Karina Charipova
- Georgetown University School of Medicine, Washington, D.C., 20007, USA.
| | - Kyle L Gress
- Georgetown University School of Medicine, Washington, D.C., 20007, USA.
| | - Ivan Urits
- Department of Anesthesiology, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - Richard D Urman
- Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115, USA.
| | - Charles J Fox
- Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport LA 71103, USA.
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Sehgal G, Bal P, Bal B, Chopra R. Pattern of ocular manifestations and the prevalence of severe acute respiratory syndrome coronavirus-2 in tears of hospitalized coronavirus disease 2019 patients. Taiwan J Ophthalmol 2021; 11:380-385. [PMID: 35070667 PMCID: PMC8757522 DOI: 10.4103/tjo.tjo_40_21] [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: 07/01/2021] [Accepted: 09/25/2021] [Indexed: 01/08/2023] Open
Abstract
PURPOSE: Severe acute respiratory syndrome coronavirus2 (SARSCoV2) can affect eyes in various forms. Furthermore, ocular surface can act as potential port of entry and ocular secretions as possible route of transmission of SARSCoV2. The aims of the study are to identify ocular manifestation in confirmed coronavirus disease 2019 (COVID19) patients and to evaluate conjunctival secretions as the possible route of transmission of this disease. MATERIALS AND METHODS: A prospective, populationbased, observational study was done. Ocular symptoms and signs of every hospitalized patient with SARSCoV2 infection between September 15, 2020, and November 15, 2020, were recorded. Tear samples of the first 60 participants (30 each of patients with severe and moderate illness, can be removed) with ocular manifestations were selected for real-time polymerase chain reaction (RTPCR). Data were analyzed using the Statistical Package for the Social Science Software (SPSS) program, version 23. When comparing mean values, ttest was used otherwise Chisquare test. RESULTS: Out of 804 admitted patients during study period, 309 (38.4%) patients were identified with ocular manifestations, out of which 78% (241) had conjunctival hyperemia, 65.6% (203) had follicular reaction in palpebral conjunctiva, 58% (180) had chemosis, and 58% (99) had discharge and 18.4% (57) complained of burning in their eyes. Mean duration from systemic manifestation to onset of ocular symptoms was 4.52 ± 1.47 days while 8 patients (1%) had conjunctivitis as the presenting symptom. SARSCoV2 was detected in 18.3% patients (11 out of 60) using RTPCR. CONCLUSION: The presence of SARSCoV2 in ocular secretions of patients with ocular manifestations suggests that COVID19infected patients with ocular manifestations should wear protective glasses to prevent secretions contamination to healthy persons.
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Affiliation(s)
- Gaurang Sehgal
- Department Of Ophthalmology, Regional Institute of Ophthalmology, Amritsar, Punjab, India
| | - Prempal Bal
- Department Of Ophthalmology, Regional Institute of Ophthalmology, Amritsar, Punjab, India
| | - Bhavkaran Bal
- Department Of Ophthalmology, Regional Institute of Ophthalmology, Amritsar, Punjab, India
| | - Riya Chopra
- Department Of Ophthalmology, Regional Institute of Ophthalmology, Amritsar, Punjab, India
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42
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Neri P, Pichi F. SARS-CoV-2 and the Eye: The Pandora's Box of Ocular Immunology. J Ocul Pharmacol Ther 2021; 37:502-509. [PMID: 34515538 DOI: 10.1089/jop.2021.0058] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The Pandora's box myth addresses the evilness in the world that undisputedly nowadays is identified in severe acute respiratory syndrome (SARS)-Coronavirus 2 (CoV-2), formerly known as Covid-19, which belongs to coronaviridae family, identified in Wuhan, Hubei district of the Republic of China in December 2019. Since then, SARS-CoV-2 has affected ∼180 million people and made almost 4 million victims, with a mortality rate of 6.1%, which is 6 times higher than influenza virus. However, coronaviruses are well known in the ophthalmology field because they were used in the so-called experimental coronavirus retinopathy model. That model certainly brings intriguing concepts for understanding coronavirus pathophysiology, which may have important implications on treatment strategies. Certainly, the recent availability of vaccines gives hope on the control of virus spreading; however, vaccines might create immune reactions involving the eye structure. In this study, we reviewed the literature and elaborated the available data to speculate on possible new interpretation of both pathophysiology and treatment of SARS-CoV-2.
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Affiliation(s)
- Piergiorgio Neri
- Uveitis Service of The Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.,Cleveland Lerner College of Medicine, Case Western University, Cleveland, Ohio, USA.,Khalifa University Medical School, Abu Dhabi, United Arab Emirates
| | - Francesco Pichi
- Uveitis Service of The Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.,Cleveland Lerner College of Medicine, Case Western University, Cleveland, Ohio, USA
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43
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Patel NS, Moon JY, Katz R, Wai KM, Sobrin L, Vavvas DG, Miller JB. Retrospective Analysis of Retinal Imaging in COVID-19 Positive Patients at a Tertiary Eye Care Center. Clin Ophthalmol 2021; 15:3727-3731. [PMID: 34511877 PMCID: PMC8423487 DOI: 10.2147/opth.s309346] [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: 03/03/2021] [Accepted: 04/14/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Since the start of the COVID-19 pandemic, numerous authors have published data demonstrating retinal changes found in patients with COVID-19. However, others have debated the significance of these findings and the effects of COVID-19 on the retina remain uncertain. This study aims to better understand retinal findings in patients with COVID-19. PATIENTS AND METHODS A retrospective review of patients with a history of a positive COVID-19 polymerase chain reaction test was performed between March 1st, 2020 and October 31st, 2020. Patients were included if they presented within 90 days of their first positive COVID-19 test and underwent color fundus photography and/or OCT of the macula. All images were reviewed by two independent graders who assessed the presence of retinal heme, cotton wool spots, vascular sheathing, and disc edema, as well as hyper-reflective changes, intra-retinal fluid, and sub-retinal fluid on OCT. RESULTS A total of 119 eyes from 61 patients were included. Among 83 eyes which underwent OCT of the macula, inner retinal hyper-reflective changes were seen in 16.9% (n=14), outer retinal hyper-reflective changes in 18.1% (n=15), intra-retinal fluid in 28.9% (n=24), and sub-retinal fluid in 14.5% (n=12). Among 48 eyes which underwent color fundus photography, retinal hemorrhage was seen in 27.1% (n=13), optic disc edema in 2.1% (n=1), and cotton wool spots in none of the eyes. Sub-analysis of 70 eyes from 41 patients with no alternative retinal pathology to potentially explain the above findings revealed none of the above exam findings on OCT of the macula (n=35), fundus photography (n=28), or documented exam (n=66). CONCLUSION While a number of patients seen after COVID-19 infection demonstrated retinal findings, all could be explained by pre-existing retinal conditions. In a sub-group of eyes without pre-existing retinal disease, we did not identify any retinal findings that could be associated with COVID-19.
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Affiliation(s)
- Neal S Patel
- Harvard Retinal Imaging Lab, Mass Eye and Ear, Boston, MA, USA
| | - Jade Y Moon
- Harvard Retinal Imaging Lab, Mass Eye and Ear, Boston, MA, USA
| | - Raviv Katz
- Harvard Retinal Imaging Lab, Mass Eye and Ear, Boston, MA, USA
| | - Karen M Wai
- Harvard Retinal Imaging Lab, Mass Eye and Ear, Boston, MA, USA
| | - Lucia Sobrin
- Retina Service, Mass Eye and Ear, Boston, MA, USA
| | | | - John B Miller
- Harvard Retinal Imaging Lab, Mass Eye and Ear, Boston, MA, USA
- Retina Service, Mass Eye and Ear, Boston, MA, USA
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44
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Chen X, Yu H, Mei T, Chen B, Chen L, Li S, Zhang X, Sun X. SARS-CoV-2 on the ocular surface: is it truly a novel transmission route? Br J Ophthalmol 2021; 105:1190-1195. [PMID: 32788324 PMCID: PMC8380887 DOI: 10.1136/bjophthalmol-2020-316263] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 05/29/2020] [Accepted: 07/07/2020] [Indexed: 12/18/2022]
Abstract
Since December 2019, the novel COVID-19 outbreak has spread rapidly around the globe and infected millions of people. Although the major transmission route of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is considered to be airborne droplets and close contact, the ocular transmission route has been reported with great concern. The current work summarises the characteristics of SARS-CoV-2, the ocular distribution of the major SARS-CoV-2 binding protein, and the experimental and clinical evidence of the ocular transmission route. Although it seems that the likelihood of the ocular surface being an infection gateway is low, SARS-CoV-2 infection or transmission via the ocular surface may cause conjunctivitis and other ocular discomfort. Therefore, good eye protection is an essential safeguard procedure, especially for medical staff.
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Affiliation(s)
- Xuhui Chen
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huimin Yu
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ting Mei
- Department of Nursing, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bo Chen
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liwen Chen
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shanling Li
- Department of Nursing, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xian Zhang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xufang Sun
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Pathology of the Brain and the Eye in Severe Acute Respiratory Syndrome Coronavirus-2-Infected Patients: A Review. J Neuroophthalmol 2021; 41:285-292. [PMID: 33935221 DOI: 10.1097/wno.0000000000001275] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) may present or eventually develop central nervous system and ophthalmic signs and symptoms. Varying reports have emerged regarding isolation of viral RNA from these tissue sites, as well as largely autopsy-based histopathologic descriptions of the brain and the eye in patients with COVID-19. EVIDENCE ACQUISITION A primary literature search was performed in literature databases such as PubMed, Google Scholar, and Cochrane Library. Keywords were used alone and in combination including the following: SARS CoV-2, COVID-19, eye, brain, central nervous system, histopathology, autopsy, ocular pathology, aqueous, tears, vitreous, neuropathology, and encephalitis. RESULTS The reported ophthalmic pathologic and neuropathologic findings in patients with SARS-CoV-2 are varied and inconclusive regarding the role of direct viral infection vs secondary pathology. The authors own experience with autopsy neuropathology in COVID-19 patients is also described. There is a particular paucity of data regarding the histopathology of the eye. However, it is likely that the ocular surface is a potential site for inoculation and the tears a source of spread of viral particles. CONCLUSIONS Additional large postmortem studies are needed to clarify the role of SARS-CoV in the ophthalmic and neuropathologic manifestations of COVID-19.
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Jiang B, Li SJ, Wang WL, Hu M, He S, Cao J, Jiang L, Li Y. Ocular manifestations and SARS-CoV-2 detection in tears and conjunctival scrape from non-severe COVID-19 patients. Int J Ophthalmol 2021; 14:1133-1137. [PMID: 34414075 PMCID: PMC8342283 DOI: 10.18240/ijo.2021.08.01] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 01/20/2021] [Indexed: 02/06/2023] Open
Abstract
AIM To explore the ocular features of corona virus disease (COVID)-19 and severe acute respiratory syndrome coronavirus (SARS-CoV)-2 detection in tears and conjunctival scrapes in non-severe COVID-19 patients. METHODS This is a multicenter observational clinical study with no intervention conducted from Jan 25th to March 1st, 2020. Clinical data and samples of tears and conjunctival scraping were collected in consecutive laboratory-confirmed, non-severe COVID-19 patients from three hospitals. COVID-19 virus was analyzed by real-time reverse transcriptase polymerase chain reaction (RT-PCR) kits. RESULTS Totally 255 laboratory-confirmed, non-severe COVID-19 patients were recruited for ocular manifestation investigation. Of them, 54.9% were females, with a mean age of 49.4y. None of the patients has evidence of uveitis; 11 patients (4.3%) complained of mild asthenopia; 2 (0.8%) had mild conjunctival congestion and serous secretion. Twenty-five of them had performed tears and conjunctival scrape for COVID-19 virus detection, with 4 yield possible positive results in the nucleoprotein gene. One of them were asymptomatic with normal chest CT and positive pharyngeal swab result. CONCLUSION Ocular manifestations are neither common nor specific in non-severe COVID-19 patients. Meanwhile, COVID-19 virus nucleotides can be detected in the tears and conjunctival scrape samples, warranting further research on the transmissibility by the ocular route.
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Affiliation(s)
- Bing Jiang
- Department of Ophthalmology, the 2nd Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
- Hunan Clinical Research Center of Ophthalmic Disease, Changsha 410011, Hunan Province, China
| | - Shao-Jie Li
- Xiangtan Central Hospital, Xiangtan 411100, Hunan Province, China
| | - Wen-Long Wang
- Department of Infectious Diseases, the 2nd Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Min Hu
- Department of Laboratory Medicine, the 2nd Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Sui He
- Xiangtan Central Hospital, Xiangtan 411100, Hunan Province, China
| | - Jian Cao
- Department of Ophthalmology, the 2nd Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
- Hunan Clinical Research Center of Ophthalmic Disease, Changsha 410011, Hunan Province, China
| | - Li Jiang
- Department of Ophthalmology, the 2nd Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
- Hunan Clinical Research Center of Ophthalmic Disease, Changsha 410011, Hunan Province, China
- Department of Nursery, Fangcang Hospital of Wuchang, Wuhan, Hubei Province, China
| | - Yun Li
- Department of Ophthalmology, the 2nd Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
- Hunan Clinical Research Center of Ophthalmic Disease, Changsha 410011, Hunan Province, China
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Bhavaniramya S, Ramar V, Vishnupriya S, Palaniappan R, Sibiya A, Baskaralingam V. Comprehensive analysis of SARS-COV-2 drug targets and pharmacological aspects in treating the COVID-19. Curr Mol Pharmacol 2021; 15:393-417. [PMID: 34382513 DOI: 10.2174/1874467214666210811120635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/27/2021] [Accepted: 02/22/2021] [Indexed: 11/22/2022]
Abstract
Corona viruses are enveloped, single-stranded RNA (Ribonucleic acid) viruses and they cause pandemic diseases having a devastating effect on both human healthcare and the global economy. To date, six corona viruses have been identified as pathogenic organisms which are significantly responsible for the infection and also cause severe respiratory diseases. Among them, the novel SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2) caused a major outbreak of corona virus diseases 2019 (COVID-19). Coronaviridae family members can affects both humans and animals. In human, corona viruses cause severe acute respiratory syndrome with mild to severe outcomes. Several structural and genomics have been investigated, and the genome encodes about 28 proteins most of them with unknown function though it shares remarkable sequence identity with other proteins. There is no potent and licensed vaccine against SARS-CoV-2 and several trials are underway to investigate the possible therapeutic agents against viral infection. However, some of the antiviral drugs that have been investigated against SARS-CoV-2 are under clinical trials. In the current review we comparatively emphasize the emergence and pathogenicity of the SARS-CoV-2 and their infection and discuss the various putative drug targets of both viral and host receptors for developing effective vaccines and therapeutic combinations to overcome the viral outbreak.
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Affiliation(s)
- Sundaresan Bhavaniramya
- Biomaterials and Biotechnology in Animal Health Lab, Department of Animal Health and Management, Alagappa University, Karaikudi 630004, Tamil Nadu. India
| | - Vanajothi Ramar
- Department of Biomedical Science, Bharathidasan University, Tiruchirappalli, Tamil Nadu, 620024. India
| | - Selvaraju Vishnupriya
- College of Food and Dairy Technology, Tamil Nadu Veterinary and Animal Sciences University, Chennai 600052. India
| | - Ramasamy Palaniappan
- Research and Development Wing, Sree Balaji Medical College and Hospital, Bharath Institute of Higher Education (BIHER), Chennai-600044, Tamilnadu. India
| | - Ashokkumar Sibiya
- Biomaterials and Biotechnology in Animal Health Lab, Department of Animal Health and Management, Alagappa University, Karaikudi 630004, Tamil Nadu. India
| | - Vaseeharan Baskaralingam
- Biomaterials and Biotechnology in Animal Health Lab, Department of Animal Health and Management, Alagappa University, Karaikudi 630004, Tamil Nadu. India
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Bak A, Mugglestone MA, Ratnaraja NV, Wilson JA, Rivett L, Stoneham SM, Bostock J, Moses SE, Price JR, Weinbren M, Loveday HP, Islam J, Wilson APR. SARS-CoV-2 routes of transmission and recommendations for preventing acquisition: joint British Infection Association (BIA), Healthcare Infection Society (HIS), Infection Prevention Society (IPS) and Royal College of Pathologists (RCPath) guidance. J Hosp Infect 2021; 114:79-103. [PMID: 33940093 PMCID: PMC8087584 DOI: 10.1016/j.jhin.2021.04.027] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/26/2021] [Accepted: 04/26/2021] [Indexed: 02/06/2023]
Affiliation(s)
- A Bak
- Healthcare Infection Society, UK.
| | | | - N V Ratnaraja
- British Infection Association, UK; University Hospitals Coventry & Warwickshire NHS Trust, UK
| | - J A Wilson
- Infection Prevention Society, UK; Richard Wells Research Centre, University of West London, UK
| | - L Rivett
- Healthcare Infection Society, UK; Cambridge University NHS Hospitals Foundation Trust, UK
| | - S M Stoneham
- Healthcare Infection Society, UK; Brighton and Sussex University Hospitals NHS Trust, UK
| | | | - S E Moses
- British Infection Association, UK; Royal College of Pathologists, UK; East Kent Hospitals University NHS Foundation Trust, UK
| | - J R Price
- Healthcare Infection Society, UK; Imperial College Healthcare NHS Trust, UK
| | - M Weinbren
- Healthcare Infection Society, UK; Sherwood Forest Hospitals NHS Foundation Trust, UK
| | - H P Loveday
- Infection Prevention Society, UK; Richard Wells Research Centre, University of West London, UK
| | - J Islam
- Healthcare Infection Society, UK; Brighton and Sussex University Hospitals NHS Trust, UK
| | - A P R Wilson
- Healthcare Infection Society, UK; University College London Hospitals NHS Foundation Trust, UK
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Kaur P, Sehgal G, Shailpreet, Singh KD, Singh B. Evaluation and comparison of conjunctival swab polymerase chain reaction results in SARS-CoV-2 patients with and without ocular manifestations. Indian J Ophthalmol 2021; 69:2211-2214. [PMID: 34304212 PMCID: PMC8482915 DOI: 10.4103/ijo.ijo_587_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Purpose: The aim of this study was to evaluate and compare the presence of SARS-CoV-2 in tears of patients with and without ocular symptoms in SARS-CoV-2 positive patients. Methods: The prospective observational study conducted on 60 consecutive SARS-CoV-2 positive patients with ocular complaints was compared with 60 controls who had no ocular manifestations. The tear samples were taken within 48 h of admission from both the eyes of the enrolled patients for evaluating the presence SARS-CoV-2 by reverse transcription-polymerase chain reaction. Results: Eleven cases (18.33%) tested positive for SARS-CoV-2 in tears on RT-PCR from cojunctival swab compared to 10 (16.66%) controls. The difference was not statistical significant. The difference between mean age of patients who tested positive or negative was also without statistical significance (P = 0.652), but the difference between patients who tested positive or negative by conjunctival swab for SARS-CoV-2 was statistically significant in terms of severity of COVID-19 disease (P = 0.0011), presence of comorbidity (P = 0.0015), mean TLC (P = 0.00498), and mean d dimer (P = 0.00465). Conclusion: Though the percentage of patients with positive RT PCR from conjunctival secretions is significantly less than nasopharyngeal swabs, potential risk of transmission of SARS-Co-2 through tears cannot be ruled out. Moreover, SARS-CoV-2 can be present in tears irrespective of ocular involvement.
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Affiliation(s)
- Prempal Kaur
- Department of Ophthalmology, Regional Institute of Ophthalmology, GMC, Amritsar, India
| | - Gaurang Sehgal
- Department of Ophthalmology, Regional Institute of Ophthalmology, GMC, Amritsar, India
| | - Shailpreet
- Department of Microbiology, GMC, Amritsar, Punjab, India
| | - K D Singh
- Department of Microbiology, GMC, Amritsar, Punjab, India
| | - Bhavkaran Singh
- Department of Ophthalmology, Regional Institute of Ophthalmology, GMC, Amritsar, India
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50
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Richter SM, Barnard TG. Adaptation of the WHO Hand Hygiene Observation Form for Application in Optometry Training Facilities. CLINICAL OPTOMETRY 2021; 13:227-234. [PMID: 34326677 PMCID: PMC8315776 DOI: 10.2147/opto.s304315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 06/17/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The link between hand and surface hygiene and the spread of disease has been reported by various studies and understanding the appropriate use of hand hygiene is important in healthcare. The World Health Organization (WHO) introduced the "My Five Moments for Hand Hygiene" model to educate healthcare workers about the importance of hand hygiene to stop the spread of disease. OBJECTIVE The objectives of this paper were to determine if the WHO Hand Hygiene Observation Form could be used to monitor for hand and personal hygiene practices of Optometry students, and what their actual hygiene practices are in an Optometry training facility in South Africa. METHODS This cross-sectional study was performed at an Optometry training facility in South Africa using third (n=32) and fourth year (n=39) students. The Hand Hygiene Knowledge Questionnaire for Health Care Workers by the WHO was used to determine their knowledge regarding hand hygiene. After completing the questionnaire, participants were observed in the clinic while consulting patients to determine the hand and surface hygiene practices they apply. RESULTS The WHO hand hygiene observation rubric was not appropriate to evaluate hand and surface hygiene in Optometry facilities. The adapted observation rubric created was a better tool to evaluate student hygiene practices and was able to record which hand or surface hygiene were missed when presented with such opportunities. Although 90.1% of the students knew that germs could be transferred to the patients via hands, only 46.5% routinely used an alcohol-based hand sanitizer. CONCLUSION This observation rubric developed during this study can assist in creating awareness with students about their own hand and surface hygiene deficiencies when interacting with patients.
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Affiliation(s)
- Susarah Maria Richter
- Department of Optometry, University of Johannesburg, Johannesburg, South Africa
- Water and Health Research Centre, University of Johannesburg, Johannesburg, South Africa
| | - Tobias George Barnard
- Water and Health Research Centre, University of Johannesburg, Johannesburg, South Africa
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