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Liu ZH, Li Y, Tian ZR, Zhao YJ, Cheung T, Su Z, Chen P, Ng CH, An FR, Xiang YT. Prevalence, correlates, and network analysis of depression and its associated quality of life among ophthalmology nurses during the COVID-19 pandemic. Front Psychol 2023; 14:1218747. [PMID: 37691783 PMCID: PMC10484007 DOI: 10.3389/fpsyg.2023.1218747] [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: 05/08/2023] [Accepted: 07/24/2023] [Indexed: 09/12/2023] Open
Abstract
Background Nurses in Ophthalmology Department (OD) had a high risk of infection during the novel coronavirus disease 2019 (COVID-19) pandemic. This study examined the prevalence, correlates, and network structure of depression, and explored its association with quality of life (QOL) in Chinese OD nurses. Methods Based on a cross-sectional survey, demographic and clinical data were collected. Depression was measured with the 9-item Self-reported Patient Health Questionnaire (PHQ-9), and QOL was measured using the World Health Organization Quality of Life Questionnaire-brief version (WHOQOL-BREF). Univariate analyses, multivariate logistic regression analyses, and network analyses were performed. Results Altogether, 2,155 OD nurses were included. The overall prevalence of depression among OD nurses was 32.71% (95%CI: 30.73-34.70%). Multiple logistic regression analysis revealed that having family or friends or colleagues who were infected (OR = 1.760, p = 0.003) was significantly associated with higher risk of depression. After controlling for covariates, nurses with depression reported lower QOL (F(1, 2,155) = 596.784, p < 0.001) than those without depression. Network analyses revealed that 'Sad Mood', 'Energy Loss' and 'Worthlessness' were the key central symptoms. Conclusion Depression was common among OD nurses during the COVID-19 pandemic. Considering the negative impact of depression on QOL and daily life, regular screening for depression, timely counselling service, and psychiatric treatment should be provided for OD nurses, especially those who had infected family/friends or colleagues. Central symptoms identified in network analysis should be targeted in the treatment of depression.
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Affiliation(s)
- Zi-Han Liu
- Department of Psychiatry, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China
| | - Yue Li
- Department of Nursing, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Zi-Rong Tian
- Department of Nursing, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yan-Jie Zhao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Pan Chen
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao, Macao SAR, China
| | - Chee H. Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent’s Hospital, University of Melbourne, Richmond, VIC, Australia
| | - Feng-Rong An
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao, Macao SAR, China
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2
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Betancourt-Sánchez LC, Ochoa-Gelvez EO, Velásquez-Bernal CC, Rozo-Silva YA, Quiroga-Vargas DA. Occupational health in the framework of the COVID-19 pandemic: a scoping review. Rev Salud Publica (Bogota) 2023; 22:381-388. [PMID: 36753167 DOI: 10.15446/rsap.v22n3.87238] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 05/29/2020] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To collect the available evidence related to occupational health in the face of the introduction of the new SARS-CoV-2 coronavirus pandemic. METHODS Scoping review developed from the Arksey and O'Malley framework. The search was performed in the databases PubMed, Academic Search Complete, Science Direct, Medline, Scopus, Web of Science and Google Scholar. Documents on COVID-19 and its relationship with occupational health published in English, Portuguese and Spanish were included. The review, selection and characterization of the studies was carried out by five reviewers. RESULTS The search and selection identified 43 documents published between December 2019 and April 2020. The topics covered include occupational exposure, protection measures, psychosocial affectations of workers, particularly health, as well as conditions of work organization that can influence contagion. CONCLUSIONS Health workers are the most exposed workforce. Accompaniment, coaching and training in relation to patient care and the use of personal protection equipment are essential to reduce contagion among health personnel. In other work activities, social distancing is the standard measure for the mitigation of transmission, as well as the continuous disinfection of workplaces.
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Affiliation(s)
- Luis C Betancourt-Sánchez
- LB: Fonoaudiólogo. Esp. Salud Ocupacional. M.Sc. Seguridad y Salud en el Trabajo. Corporación Universitaria Minuto de Dios. Bogotá, Colombia.
| | - Edwin O Ochoa-Gelvez
- EO: Bacteriólogo. Esp. Salud Ocupacional. M.Sc. Epidemiología. Secretaria de Salud. Yopal, Colombia.
| | - Claudia C Velásquez-Bernal
- CV. Fonoaudióloga. Esp. Gerencia de la Seguridad y la Salud en el Trabajo. Universidad Nacional de Colombia. Bogotá, Colombia.
| | - Yenny A Rozo-Silva
- YR: Terapeuta Respiratoria. Esp. Gerencia de la Salud Ocupacional. M.Sc. Epidemiología. Corporación Universitaria Minuto de Dios. UVD. Bogotá, Colombia.
| | - Daniel A Quiroga-Vargas
- DQ: Ing. Químico. Esp. Gerencia en Salud Ocupacional. Consejo Colombiano de Seguridad. Bogotá, Colombia.
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El-Kassas M, Alboraie M, Elbadry M, El Sheemy R, Abdellah M, Afify S, Madkour A, Zaghloul M, Awad A, Wifi MN, Al Balakosy A, Eltabbakh M. Non-pulmonary involvement in COVID-19: A systemic disease rather than a pure respiratory infection. World J Clin Cases 2023; 11:493-505. [PMID: 36793640 PMCID: PMC9923857 DOI: 10.12998/wjcc.v11.i3.493] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 11/07/2022] [Accepted: 01/05/2023] [Indexed: 01/23/2023] Open
Abstract
During the early phase of the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), diagnosis was difficult due to the diversity in symptoms and imaging findings and the variability of disease presentation. Pulmonary manifestations are reportedly the main clinical presentations of COVID-19 patients. Scientists are working hard on a myriad of clinical, epidemiological, and biological aspects to better understand SARS-CoV-2 infection, aiming to mitigate the ongoing disaster. Many reports have documented the involvement of various body systems and organs apart from the respiratory tract including the gastrointestinal, liver, immune system, renal, and neurological systems. Such involvement will result in diverse presentations related to effects on these systems. Other presentations such as coagulation defects and cutaneous manifestation may also occur. Patients with specific comorbidities including obesity, diabetes, and hypertension have increased morbidity and mortality risks with COVID-19.
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Affiliation(s)
- Mohamed El-Kassas
- Department of Endemic Medicine, Faculty of Medicine, Helwan University, Cairo 11731, Egypt
| | - Mohamed Alboraie
- Department of Internal Medicine, Al-Azhar University, Cairo 11884, Egypt
| | - Mohamed Elbadry
- Department of Endemic Medicine, Faculty of Medicine, Helwan University, Cairo 11731, Egypt
| | - Reem El Sheemy
- Department of Tropical Medicine, Minia Faculty of Medicine, Minia University, Minia 61511, Egypt
| | - Mohamed Abdellah
- Department of Internal Medicine, Al-Azhar University, Cairo 11884, Egypt
| | - Shimaa Afify
- Department of Gastroenterology, National Hepatology and Tropical Medicine Research Institute, Cairo 11451, Egypt
| | - Ahmad Madkour
- Department of Endemic Medicine, Faculty of Medicine, Helwan University, Cairo 11731, Egypt
| | - Mariam Zaghloul
- Department of Hepatology, Gastroenterology and Infectious Diseases, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh 33511, Egypt
| | - Abeer Awad
- Department of Internal Medicine, Hepatogastroenterology Unit, Kasr Al-Ainy School of Medicine, Cairo 11451, Egypt
| | - Mohamed-Naguib Wifi
- Department of Internal Medicine, Hepatogastroenterology Unit, Kasr Al-Ainy School of Medicine, Cairo 11451, Egypt
| | - Amira Al Balakosy
- Department of Tropical Medicine, Ain Shams University, Cairo 11451, Egypt
| | - Mohamed Eltabbakh
- Department of Tropical Medicine, Ain Shams University, Cairo 11451, Egypt
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4
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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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5
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Pal S, Alam M, Giratkar S, Mukherjee B. Analysis of ophthalmic emergency visits during COVID-19 Lockdown in a tertiary eye care center in South India. TNOA JOURNAL OF OPHTHALMIC SCIENCE AND RESEARCH 2022. [DOI: 10.4103/tjosr.tjosr_118_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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6
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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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7
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Clinical operational considerations and responses to lockdown and reopening in the Covid-19 pandemic: experience of a tertiary ophthalmology centre in Singapore. Eye (Lond) 2021; 36:1924-1933. [PMID: 34584232 PMCID: PMC8477723 DOI: 10.1038/s41433-021-01566-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 03/04/2021] [Accepted: 04/15/2021] [Indexed: 01/22/2023] Open
Abstract
Background Much has been written on infection control and clinical measures for ophthalmic institutions and departments to cope with the COVID-19 pandemic. However, few articles have detailed implementation plans to manage lockdowns and subsequent re-openings. In this article, specific operational responses and their outcomes in a large tertiary ophthalmology centre are described. Method Through a concerted effort led by a dedicated task force, the Singapore National Eye Centre (SNEC) planned and executed an operational transformation to respond to the restrictions imposed on healthcare delivery during a national lock down. A carefully calibrated re-starting of services was carried out with the subsequent phased reopening of the country, taking into consideration unique constraints faced at that time. Strategies for operating in the new normal environment were also developed. Results Outpatient attendances were safely and expediently reduced by 70% (8749 vs. 29,311) and 82% (5164 vs. 29,342) in April and May 2020, respectively, compared to the corresponding months in 2019. A correspondingly large reduction in surgical load was also achieved through a similar triaging and prioritization system. Through optimizing the center’s use of space and time, as well as expanding on new models of care, a return to pre-pandemic patient load was achieved 3 months into the phased reopening of the country, and subsequently exceeded in the following months. Conclusion The lessons gleaned from SNEC’s experience may be useful for institutions currently facing the same challenges, and for future responses to COVID-19 resurgences or other pandemics.
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8
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Pérez-Peralta L, Sauceda-Valenzuela AL, La Parra DRD, Suarez-Ajoleza AA, Beauregard-Escobar AM, Torres-Dominguez JA. Systematic review: SARS-COV-2 contagion prevention measures in vision health professionals. Oman J Ophthalmol 2021; 14:136-143. [PMID: 34880572 PMCID: PMC8597808 DOI: 10.4103/ojo.ojo_134_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 06/21/2021] [Accepted: 08/12/2021] [Indexed: 11/04/2022] Open
Abstract
The disease, which originated from the SARS-CoV-2 virus, is primarily transmitted by direct contact with infected individuals. Visual healthcare professionals perform clinical practices that pose a significant risk of infection due to their proximity with patients during the examination. This systematic review aims to identify preventive measures that will aid in reducing the risk of infection during standard appointments between patients and visual health professionals. A systematic review was done for articles published in indexed journals from December 2019 to December 2020. The search for these articles was done in 3 electronic databases. As part of the search criteria, articles were selected if they had the keywords (SARS-CoV-2), (COVID-19), and coronavirus combined with ophthalmology, optometry, eye care, and the eye. Once duplicated and unrelated items were eliminated, 36 articles of interest were selected. Seven sections were described in detail: telephone screening, (COVID-19) triage, decreasing transmission within shared spaces, hand washing, use of personal protective equipment Personal Protective Equipment (PPE), cleaning of diagnostic instruments, and use of telemedicine. This paper helps healthcare professionals to better understand the context of the "new normal" clinical practice. Visual health professionals and their patients must adhere to norms and use the indicated PPE during the consultation to safeguard each other.
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Affiliation(s)
- Liliana Pérez-Peralta
- Institute of Ophthalmology Conde de Valenciana, Mexico City, Mexico
- CAIPaDi, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico
| | | | - David Rivera-de La Parra
- Institute of Ophthalmology Conde de Valenciana, Mexico City, Mexico
- CAIPaDi, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico
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9
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Sieberer J, Hughes P, Sian I. Telephone-based consultation in an acute eye clinic service: A patient satisfaction survey. Eur J Ophthalmol 2021; 32:1390-1397. [PMID: 34250818 DOI: 10.1177/11206721211030774] [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: 11/16/2022]
Abstract
OBJECTIVES The coronavirus pandemic has forced healthcare staff across all medical specialties to adapt new and different ways of working. A new approach has been set up in the Acute Referral Clinic (ARC) at Musgrove Park Hospital and a survey has been conducted to measure the impact of the new method on patient and healthcare professionals' satisfaction with the new service. METHODS A telephone-based consultation was introduced in ARC at Musgrove Park Hospital in March 2020 and patients were instructed to fill out a questionnaire containing eight items using a Likert Scale 1 ('very poor/disagree') to 4 ('very good/strongly agree') plus two boxes for open positive and negative comments respectively. Likewise a questionnaire was designed in order to assess the healthcare professionals' satisfaction using the new approach. Data collection took place over a two month period between the end of March 2020 and end of May 2020. The data underwent quality control and was analysed using descriptive statistics. RESULTS Patient responses illustrated high satisfaction scores with an overall rating of very good (89.4%). The healthcare professionals' rating of the service was good (28.6% - 'very good/strongly agree', 57.1% - 'good/agree'). The safety rating of the new approach was overall rated 'very good' with 90.4% and 71.4% of patients and healthcare professionals respectively. CONCLUSIONS The telephone consultations introduced in the wake of COVID-19 are well accepted by both patients and doctors. There are some limitations of the approach, foremost being consultation time and clinic space but these do not outweigh the general benefit of this format amidst a pandemic setting.
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Affiliation(s)
- Julia Sieberer
- Ophthalmology, Musgrove Park Hospital, Somerset NHS Foundation Trust, Taunton, Somerset, UK
| | - Patrick Hughes
- Ophthalmology, Musgrove Park Hospital, Somerset NHS Foundation Trust, Taunton, Somerset, UK
| | - Indy Sian
- Ophthalmology, Musgrove Park Hospital, Somerset NHS Foundation Trust, Taunton, Somerset, UK
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10
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Salvetat ML, Salati C, Busatto P, Zeppieri M. The impact of COVID-19 related national lockdown on ophthalmic emergency in Italy: A multicenter study. Eur J Ophthalmol 2021; 32:1782-1794. [PMID: 34219482 PMCID: PMC9111919 DOI: 10.1177/11206721211028046] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Purpose: To assess ocular pathologies admitted to Italian Emergency Eye Departments
(EEDs) during the COVID-19 pandemic national lockdown in 2020 in comparison
with the same period in 2019. Methods: Electronic records of all patients presenting at EEDs of two tertiary-care
Eye Centers during the COVID-19 national lockdown in Italy (March 10–May 3,
2020) were compared with the equivalent period in 2019. Main outcomes were
patient age, gender, and diagnoses. Statistical analysis included unpaired
Student t-tests, Poisson regression, and chi-square
test. Results: Overall EED visits significantly decreased by 54.1% during the 2020 lockdown
compared to 2019 (851 vs 1854, p < 0.001). During
lockdown, patients showed comparable mean age (52.8 years in 2020 vs
53.3 years in 2019, p = 0.52) and significant male gender
bias (61.1% in 2020 vs 55.8% in 2019, p < 0.0001). The
most frequent pathologies were eye inflammations, trauma-related incidents,
and spontaneous acute vitreous detachment. Patients with inflammation,
headache/hemicrania, and spontaneous subconjunctival hemorrhages were
significantly less, whereas those with trauma-related diagnoses were
significantly higher during the lockdown as compared with 2019
(p < 0.05). The proportion of non-urgent visits
decreased from 17% in 2019 to 8% in 2020
(p < 0.001). Conclusions: During the 2020 lockdown, there was a significant reduction of accesses to
EED, especially for non-urgent pathologies. Potentially visual function
threatening conditions, such as trauma-related pathologies, retinal
detachment or ruptures, and wet AMD, showed lower number of cases but higher
or stable proportion relative to the total caseload, suggesting a correct
and efficient access to ophthalmic health care during the pandemic
period.
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Affiliation(s)
- Maria L Salvetat
- Department of Ophthalmology, Azienda Sanitaria "Friuli Occidentale", Pordenone, Italy
| | - Carlo Salati
- Department of Ophthalmology, University Hospital of Udine, Udine, Italy
| | - Patrizia Busatto
- Department of Ophthalmology, Azienda Sanitaria "Friuli Occidentale", Pordenone, Italy
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, Udine, Italy
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Ahsan R, Tahsili MR, Ebrahimi F, Ebrahimie E, Ebrahimi M. Image processing unravels the evolutionary pattern of SARS-CoV-2 against SARS and MERS through position-based pattern recognition. Comput Biol Med 2021; 134:104471. [PMID: 34004573 PMCID: PMC8106241 DOI: 10.1016/j.compbiomed.2021.104471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 04/27/2021] [Accepted: 05/02/2021] [Indexed: 12/16/2022]
Abstract
SARS-COV-2, Severe Acute Respiratory Syndrome (SARS), and the Middle East respiratory syndrome-related coronavirus (MERS) viruses are from the coronaviridae family; the former became a global pandemic (with low mortality rate) while the latter were confined to a limited region (with high mortality rates). To investigate the possible structural differences at basic levels for the three viruses, genomic and proteomic sequences were downloaded and converted to polynomial datasets. Seven attribute weighting (feature selection) models were employed to find the key differences in their genome's nucleotide sequence. Most attribute weighting models selected the final nucleotide sequences (from 29,000th nucleotide positions to the end of the genome) as significantly different among the three virus classes. The genome and proteome sequences of this hot zone area (which corresponds to the 3'UTR region and encodes for nucleoprotein (N)) and Spike (S) protein sequences (as the most important viral protein) were converted into binary images and were analyzed by image processing techniques and Convolutional deep Neural Network (CNN). Although the predictive accuracy of CNN for Spike (S) proteins was low (0.48%), the machine-based learning algorithms were able to classify the three members of coronaviridae viruses with 100% accuracy based on 3'UTR region. For the first time ever, the relationship between the possible structural differences of coronaviruses at the sequential levels and their pathogenesis are being reported, which paves the road to deciphering the high pathogenicity of the SARS-COV-2 virus.
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Affiliation(s)
- Reza Ahsan
- Department of Computer Engineering, Qom Branch, Islamic Azad University, Qom, Iran
| | | | - Faezeh Ebrahimi
- Faculty of Life Sciences and Biotechnology, Department of Microbiology and Microbial Biotechnology, Shahid Beheshti University, Tehran, Iran
| | - Esmaeil Ebrahimie
- Genomics Research Platform, School of Life Sciences, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, 3086, Australia,School of Animal and Veterinary Sciences, The University of Adelaide, South Australia, 5371, Australia
| | - Mansour Ebrahimi
- Department of Biology, School of Basic Sciences, University of Qom, Qom, Iran,School of Animal and Veterinary Sciences, The University of Adelaide, South Australia, 5371, Australia,Corresponding author. Department of Biology, School of Basic Sciences, University of Qom, Qom, Iran
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12
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Zhang XM, Yang LT, Zhang Q, Fan QX, Zhang C, You Y, Zhang CG, Lin TZ, Xu L, Moutari S, Moore JE, Pazo EE, He W. Reliability of Chinese web-based ocular surface disease index questionnaire in dry eye patients: a randomized, crossover study. Int J Ophthalmol 2021; 14:834-843. [PMID: 34150537 DOI: 10.18240/ijo.2021.06.07] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 01/22/2021] [Indexed: 01/11/2023] Open
Abstract
AIM To assess the reliability of web-based version of ocular surface disease index in Chinese (C-OSDI) on clinically diagnosed dry eye disease (DE) patients. METHODS A total of 254 Chinese participants (51% male, 129/254; mean age: 27.90±9.06y) with DED completed paper- and web-based versions of C-OSDI questionnaires in a randomized crossover design. Ophthalmology examination and DED diagnosis were performed prior to the participants being invited to join the study. Participants were randomly designated to either group A (paper-based first and web-based second) or group B (web-based first and paper-based second). Final data analysis included participants that had successfully completed both versions of the C-OSDI. Demographic characteristics, test-retest reliability, and agreement of individual items, subscales, and total score were evaluated with intraclass correlation coefficients (ICC), Spearman rank correlation, Wilcoxon test and Rasch analysis. RESULTS Reliability indexes were adequate, Pearson correlation was greater than 0.8 and ICCs range was 0.827 to 0.982; total C-OSDI score was not statistically different between the two versions. The values of mean-squares fit statistics were very low compared to 1, indicating that the responses to the items by the model had a high degree of predictability. While comparing the favorability 72% (182/254) of the participants preferred web-based assessment. CONCLUSION Web-based C-OSDI is reliable in assessing DED and correlation with the paper-based version is significant in all subscales and overall total score. Web-based C-OSDI can be administered to assess individuals with DED as participants predominantly favored online assessment.
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Affiliation(s)
- Xin-Mei Zhang
- Department of Ophthalmology, He Eye Specialists Hospital, Shenyang 110034, Liaoning Province, China.,The Second Affiliated Hospital of Dalian Medical University, Dalian 116000, Liaoning Province, China
| | - Lan-Ting Yang
- Department of Ophthalmology, He Eye Specialists Hospital, Shenyang 110034, Liaoning Province, China.,The Second Affiliated Hospital of Dalian Medical University, Dalian 116000, Liaoning Province, China
| | - Qing Zhang
- Department of Ophthalmology, He Eye Specialists Hospital, Shenyang 110034, Liaoning Province, China.,The Second Affiliated Hospital of Dalian Medical University, Dalian 116000, Liaoning Province, China
| | - Qing-Xia Fan
- Department of Ophthalmology, He Eye Specialists Hospital, Shenyang 110034, Liaoning Province, China
| | - Can Zhang
- Department of Ophthalmology, He Eye Specialists Hospital, Shenyang 110034, Liaoning Province, China
| | - Yue You
- Department of Ophthalmology, He Eye Specialists Hospital, Shenyang 110034, Liaoning Province, China
| | - Chen-Guang Zhang
- Department of Ophthalmology, He Eye Specialists Hospital, Shenyang 110034, Liaoning Province, China
| | - Tie-Zhu Lin
- Department of Ophthalmology, He Eye Specialists Hospital, Shenyang 110034, Liaoning Province, China
| | - Ling Xu
- Department of Ophthalmology, He Eye Specialists Hospital, Shenyang 110034, Liaoning Province, China
| | - Salissou Moutari
- School of Mathematics and Physics, Queens University Belfast, University Road, Belfast, Northern Ireland BT7 1NN, United Kingdom
| | - Jonathan E Moore
- Cathedral Eye Clinic, 89-91 Academy Street, Belfast, Northern Ireland BT1 2LS, United Kingdom.,Biomedical Sciences Research Institute, University of Ulster, Coleraine, Northern Ireland BT52 1SA, United Kingdom
| | - Emmanuel E Pazo
- Department of Ophthalmology, He Eye Specialists Hospital, Shenyang 110034, Liaoning Province, China
| | - Wei He
- Department of Ophthalmology, He Eye Specialists Hospital, Shenyang 110034, Liaoning Province, China
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13
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Rokohl AC, Grajewski RS, Matos PAW, Kopecky A, Heindl LM, Cursiefen C. Ocular Involvement in COVID-19: Conjunctivitis and More. Klin Monbl Augenheilkd 2021; 238:555-560. [PMID: 34020483 DOI: 10.1055/a-1344-8138] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Since the beginning of 2020, SARS-CoV-2, the pathogen of COVID-19, has led to a global pandemic that also affects ophthalmology. Ophthalmologists can be confronted at any time with potentially COVID-19 associated ocular symptoms or manifestations in patients and also become infected through close patient contact. Even without systemic infection, the ocular surface can come into direct contact with aerosols or liquids containing SARS-CoV-2 particles. A smear infection through hand-to-eye contact is also possible. A purely isolated ocular infection has not yet been shown. Rather, it seems that ocular complications occur in the context of a systemic infection. However, ocular symptoms can also be the first symptom of COVID-19. The most common ocular complication of COVID-19 is mild follicular conjunctivitis. Haemorrhagic conjunctivitis, dry eye disease, episcleritis, or retinal involvement can also occur less frequently. There are currently no evidence-based therapy recommendations for COVID-19 associated diseases of the ocular surface. Artificial tears might be helpful for symptom relief. There is no evidence for antiviral, antibiotic, or anti-inflammatory therapies, but these medications might be used in individual cases. Potential intraocular complications include retinal artery occlusions and haemorrhages, as well as cotton wool spots caused by complement-mediated thrombotic angiopathy. Neuro-ophthalmological complications including Miller-Fisher syndrome or infarct-related central blindness can also occur in very rare cases. Knowledge of potential transmission routes and personal protective equipment is just as essential for each ophthalmologist as a basic knowledge of potential ocular symptoms and complications.
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Affiliation(s)
- Alexander C Rokohl
- Zentrum für Augenheilkunde, Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Köln, Deutschland
| | - Rafael S Grajewski
- Zentrum für Augenheilkunde, Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Köln, Deutschland
| | - Philomena A Wawer Matos
- Zentrum für Augenheilkunde, Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Köln, Deutschland
| | - Adam Kopecky
- Zentrum für Augenheilkunde, Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Köln, Deutschland.,Klinik für Augenheilkunde, Universitätskrankenhaus Ostrava, Ostrava, Tschechische Republik
| | - Ludwig M Heindl
- Zentrum für Augenheilkunde, Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Köln, Deutschland
| | - Claus Cursiefen
- Zentrum für Augenheilkunde, Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Köln, Deutschland
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14
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Abstract
The emergence of the coronavirus disease 2019 pandemic has led to a change in the whole world order. The key actors and occupational groups most at risk during this period have been health care professionals. In this pandemic, we, as dermatologists, also have many responsibilities regarding patients, ourselves, and society. Dermatologists have to protect themselves, their families, and their patients while working in pandemic services and outpatient clinics, as well as in their practices. One of their roles is to inform the public about protective measures for cutaneous side effects associated with the intensive use of disinfectants and long-term use of masks. In hospitals, only emergency patients had been admitted for treatment in all units during the pandemic, and elective operations and procedures were delayed. In this context, it is very important to determine what procedures will be carried out during this period in the follow up and treatment of chronic dermatologic diseases, as well as what interventional and cosmetic procedures may performed. Guidelines issued by various medical societies have made valuable contributions. The benefits and associated issues of teledermatology have pros and cons. Finally, one of the issues to ponder in the long term seems to be how we should pursue online education.
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Affiliation(s)
- Ayse Serap Karadag
- Department of Dermatology, Ataşehir Memorial Hospital, Istanbul, Turkey.
| | - Melek Aslan Kayıran
- Department of Dermatology, Istanbul Medeniyet University, School of Medicine, Goztepe Prof Dr Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Uwe Wollina
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden Academic Teaching Hospital of the Technical University, Freidrichstrasse, Dresden, Germany
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15
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Abstract
PURPOSE OF REVIEW The current article reviews the impact of the coronavirus disease 2019 (COVID-19) pandemic on the delivery of ophthalmic, and specifically, glaucoma care. RECENT FINDINGS Literature from the review period includes case series demonstrating the presence of severe acute respiratory syndrome coronavirus 2 RNA in the conjunctival secretions of patients with laboratory-confirmed COVID-19. The global ophthalmology community published reports outlining the enhanced infection control measures undertaken by different institutions around the world to mitigate transmission of the novel coronavirus. Telemedicine has been increasingly implemented in glaucoma practices to reduce in-office patient volume. New data regarding the efficacy and feasibility of tools for home monitoring of intraocular pressure, virtual visual field testing, and remote disc photography are reviewed. SUMMARY COVID-19 has posed a global public health threat due to the severity of its contagion and associated morbidity and mortality. Glaucoma specialists have responded to the pandemic with innovative modifications to reduce viral transmission and optimize patient and staff safety in the office and operating room. The role of teleglaucoma has expanded and will continue to evolve as remote diagnostic devices undergo further refinement and validation.
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Affiliation(s)
- Kateki Vinod
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, USA
| | - Paul A Sidoti
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, USA
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16
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Salica JP, Potilinski C, Querci M, Navarro I, Rivero JS, Daponte P, Pineda Ll R, Gallo JE. A Year of Living Dangerously: Challenges and Recommendations for Safely Performing Ophthalmic Surgery During the COVID-19 Pandemic, from Start to Finish. Clin Ophthalmol 2021; 15:261-278. [PMID: 33519188 PMCID: PMC7837588 DOI: 10.2147/opth.s283327] [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: 09/23/2020] [Accepted: 12/10/2020] [Indexed: 12/18/2022] Open
Abstract
The COVID-19 pandemic has forced all nations to take an active role in infection control incorporating recommendations and measures to control viral dissemination. The epidemiological impact is very diverse and dynamic, even within the same region. Scientific knowledge regarding SARS-CoV-2 continues to improve every day with protocols needing to be updated and adjusted on a regular basis. Ophthalmology is a medical specialty identified to be at high risk for several reasons: it has very close doctor-patient contact, the virus has been detected in tears, and the ocular surface serves as a gateway to developing the infection. We have reviewed the current information on SARS-CoV-2 in the ophthalmologic field and provide up-to-date recommendations to help create protocols that can adapt to the dynamic situation of ophthalmologic institutions, patient cases, economic situations and access to diagnostic tests. This paper outlines the main recommendations regarding the initial consultation and outpatient clinics, measures to apply in the operating room (OR), and suggestions for post-surgical controls. Triage, according to the patient’s conditions and eye pathology, reduction of the time the patient is at the institution, social distancing, correct use of personal protective equipment (PPE), barrier methods, hygiene, as well as other recommendations mentioned in this document, will allow physicians to take care of the visual health of the patients while reducing the impact of the COVID-19 pandemic.
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Affiliation(s)
- Juan Pablo Salica
- Committee for Prevention of Ocular Infections, Argentinean Ophthalmology Council, Buenos Aires, Argentina.,Department of Ophthalmology, Hospital Universitario Austral, Pilar, Buenos Aires, Argentina.,Nanomedicine & Vision Lab, Instituto de Investigaciones en Medicina Traslacional, Universidad Austral, CONICET, Pilar, Buenos Aires, Argentina
| | - Constanza Potilinski
- Nanomedicine & Vision Lab, Instituto de Investigaciones en Medicina Traslacional, Universidad Austral, CONICET, Pilar, Buenos Aires, Argentina
| | - Marcia Querci
- Division of Infectious Diseases, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno (CEMIC), Buenos Aires, Argentina
| | - Ignacio Navarro
- Nanomedicine & Vision Lab, Instituto de Investigaciones en Medicina Traslacional, Universidad Austral, CONICET, Pilar, Buenos Aires, Argentina
| | - Juan Sebastián Rivero
- Committee for Prevention of Ocular Infections, Argentinean Ophthalmology Council, Buenos Aires, Argentina
| | - Pablo Daponte
- Committee for Prevention of Ocular Infections, Argentinean Ophthalmology Council, Buenos Aires, Argentina
| | - Roberto Pineda Ll
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - Juan E Gallo
- Department of Ophthalmology, Hospital Universitario Austral, Pilar, Buenos Aires, Argentina.,Nanomedicine & Vision Lab, Instituto de Investigaciones en Medicina Traslacional, Universidad Austral, CONICET, Pilar, Buenos Aires, Argentina
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17
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Khanna RC, Garg P, Vaddavalli PK, Fernandes M, Rath S, Nayak S, Narayanan R, Pappuru RR, Kaliki S, Das AV, Sharma S, Jalali S. Response of L V Prasad Eye Institute to COVID-19 outbreak in India: experience at its tertiary eye care centre and adoption to its Eye Health Pyramid. Int J Ophthalmol 2021; 14:1-9. [PMID: 33469477 PMCID: PMC7790675 DOI: 10.18240/ijo.2021.01.01] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 09/01/2020] [Indexed: 01/08/2023] Open
Abstract
AIM To summarize the experience of response to COVID-19 outbreak at a tertiary eye care institute and its network of health facilities in India. METHODS Our responses are based on the principles of social distancing, hand hygiene, respiratory etiquettes, surface disinfection protocol, and rational use of appropriate personal protective equipment (PPE). We describe our response in terms of administrative controls, clinical protocols, staff protection, environmental controls, and social distancing measures. We also discuss our communication strategies and monitoring systems, to ensure compliance to protocols. RESULTS Administrative control is mainly related to formation of task force and its functions. Clinical protocols are related to patient triaging methods and clinical examination guidelines in Outpatient, Inpatient and Operating Room. Staff protection is focused on training staff on the protocols to be followed in hospital as well as at home, and use of PPE. Environmental protocol is focused on cleaning and disinfectant methods to be used in the hospital. In addition, there are systems for communication as well as monitoring compliance to protocols. CONCLUSION We hope that these protocols and our experience would help the ophthalmic community globally and serve as a guide to protect ophthalmologists and ophthalmic care personnel, and their patients across the world.
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Affiliation(s)
- Rohit C Khanna
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad 500030, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana 500034, India
- School of Optometry and Vision Science, University of New South Wales, Sydney 2033, Australia
- University of Rochester, School of Medicine and Dentistry, Rochester, NY 14642, USA
| | - Prashant Garg
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana 500034, India
- Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad 500034, India
| | - Pravin K Vaddavalli
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana 500034, India
- Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad 500034, India
| | - Merle Fernandes
- Grandhi Mallikarjun Rao Varalakshmi Campus, L V Prasad Eye Institute, Vishakhapatnam, Andhra Pradesh 530040, India
| | - Suryasnata Rath
- Mithu Tulsi Chanrai Campus, L V Prasad Eye Institute, Bhubaneswara, Odisha 751024, India
| | - Sameera Nayak
- Kode Venkatadri Chowdary Campus, L V Prasad Eye Institute, Vijayawada 521134, India
| | - Raja Narayanan
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana 500034, India
- University of Rochester, School of Medicine and Dentistry, Rochester, NY 14642, USA
- Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad 500034, India
| | - Rajeev Reddy Pappuru
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana 500034, India
- Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad 500034, India
| | - Swathi Kaliki
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana 500034, India
- Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad 500034, India
| | - Anthony Vipin Das
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana 500034, India
- Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad 500034, India
- Department of eyeSmart EMR & AEye, L V Prasad Eye Institute 500034, India
| | - Savitri Sharma
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana 500034, India
- Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad 500034, India
| | - Subhadra Jalali
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana 500034, India
- Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad 500034, India
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18
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Monferrer-Adsuara C, Castro-Navarro V, González-Girón N, Remolí-Sargues L, Ortiz-Salvador M, Montero-Hernández J, Cervera-Taulet E. A case of bilateral unusual retinal hemorrhages in a COVID-19 patient. Eur J Ophthalmol 2020; 32:1120672120984381. [PMID: 33353419 PMCID: PMC8935154 DOI: 10.1177/1120672120984381] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 12/08/2020] [Indexed: 01/08/2023]
Abstract
PURPOSE There have been anecdotal reports of ocular manifestations in the Coronavirus Disease 2019 (COVID-19). As the pandemic is spreading and the whole picture is yet unknown, ophthalmologists should be aware of unusual ocular presentations of COVID-19 since they could precede the development of severe respiratory distress. METHODS We report here the first case of a patient with bilateral unusual dot-blot retinal hemorrhages and retinal venous dilation who presented shortly thereafter a PCR-proven COVID-19. CASE REPORT A 59-year-old woman presented with a 7 days history of blurred vision in both eyes. Fundus examination revealed bilateral venous stasis and dot and blot intra-retinal hemorrhages preceding the diagnosis of COVID-19 in a patient with mild respiratory symptoms that progressed within a few days to a severe respiratory distress. After 1 month of the COVID-19 treatment, fundus examination improved and fluorescein angiography demonstrated no diabetic retinopathy signs, no retinal vasculitis and no significant delay in arterial or venous filling. CONCLUSION Intraretinal hemorrhages similar to those found in the retinopathy associated to blood dyscrasias could be an association with SARS-CoV-2 in the context of a coagulopathy induced by the infection.
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Affiliation(s)
| | - Verónica Castro-Navarro
- Hospital General Universitario de Valencia, Valencia, Spain
- Facultad de Medicina, Universidad Católica de Valencia ‘San Vicente Mártir’, Valencia, Spain
| | | | | | | | - Javier Montero-Hernández
- Hospital General Universitario de Valencia, Valencia, Spain
- Facultad de Medicina, Universidad Católica de Valencia ‘San Vicente Mártir’, Valencia, Spain
| | - Enrique Cervera-Taulet
- Hospital General Universitario de Valencia, Valencia, Spain
- Facultad de Medicina, Universidad Católica de Valencia ‘San Vicente Mártir’, Valencia, Spain
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19
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Prevalence of SARS-CoV-2 infection in patients presenting for intravitreal injection. SPEKTRUM DER AUGENHEILKUNDE 2020; 35:70-74. [PMID: 33343086 PMCID: PMC7731141 DOI: 10.1007/s00717-020-00473-3] [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] [Received: 10/11/2020] [Accepted: 11/18/2020] [Indexed: 02/04/2023]
Abstract
Aim Due to the coronavirus disease 2019 (COVID-19) pandemic, nosocomial transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is of great concern to clinicians of all specialties. Currently there are no published data available on the prevalence of the infection in ophthalmology patients presenting for intravitreal injection (IVI). The purpose of this retrospective study was to estimate the prevalence of SARS-CoV‑2 infection in patients presenting for IVI at our hospital. Methods Patients presenting for IVI in April 2020 at our hospital who had been screened for SARS-CoV‑2 infection using nasopharyngeal and oropharyngeal specimen for real-time reverse transcription polymerase chain reaction analysis were included in a retrospective study. To assess the representativity of this sample for IVI patients, characteristics were compared with patients presenting for IVI during March–April 2019. Results The study included 279 patients and 319 historic control patients. Of 277 valid test results, one SARS-CoV‑2 positive patient was found, resulting in a carrier rate of 0.36% with a 95% Clopper–Pearson confidence interval of 0.01–1.99%. No differences in sex (57.7% vs. 59.9% female, p = 0.650), age (77.63 ± 10.29 vs. 77.59 ± 10.94 years, p = 0.962), and region of residence were found between groups. Conclusion The study provides an estimate for the prevalence of SARS-CoV‑2 infection in asymptomatic patients presenting for IVI. While these data may be used as a baseline, further research is needed to assess the development of SARS-CoV‑2 prevalence in this patient group in order to support risk assessment and infection prevention strategies.
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20
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Aggarwal K, Agarwal A, Jaiswal N, Dahiya N, Ahuja A, Mahajan S, Tong L, Duggal M, Singh M, Agrawal R, Gupta V. Ocular surface manifestations of coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis. PLoS One 2020; 15:e0241661. [PMID: 33151999 PMCID: PMC7643964 DOI: 10.1371/journal.pone.0241661] [Citation(s) in RCA: 88] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/19/2020] [Indexed: 02/07/2023] Open
Abstract
Purpose This study was performed to determine the occurrence of ocular surface manifestations in patients diagnosed with coronavirus disease 2019 (COVID-19) due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods A systematic search of electronic databases i.e. PubMed, Web of Science, CINAHL, OVID and Google scholar was performed using a comprehensive search strategy. The searches were current through 31st May 2020. Pooled data from cross-sectional studies was used for meta-analysis and a narrative synthesis was conducted for studies where a meta-analysis was not feasible. Results A total of 16 studies reporting 2347 confirmed COVID-19 cases were included. Pooled data showed that 11.64% of COVID-19 patients had ocular surface manifestations. Ocular pain (31.2%), discharge (19.2%), redness (10.8%), and follicular conjunctivitis (7.7%) were the main features. 6.9% patients with ocular manifestations had severe pneumonia. Viral RNA was detected from the ocular specimens in 3.5% patients. Conclusion The most common reported ocular presentations of COVID-19 included ocular pain, redness, discharge, and follicular conjunctivitis. A small proportion of patients had viral RNA in their conjunctival/tear samples. The available studies show significant publication bias and heterogeneity. Prospective studies with methodical collection and data reporting are needed for evaluation of ocular involvement in COVID-19.
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Affiliation(s)
- Kanika Aggarwal
- Advanced Eye Centre, Department of Ophthalmology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Aniruddha Agarwal
- Advanced Eye Centre, Department of Ophthalmology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Nishant Jaiswal
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Neha Dahiya
- School of Medicine, St Joseph Mercy Hospital, Oakland, Pontiac, Michigan, United States of America
| | - Alka Ahuja
- Advanced Eye Centre, Department of Ophthalmology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Sarakshi Mahajan
- School of Medicine, St Joseph Mercy Hospital, Oakland, Pontiac, Michigan, United States of America
| | - Louis Tong
- Singapore National Eye Centre, Singapore, Singapore
- Singapore Eye Research Institute, Singapore, Singapore
- Eye-Academic Clinical Program, Duke-National University of Singapore (NUS) Medical School, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Mona Duggal
- Advanced Eye Centre, Department of Ophthalmology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Meenu Singh
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Rupesh Agrawal
- Singapore National Eye Centre, Singapore, Singapore
- Singapore Eye Research Institute, Singapore, Singapore
- Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore
| | - Vishali Gupta
- Advanced Eye Centre, Department of Ophthalmology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
- * E-mail: ,
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21
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Guo H, Li W, Huang Y, Li X, Li Z, Zhou H, Sun E, Li L, Li J. Increased microbial loading in aerosols produced by non-contact air-puff tonometer and relative suggestions for the prevention of coronavirus disease 2019 (COVID-19). PLoS One 2020; 15:e0240421. [PMID: 33031477 PMCID: PMC7544126 DOI: 10.1371/journal.pone.0240421] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 09/27/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To evaluate the microbial loading in aerosols produced after air-puff by non-contact tonometer (NCT) as well as the effect of alcohol disinfection on the inhibition of microbes and thus to provide suggestions for the prevention and control of COVID-19 in ophthalmic departments of hospitals or clinics during the great pandemics. METHODS A cross-sectional study was carried out in this study. A NIDEK NCT was used for intraocular pressure (IOP) measurement for patients who visited Department of Ophthalmology in Qilu Hospital of Shandong University during March 18-25 2020. After ultra-violate (UV) light disinfection, the room air was sampled for 5 minutes. Before and after alcohol disinfection, the air samples and nozzle surface samples were respectively collected by plate exposure method and sterile moist cotton swab technique after predetermined times of NCT air-puff. Microbial colony counts were calculated after incubation for 48 hours. Finally, mass spectrometry was performed for the accurate identification of microbial species. RESULTS Increased microbial colonies were detected from air samples close to NCT nozzle after air-puff compared with air samples at a distance of 1 meter from the nozzle (p = 0.001). Interestingly, none microbes were detected on the surface of NCT nozzle. Importantly, after 75% alcohol disinfection less microbes were detected in the air beside the nozzle (p = 0.003). Microbial species identification showed more than ten strains of microbes, all of which were non-pathogenic. CONCLUSION Aerosols containing microbes were produced by NCT air-puff in the ophthalmic consultation room, which may be a possible virus transmission route in the department of ophthalmology during the COVID-19 pandemic. Alcohol disinfection for the nozzle and the surrounding air was efficient at decreasing the microbes contained in the aerosols and theoretically this prevention measure could also inhibit the virus. This will give guidance for the prevention of virus transmission and protection of hospital staff and patients.
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Affiliation(s)
- Hui Guo
- Department of Ophthalmology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China
| | - Wei Li
- Department of Clinical Laboratory, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China
| | - Yingying Huang
- Department of Ophthalmology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China
| | - Xiaoyan Li
- Department of Ophthalmology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China
| | - Zhi Li
- Department of Ophthalmology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China
| | - Hongxia Zhou
- Department of Clinical Laboratory, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China
| | - Enhua Sun
- Department of Clinical Laboratory, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China
| | - Li Li
- Department of Medical Oncology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China
| | - Jisheng Li
- Department of Medical Oncology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China
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22
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Trigaux C, Salla S, Schroeter J, Tourtas T, Thomasen H, Maier P, Hellwinkel OJC, Wittmershaus I, Merz PR, Seitz B, Nölle B, Schrage N, Roters S, Apel M, Gareiss-Lok A, Uhlig CE, Thaler S, Raber F, Kampik D, Geerling G, Menzel-Severing J. SARS-CoV-2: Impact on, Risk Assessment and Countermeasures in German Eye Banks. Curr Eye Res 2020; 46:666-671. [PMID: 33016144 DOI: 10.1080/02713683.2020.1828487] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Since the beginning of the COVID-19 pandemic there has been some debate regarding the risk of transmission through tissue transplantation and tissue banking processes. AIM OF THE STUDY To analyze the changes that SARS-CoV-2 has caused regarding the harvesting of corneal donor tissue and eye bank activities in Germany. METHODS A questionnaire was provided to 26 eye banks in Germany, consisting of questions about adaptations made in the screening of potential donors and the harvesting of corneal tissue following the pandemic spread of SARS-CoV-2. RESULTS Eighteen eye banks actively reduced recruitment of donors and two banks ceased all activity. Additional diagnostic screening was performed in eight banks, using conjunctival swabs and/or nasopharyngeal swabs. In six eye banks, additional protective measures, such as FFP2 masks and/or facial shields, were implemented. Overall, a mean reduction in the number of obtained donor tissues of 17% was observed. DISCUSSION Conjunctival and/or nasopharyngeal swabs of donors have been implemented by a minority. Reasons for not performing additional tests may be moderate sensitivity and lack of validation for postmortem use of RT-PCR testing. Also, the hazard of SARS-CoV-2 entering the corneal donor pool with subsequent transmission might be perceived as theoretical. Face shields provide a sufficient barrier against splash and splatter contamination but may be insufficient against aerosols. Additional face masks would provide support against aerosols, but it remains debatable if corneal harvesting can be considered an aerosol-producing procedure. In the future we expect to see changes in current guidelines because of a surge in scientific activities to improve our understanding of the risks involved with cornea donation in the COVID-19 pandemic, and because current practice may reduce the availability of donor corneas due to new exclusion criteria while the demand remains unchanged.
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Affiliation(s)
- Céline Trigaux
- Department of Ophthalmology, University of Düsseldorf, Düsseldorf, Germany
| | - Sabine Salla
- Department of Ophthalmology, RWTH University Aachen, Aachen, Germany
| | - Jan Schroeter
- Institute of Transfusion Medicine, University Tissue Bank, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Theofilos Tourtas
- Department of Ophthalmology, University of Erlangen-Nuremberg, Erlangen-Nuremberg, Germany
| | - Henning Thomasen
- Department of Ophthalmology, University of Essen, Essen, Germany
| | - Philip Maier
- Department of Ophthalmology, University of Freiburg, Freiburg, Germany
| | | | - Ilka Wittmershaus
- Department of eye banking, Deutsche Gesellschaft Für Gewebetransplantation, Hannover, Germany
| | - Patrick R Merz
- Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Berthold Seitz
- Department of Ophthalmology, Saarland University Medical Center, UKS, Homburg, Saar, Germany
| | - Bernhard Nölle
- Department of Ophthalmology, University of Kiel, Kiel, Germany
| | - Norbert Schrage
- Department of Ophthalmology, Städt. Kliniken Köln, Cologne, Germany
| | - Sigrid Roters
- Department of Ophthalmology, University of Cologne, Cologne, Germany
| | - Melissa Apel
- Department of Ophthalmology, University of Mainz, Mainz, Germany
| | | | | | - Sebastian Thaler
- Department of Ophthalmology, University of Tübingen, Tübingen, Germany
| | - Florian Raber
- Department of Ophthalmology, University of Ulm, Ulm, Germany
| | - Daniel Kampik
- Department of Ophthalmology, University of Würzburg, Würzburg, Germany
| | - Gerd Geerling
- Department of Ophthalmology, University of Düsseldorf, Düsseldorf, Germany
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23
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Affiliation(s)
- Paul T Finger
- The New York Eye Cancer Center, New York City, New York, USA
| | - Anthony Fam
- The New York Eye Cancer Center, New York City, New York, USA
| | - Ankit S Tomar
- The New York Eye Cancer Center, New York City, New York, USA
| | - Gaurav Garg
- The New York Eye Cancer Center, New York City, New York, USA
| | - Kimberly J Chin
- The New York Eye Cancer Center, New York City, New York, USA
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24
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Systematic Review of Ocular Involvement of SARS-CoV-2 in Coronavirus Disease 2019. CURRENT OPHTHALMOLOGY REPORTS 2020; 8:185-194. [PMID: 33014631 PMCID: PMC7519854 DOI: 10.1007/s40135-020-00257-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2020] [Indexed: 01/10/2023]
Abstract
Purpose of Review Studies have reported ocular involvement in the coronavirus disease 2019 (COVID-19), with SARS-CoV-2 having been detected in ocular swab samples. This has implicated the eye as a portal of transmission. The aim of this systemic review is to summarise and discuss the current literature regarding ocular involvement of SARS-CoV-2 in COVID-19. Recent Findings In this systematic review, the prevalence of ocular symptoms and signs was low (from 0 to 31.58%) and conjunctivitis was a relatively rare occurrence. The rate of detection of SARS-CoV-2 in the ocular swab samples was low as well and this ranged from 0 to 11.11%. The development of ocular symptoms and signs was not always accompanied by the detection of SARS-CoV-2 in the ocular swab samples. The opposite was described as well. This may reflect issues related to the characteristics of SARS-CoV-2 and of the study design. Nonetheless, the nature of research in a pandemic is that conclusions can change as more information is obtained. Summary Whilst the eye is unlikely to be a main transmission route, we need to consider the possibilities of conjunctivitis as a presenting complaint and of the eye playing a role in the transmission of SARS-CoV-2. Furthermore, we need to take the appropriate precautions in our practice. Further studies are needed to evaluate the viral tropism of SARS-CoV-2 and its role in the eyes.
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25
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Shemer A, Einan-Lifshitz A, Itah A, Dubinsky-Pertzov B, Pras E, Hecht I. Ocular involvement in coronavirus disease 2019 (COVID-19): a clinical and molecular analysis. Int Ophthalmol 2020; 41:433-440. [PMID: 32929665 PMCID: PMC7489575 DOI: 10.1007/s10792-020-01592-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 09/05/2020] [Indexed: 02/02/2023]
Abstract
Purpose Coronavirus disease 2019 (COVID-19) caused a global pandemic with millions infected worldwide. Little is known on the ocular involvement associated with the disease. The aim of this study was to assess the clinical and molecular ocular involvement among patients with confirmed COVID-19 admitted to a tertiary care facility. Methods Consecutive patients admitted to the COVID-19 Ward of the Shamir Medical Center in Israel during March and April, 2020 were included. The control group included patients negative for COVID-19 admitted during a similar period to a different ward. Patients were examined by trained Ophthalmologists. SARS-CoV-2 conjunctival swab samples were obtained. Results Included were 48 patients, 16 with confirmed COVID-19 and 32 controls. Median patient age was 68.5 (interquartile range: 31.5, mean: 63 ± 21) years and 48% were male. Active conjunctival injection was present in three patients (19%) with COVID-19, compared to none in the controls (p = 0.034). Patients with COVID-19 were more likely to complain of foreign body sensation (31.3% vs 3.1%, p = 0.005) and redness of the eye (25% vs 0%, p = 0.003). Conjunctival injection was associated with loss of smell and taste (75% vs 7.7%, p = 0.018). Viral conjunctival swab tests all showed negative results for all three viral genes tested (E, N, and RdRp). Conclusions Among patients admitted to a tertiary referral center with confirmed COVID-19, active conjunctival injection was noted in one out of five cases, and was associated with loss of smell and taste. Conjunctival swabs for viral RNA were negative in patients with and without ocular involvement. Electronic supplementary material The online version of this article (10.1007/s10792-020-01592-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Asaf Shemer
- Department of Ophthalmology, Shamir Medical Center (Formerly Assaf-Harofeh), Tzrifin, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Adi Einan-Lifshitz
- Department of Ophthalmology, Shamir Medical Center (Formerly Assaf-Harofeh), Tzrifin, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Amir Itah
- Department of Ophthalmology, Shamir Medical Center (Formerly Assaf-Harofeh), Tzrifin, Israel
- Faculty of Medicine, The Hebrew University - Hadassah School of Medicine, Hadassah Campus, Jerusalem, Israel
| | - Biana Dubinsky-Pertzov
- Department of Ophthalmology, Shamir Medical Center (Formerly Assaf-Harofeh), Tzrifin, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eran Pras
- Department of Ophthalmology, Shamir Medical Center (Formerly Assaf-Harofeh), Tzrifin, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Matlow's Ophthalmo-Genetics Laboratory, Department of Ophthalmology, Shamir Medical Center (Formerly Assaf-Harofeh), Tzrifin, Israel
| | - Idan Hecht
- Department of Ophthalmology, Shamir Medical Center (Formerly Assaf-Harofeh), Tzrifin, Israel.
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Amesty MA, Alió Del Barrio JL, Alió JL. COVID-19 Disease and Ophthalmology: An Update. Ophthalmol Ther 2020; 9:1-12. [PMID: 32445134 PMCID: PMC7243216 DOI: 10.1007/s40123-020-00260-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Indexed: 12/20/2022] Open
Abstract
The worldwide outbreak of the severe and acute respiratory coronavirus disease (COVID-19) caused by the coronavirus strain SARS-CoV-2 is currently the focal point of discussion due to the suffering this syndrome is causing to humanity. However, the ophthalmological implications of this syndrome has not yet been well described. Both eyes and tears as portals of entry and sources of contagion have been the subject of debate by many authors. The purpose of this review is to summarize the evidence currently available on COVID-19 and its ocular implications and manifestations, in both animals and humans, with the aim to facilitate prevention and educate the ophthalmological community on this subject. A review of the literature revealed that the results of some studies suggest that ocular symptoms commonly appear in patients with severe COVID-19 pneumonia and that it is possible to isolate the virus from the conjunctival sac of these patients. Conjunctivitis is not a common manifestation of the disease, but contact with infected eyes could be one route of transmission. Consequently, ophthalmologists need to have correct prevention strategies in place. Some guidelines regarding the prevention and management of ophthalmology clinics are reviewed. However, well-designed trials should be conducted to rule out other ocular manifestations that may result from COVID-19 infection and to understand the transmission of the virus through the eyes.
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Affiliation(s)
- María A Amesty
- Oculoplastic Department, Vissum (Grupo Miranza), Alicante, Spain
| | - Jorge L Alió Del Barrio
- Cornea, Cataract and Refractive Surgery Unit, Vissum (Grupo Miranza), Alicante, Spain
- Division of Ophthalmology, School of Medicine, Universidad Miguel Hernández, Alicante, Spain
| | - Jorge L Alió
- Cornea, Cataract and Refractive Surgery Unit, Vissum (Grupo Miranza), Alicante, Spain.
- Division of Ophthalmology, School of Medicine, Universidad Miguel Hernández, Alicante, Spain.
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27
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Breazzano MP, Shen J, Abdelhakim AH, Glass LRD, Horowitz JD, Xie SX, de Moraes CG, Chen-Plotkin A, Chen RW. New York City COVID-19 resident physician exposure during exponential phase of pandemic. J Clin Invest 2020; 130:4726-4733. [PMID: 32463802 PMCID: PMC7456242 DOI: 10.1172/jci139587] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 05/21/2020] [Indexed: 01/25/2023] Open
Abstract
BACKGROUNDFrom March 2, 2020, to April 12, 2020, New York City (NYC) experienced exponential growth of the COVID-19 pandemic due to novel coronavirus (SARS-CoV-2). Little is known regarding how physicians have been affected. We aimed to characterize the COVID-19 impact on NYC resident physicians.METHODSIRB-exempt and expedited cross-sectional analysis through survey to NYC residency program directors April 3-12, 2020, encompassing events from March 2, 2020, to April 12, 2020.RESULTSFrom an estimated 340 residency programs around NYC, recruitment yielded 91 responses, representing 24 specialties and 2306 residents. In 45.1% of programs, at least 1 resident with confirmed COVID-19 was reported. One hundred one resident physicians were confirmed COVID-19-positive, with an additional 163 residents presumed positive for COVID-19 based on symptoms but awaiting or unable to obtain testing. Two COVID-19-positive residents were hospitalized, with 1 in intensive care. Among specialties with more than 100 residents represented, negative binomial regression indicated that infection risk differed by specialty (P = 0.039). In 80% of programs, quarantining a resident was reported. Ninety of 91 programs reported reuse or extended mask use, and 43 programs reported that personal protective equipment (PPE) was suboptimal. Sixty-five programs (74.7%) redeployed residents elsewhere to support COVID-19 efforts.CONCLUSIONMany resident physicians around NYC have been affected by COVID-19 through direct infection, quarantine, or redeployment. Lack of access to testing and concern regarding suboptimal PPE are common among residency programs. Infection risk may differ by specialty.FUNDINGNational Eye Institute Core Grant P30EY019007; Research to Prevent Blindness Unrestricted Grant; Parker Family Chair; University of Pennsylvania.
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Affiliation(s)
- Mark P. Breazzano
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, New York, USA
- Department of Ophthalmology, New York University School of Medicine, New York University Langone Health, New York, New York, USA
- Manhattan Eye, Ear and Throat Hospital, Lenox Hill Hospital, Northwell Health, New York, New York, USA
| | | | - Aliaa H. Abdelhakim
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, New York, USA
- Department of Ophthalmology, New York University School of Medicine, New York University Langone Health, New York, New York, USA
- Manhattan Eye, Ear and Throat Hospital, Lenox Hill Hospital, Northwell Health, New York, New York, USA
| | - Lora R. Dagi Glass
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, New York, USA
| | - Jason D. Horowitz
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, New York, USA
| | - Sharon X. Xie
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - C. Gustavo de Moraes
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, New York, USA
| | | | - Royce W.S. Chen
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, New York, USA
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28
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Babu N, Kohli P, Mishra C, Sen S, Arthur D, Chhablani D, Baliga G, Ramasamy K. To evaluate the effect of COVID-19 pandemic and national lockdown on patient care at a tertiary-care ophthalmology institute. Indian J Ophthalmol 2020; 68:1540-1544. [PMID: 32709770 PMCID: PMC7640832 DOI: 10.4103/ijo.ijo_1673_20] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Purpose: To evaluate the effect of COVID-19 pandemic and national lockdown on patient care at a tertiary-care ophthalmology institute. Methods: Records of all the patients who presented from March 25th to May 3rd, 2020 were scanned to evaluate the details regarding the presenting complaints, diagnosis, advised treatment and surgical interventions. Results: The number of outpatient department visits, retinal laser procedures, intravitreal injections and cataract surgeries during this lockdown decreased by 96.5%, 96.5%, 98.7% and 99.7% respectively compared from the corresponding time last year. Around 38.8% patients could be triaged as non-emergency cases based on history alone while 59.5% patients could be triaged as non-emergency cases after examination. Only eighty-four patients opted for video-consultation from April 15th to May 3rd, 2020. Nine patients presented with perforated corneal ulcer, but could not undergo penetrating keratoplasty due to the lack to available donor corneal tissue. One of these patients had to undergo evisceration due to disease progression. Two patients with open globe injury presented late after trauma and had to undergo enucleation. Around 9% patients could not undergo the advised urgent procedure due to logistical issues related to the lockdown. Conclusion: A significant number of patients could not get adequate treatment during the lockdown period. Hospitals need to build capacity to cater to the expected patient surge post-COVID-19-era, especially those requiring immediate in-person attention. A large number of patients can be classified as non-emergency cases. These patients need to be encouraged to follow-up via video-consultation to carve adequate in-person time for the high-risk patients.
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Affiliation(s)
- Naresh Babu
- Vitreo-Retinal Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, Tamil Nadu, India
| | - Piyush Kohli
- Vitreo-Retinal Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, Tamil Nadu, India
| | - Chitaranjan Mishra
- Vitreo-Retinal Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, Tamil Nadu, India
| | - Sagnik Sen
- Vitreo-Retinal Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, Tamil Nadu, India
| | - Dhipak Arthur
- Vitreo-Retinal Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, Tamil Nadu, India
| | - Deepesh Chhablani
- Vitreo-Retinal Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, Tamil Nadu, India
| | - Girish Baliga
- Vitreo-Retinal Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, Tamil Nadu, India
| | - Kim Ramasamy
- Vitreo-Retinal Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, Tamil Nadu, India
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29
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Lindsley WG, Blachere FM, Burton NC, Christensen B, Estill CF, Fisher EM, Martin SB, Mead KR, Noti JD, Seaton M. COVID-19 and the Workplace: Research Questions for the Aerosol Science Community. AEROSOL SCIENCE AND TECHNOLOGY : THE JOURNAL OF THE AMERICAN ASSOCIATION FOR AEROSOL RESEARCH 2020; 54:1117-1123. [PMID: 35924028 PMCID: PMC9345404 DOI: 10.1080/02786826.2020.1796921] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 07/14/2020] [Indexed: 06/13/2023]
Affiliation(s)
- William G. Lindsley
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA
| | - Francoise M. Blachere
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA
| | - Nancy C. Burton
- Division of Field Studies & Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio, USA
| | | | - Cherie F. Estill
- Division of Field Studies & Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio, USA
| | - Edward M. Fisher
- National Personal Protective Technology Laboratory, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Pittsburgh, Pennsylvania, USA
| | - Stephen B. Martin
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA
| | - Kenneth R. Mead
- Division of Field Studies & Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio, USA
| | - John D. Noti
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA
| | - Melissa Seaton
- Division of Science Integration, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio, USA
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30
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Rokohl AC, Loreck N, Wawer Matos PA, Mor JM, Zwingelberg S, Grajewski RS, Cursiefen C, Heindl LM. [The role of ophthalmology in the COVID-19 pandemic]. Ophthalmologe 2020; 117:642-647. [PMID: 32519117 PMCID: PMC7282201 DOI: 10.1007/s00347-020-01148-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 19 (COVID-19) has led to a worldwide pandemic. This pandemic presents a huge challenge for the healthcare system and also for ophthalmologists. Previous studies and case reports indicated that SARS-CoV‑2 also infects the conjunctiva resulting in conjunctivitis. In addition, infectious virus particles in the tear fluid can be potential sources of infection; however, the detection of SARS-CoV‑2 RNA in the tear fluid has rarely been successful. Although isolated conjunctival involvement is highly unlikely, at the current point in time of the COVID-19 pandemic, practically every patient examined by an ophthalmologist could be infected with SARS-CoV‑2. Therefore, protective and hygiene measures should currently be consistently followed to minimize the risk of spreading the virus. Currently, there are no treatment recommendations for conjunctivitis associated with COVID-19. Tear substitutes might be helpful for symptom relief but there is no evidence for a topical antiviral therapy. In the future ophthalmologists could play a decisive role in the screening of maculopathies that might occur during COVID-19 treatment using chloroquine or hydroxychloroquine.
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Affiliation(s)
- Alexander C Rokohl
- Zentrum für Augenheilkunde, Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Kerpener Str. 62, 50924, Köln, Deutschland.
| | - Niklas Loreck
- Zentrum für Augenheilkunde, Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Kerpener Str. 62, 50924, Köln, Deutschland
| | - Philomena A Wawer Matos
- Zentrum für Augenheilkunde, Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Kerpener Str. 62, 50924, Köln, Deutschland
| | - Joel M Mor
- Zentrum für Augenheilkunde, Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Kerpener Str. 62, 50924, Köln, Deutschland
| | - Sarah Zwingelberg
- Zentrum für Augenheilkunde, Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Kerpener Str. 62, 50924, Köln, Deutschland
| | - Rafael S Grajewski
- Zentrum für Augenheilkunde, Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Kerpener Str. 62, 50924, Köln, Deutschland
| | - Claus Cursiefen
- Zentrum für Augenheilkunde, Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Kerpener Str. 62, 50924, Köln, Deutschland
| | - Ludwig M Heindl
- Zentrum für Augenheilkunde, Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Kerpener Str. 62, 50924, Köln, Deutschland
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31
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Madanagopalan VG, Sriram Gopal MR, Sengupta S. Perspectives of physicians in general and ophthalmologists in particular about restarting services post-COVID-19 lockdown. Indian J Ophthalmol 2020; 68:1401-1406. [PMID: 32587176 PMCID: PMC7574103 DOI: 10.4103/ijo.ijo_1221_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/28/2020] [Accepted: 06/04/2020] [Indexed: 01/31/2023] Open
Abstract
PURPOSE To assess the perspectives of physicians in general and ophthalmologists in particular about restarting elective out-patient (OP) and operating (OT) services after relaxation of lockdown for COVID-19. METHODS An online survey, containing 31 questions, was conducted among medical doctors using a secure Google forms link. The survey was open for 48 hours from 16th-18th April 2020. RESULTS Responses were received from 556 physicians (including 266 ophthalmologists). About a third (n = 205) wanted to start OP immediately after lockdown. In OP, mask of any kind for patient (60.8%), 3-ply for assistants (52.7%) and N95 for doctors (72.7%) were most common preferences. In OP, 31.5% and 46.6% felt full PPE and gloves alone were sufficient respectively. Ophthalmologists were more likely to start immediately after lockdown compared to other specialists (P = 0.004). Among 299 surgeons, an almost equal number (27%) wanted to start routine OT services immediately and 2 weeks post lockdown. A large majority (76.9%) would mandate COVID-19 tests before elective surgeries. In OT, 34.1% wanted N95 for surgical team and 3-ply for patient, 23.4% wanted 3-ply masks for everyone. 40.5% felt additional personal protective equipment (PPE) is not required and 33.1% felt that full PPE is required for everyone in OT. Ophthalmic surgeons preferred 3-ply masks and were less inclined to use full PPE (P < 0.001). CONCLUSION Perspectives of doctors vary, especially with regarding to timing of restarting services and precautions to be taken in the OT. Ophthalmologists may tend to err on the side of taking lesser stringent precautions when restarting services post lockdown.
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Affiliation(s)
- V G Madanagopalan
- Vitreoretinal Services, JB Eye Care & Retina Centre, Salem, Tamil Nadu, India
| | - M R Sriram Gopal
- Vitreoretinal Services, Athreya Retinal Centre, Tiruchirapalli, Tamil Nadu, India
| | - Sabyasachi Sengupta
- Vitreoretinal Services, Future Vision Eye Care & Sengupta's Research Academy, Mumbai, India
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32
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Napoli PE, Nioi M, d’Aloja E, Fossarello M. Safety Recommendations and Medical Liability in Ocular Surgery during the COVID-19 Pandemic: An Unsolved Dilemma. J Clin Med 2020; 9:E1403. [PMID: 32397530 PMCID: PMC7290727 DOI: 10.3390/jcm9051403] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 05/06/2020] [Indexed: 11/30/2022] Open
Abstract
Ocular surgery is one of the most performed medical procedures in the world. Its limitation or suspension, recursively extended over time, could be associated with a significant increase in the number of blind people worldwide. Indeed, cataract causes more than half of all cases of visual impairment in those countries with limited availability of means for performing eye operations (e.g., Africa or India). In this scenario, the pandemic of coronavirus disease 2019 (COVID-19) quickly resulted in the suspension or sharp reduction of various ophthalmic activities considered non-urgent, including lens replacement surgery or some intraocular injections. Despite the imperative need to continuously practice eye operations to avoid the abovementioned problems, there are currently little-shared and vague recommendations among the various countries on safety in operating rooms (for health care workers and patients) and poor legal protection for surgeons (potentially transmitting the COVID-19 infectious agent). Herein, we individuated and discussed some critical points in safety recommendations and medical liability. A paradigm shift for ocular surgery during the COVID-19 era is now mandatory. While telemedicine has been able to solve some problems in clinical ophthalmology, the lack of adequate health and legal protection for surgeons and patients may result in an excessive reduction in the volume of surgical interventions during a pandemic era and the immediately following period, thus determining inability to ensure health care to all patients.
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Affiliation(s)
- Pietro Emanuele Napoli
- Department of Surgical Science, University of Cagliari, Eye Clinic, via Ospedale 46, 09124 Cagliari, Italy;
| | - Matteo Nioi
- Department of Clinical Sciences and Public Health, University of Cagliari, Forensic Medicine Unit, 09124 Cagliari, Italy; (M.N.); (E.d.A.)
| | - Ernesto d’Aloja
- Department of Clinical Sciences and Public Health, University of Cagliari, Forensic Medicine Unit, 09124 Cagliari, Italy; (M.N.); (E.d.A.)
| | - Maurizio Fossarello
- Department of Surgical Science, University of Cagliari, Eye Clinic, via Ospedale 46, 09124 Cagliari, Italy;
- Clinica Oculistica, San Giovanni di Dio Hospital, Azienda Ospedaliera Universitaria di Cagliari, 09124 Cagliari, Italy
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33
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Siedlecki J, Brantl V, Schworm B, Mayer WJ, Gerhardt M, Michalakis S, Kreutzer T, Priglinger S. COVID-19: Ophthalmological Aspects of the SARS-CoV 2 Global Pandemic. Klin Monbl Augenheilkd 2020; 237:675-680. [PMID: 32375197 PMCID: PMC7295305 DOI: 10.1055/a-1164-9381] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 04/23/2020] [Indexed: 01/08/2023]
Abstract
PURPOSE To perform a systematic analysis of articles on the ophthalmological implications of the global COVID-19 pandemic. METHODS PubMed.gov was searched for relevant articles using the keywords "COVID-19", "coronavirus", and "SARS-CoV-2" in conjunction with "ophthalmology" and "eye". Moreover, official recommendations of ophthalmological societies were systematically reviewed, with a focus on the American Academy of Ophthalmology (AAO) and the Royal College of Ophthalmologists (RCOphth). RESULTS As of April 16, 2020, in total, 21 peer-reviewed articles on the ophthalmological aspects of COVID-19 were identified. Of these, 12 (57.1%) were from Asia, 6 (28.6%) from the United States of America, and 3 (14.3%) from Europe. There were 5 (23.8%) original studies, 10 (47.6%) letters, 3 (14.2%) case reports, and 3 (14.2%) reviews. These articles could be classified into the topics "Modes and prevention of (ocular) transmission", "Ophthalmological manifestations of COVID-19", "Clinical guidance concerning ophthalmological practice during the COVID-19 pandemic", and "Practical recommendations for clinical infrastructure". Practical recommendations could be extracted from official statements of the AAO and the RCOphth. CONCLUSION Within a short period, a growing body of articles has started to elucidate the ophthalmological implications of COVID-19. As the eye can represent a route of infection (actively via tears and passively via the nasoacrimal duct), ophthalmological care has to undergo substantial modifications during this pandemic. In the eye, COVID-19 can manifest as keratoconjunctivitis.
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Affiliation(s)
- Jakob Siedlecki
- Augenklinik der LMU, Klinikum der Universität München, München, Germany
| | - Victor Brantl
- Augenklinik der LMU, Klinikum der Universität München, München, Germany
| | - Benedikt Schworm
- Augenklinik der LMU, Klinikum der Universität München, München, Germany
| | | | | | | | - Thomas Kreutzer
- Augenklinik der LMU, Klinikum der Universität München, München, Germany
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Wang H, Kong W, Zhang W, Fan Q. Letter to the Editor: Contact lens practice in the time of COVID-19. Cont Lens Anterior Eye 2020; 43:217. [PMID: 32359966 PMCID: PMC7183967 DOI: 10.1016/j.clae.2020.04.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 04/22/2020] [Accepted: 04/22/2020] [Indexed: 11/17/2022]
Affiliation(s)
| | - Wenjun Kong
- Beijing You'an Hosptial, Capital Medical University, Beijing, China
| | - Wei Zhang
- Tianjin Eye Hospital and Eye Institute, Tianjin Key Lab of Ophthalmology and Visual Science, Nankai University Affiliated Eye Hospital, Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
| | - Qian Fan
- Tianjin Eye Hospital and Eye Institute, Tianjin Key Lab of Ophthalmology and Visual Science, Nankai University Affiliated Eye Hospital, Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China.
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Sarkar S, Khanna P. Eyes Have It: From COVID-19 Perspective. Indian J Crit Care Med 2020; 24:1139-1140. [PMID: 33384526 PMCID: PMC7751054 DOI: 10.5005/jp-journals-10071-23644] [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] [Indexed: 11/23/2022] Open
Abstract
How to cite this article: Sarkar S, Khanna P. Eyes Have It: From COVID-19 Perspective. Indian J Crit Care Med 2020;24(11):1139-1140.
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Affiliation(s)
- Soumya Sarkar
- Department of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, Delhi, India
| | - Puneet Khanna
- Department of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, Delhi, India
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