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Elsakka MM, Moawad MHED, Labeeb EE, Elneny M, Siddiq A, Gahlan S, Alkhawaldeh IM, Abu Serhan H. Chorioretinopathy Post COVID-19: A Systematic Review and Prevalence Assessment, Unveiling Insights into an Emerging Ocular Entity. Semin Ophthalmol 2024; 39:353-363. [PMID: 38466227 DOI: 10.1080/08820538.2024.2323113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 02/06/2024] [Indexed: 03/12/2024]
Abstract
PURPOSE To investigate the occurrence of chorioretinopathy post-COVID-19, emphasizing demographic characteristics, medication history, clinical presentation, diagnostic evaluation, and treatment approaches, with a specific focus on the role of corticosteroid use. METHODS Our protocol was registered prospectively on PROSPERO (CRD42023457712). A systematic search of databases (PubMed, Cochrane, WOS, Scopus) from November 2020 to August 2023 were performed to identify any original research reporting chorioretinopathy in COVID-19 patients. Data extraction included patient demographics, COVID-19 timeline, medication history, symptoms, diagnostic tests, and treatment outcomes. We used Joanna Briggs Institute (JBI) critical appraisal tool to assess the quality of our included studies. RESULTS We identified seven case reports and two case series including 10 patients, six females and four males (mean age 36.5 years), who exhibited chorioretinopathy after COVID-19. Onset varied from 6 days to three months post-infection (average = 24.3 days). Seven patients (70%) had a history of corticosteroid use during COVID-19 treatment. Symptoms included visual loss, blurred vision, and deterioration. Diagnostic assessments revealed central serous chorioretinopathy in seven patients (70%) and punctate inner choroidopathy in two (20%). Treatment approaches varied, with corticosteroid discontinuation leading to symptom improvement, while two patients were treated with corticosteroids. Five patients who discontinued corticosteroids were reported to have improvement in visual acuity, two of them changed to 20/25 after being 20/40, two changed to 6/6, and one changed to 20/20, while the visual acuity in the sixth patient was not reported. Regarding the two patients who were treated with corticosteroids, visual acuity was reported in one case only and it improved to 20/20. CONCLUSION This systematic review states the prevalence and potential association between chorioretinopathy, and corticosteroid use in the context of COVID-19. This relation is still unclear because of the relief of symptoms in some cases after corticosteroid discontinuation, while two other cases were treated with corticosteroids and their symptoms improved.
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Affiliation(s)
| | - Mostafa Hossam El Din Moawad
- Faculty of Pharmacy, Alexandria University, Alexandria, Egypt
- Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Eman E Labeeb
- Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Mohamed Elneny
- Damietta Faculty of Medicine, Al-Azhar University, Cairo, Egypt
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An G, Lei B, Wang Z, Yang K, Fan D, Li B, Fu K, Fang H, Zhang M, Li L, Zhao Y, Jin X, Du L. Multicenter and multimodal imaging study reveals rare fundus lesions in patients after SARS-CoV-2 infection. Sci Rep 2024; 14:14369. [PMID: 38909148 PMCID: PMC11193808 DOI: 10.1038/s41598-024-65216-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 06/18/2024] [Indexed: 06/24/2024] Open
Abstract
To define the characteristics of fundus manifestations in patients after SARS-CoV-2 infection with multimodal imaging techniques. This is a retrospective multicenter and multimodal imaging study including 90 patients. All patients with a visual complaint occurring immediately after SARS-CoV-2 infection were referred to six clinics between December 2022 and February 2023. Demographic information and the temporal relationship between SARS-CoV-2 infection and visual symptoms were documented. The characteristics of the fundus lesions were evaluated using multimodal imaging. Ninety patients from six hospitals were included in this study, including 24 males (26.67%) and 66 (73.33%) females. Seventy-eight patients (86.66%) (146 eyes) were diagnosed with Acute Macular Neuroretinopathy (AMN). The AMN patients were primarily young women (67.95%). Sixty-eight patients (87.18%) had AMN in both eyes. Thirty-eight eyes (24.36%) included Purtscher or Purtscher-like lesions. optical coherence tomography and infrared retinal photographs can show AMN lesions well. Eleven cases were diagnosed with simple Purtscher or Purtscher-like retinopathy (2 cases, 2.22%), Vogt‒Koyanagi‒Harada (VKH) syndrome or VKH-like uveitis (3 cases, 3.33%), multiple evanescent white-dot syndrome (MEWDS) (2 cases, 2.22%), and rhino-orbital-cerebral mucormycosis (ROCM) (5 cases, 5.56%). After SARS-CoV-2 infection, diversified fundus lesions were evident in patients with visual complaints. In this report, AMN was the dominant manifestation, followed by Purtscher or Purtscher-like retinopathy, MEWDS, VKH-like uveitis, and ROCM.
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Affiliation(s)
- Guangqi An
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Institute of Fundus Diseases, Zhengzhou University, Zhengzhou, Henan, China
| | - Bo Lei
- Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Eye institute, Henan Academy of Innovations in Medical Science, Zhengzhou, Henan, China
| | - Zhili Wang
- Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Kaizhuan Yang
- The Second People's Hospital of Zhengzhou, Zhengzhou, Henan, China
| | - Dongsheng Fan
- Department of Ophthalmology, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, Henan, China
| | - Bing Li
- Nanyang Municipal Eye Hospital, Nanyang, Henan, China
| | - Ke Fu
- Department of Ophthalmology, The First Affiliated Hospital of Nanyang Medical College, Nanyang, Henan, China
| | - Haixin Fang
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Min Zhang
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Institute of Fundus Diseases, Zhengzhou University, Zhengzhou, Henan, China
| | - Lin Li
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yu Zhao
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Xuemin Jin
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
- Institute of Fundus Diseases, Zhengzhou University, Zhengzhou, Henan, China.
| | - Liping Du
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
- Institute of Fundus Diseases, Zhengzhou University, Zhengzhou, Henan, China.
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Zhao H, Li H, Liu Q, Dong G, Hou C, Li Y, Zhao Y. Using TransR to enhance drug repurposing knowledge graph for COVID-19 and its complications. Methods 2024; 221:82-90. [PMID: 38104883 DOI: 10.1016/j.ymeth.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/14/2023] [Accepted: 12/12/2023] [Indexed: 12/19/2023] Open
Abstract
MOTIVATION The COVID-19 pandemic has been spreading globally for four years, yet specific drugs that effectively suppress the virus remain elusive. Furthermore, the emergence of complications associated with COVID-19 presents significant challenges, making the development of therapeutics for COVID-19 and its complications an urgent task. However, traditional drug development processes are time-consuming. Drug repurposing, which involves identifying new therapeutic applications for existing drugs, presents a viable alternative. RESULT In this study, we construct a knowledge graph by retrieving information on genes, drugs, and diseases from databases such as DRUGBANK and GNBR. Next, we employ the TransR knowledge representation learning approach to embed entities and relationships into the knowledge graph. Subsequently, we train the knowledge graph using a graph neural network model based on TransR scoring. This trained knowledge graph is then utilized to predict drugs for the treatment of COVID-19 and its complications. Based on experimental results, we have identified 15 drugs out of the top 30 with the highest success rates associated with treating COVID-19 and its complications. Notably, out of these 15 drugs, 10 specifically aimed at treating COVID-19, such as Torcetrapib and Tocopherol, has not been previously identified in the knowledge graph. This finding highlights the potential of our model in aiding healthcare professionals in drug development and research related to this disease.
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Affiliation(s)
- Hongxi Zhao
- College of Computer and Control Engineering, Northeast Forestry University, 150040, Harbin, HeiLongJiang, China
| | - Hongfei Li
- College of Computer and Control Engineering, Northeast Forestry University, 150040, Harbin, HeiLongJiang, China; College of Life Science, Northeast Forestry University, 150040, Harbin, HeiLongJiang, China
| | - Qiaoming Liu
- School of Medicine and Health, Harbin Institute of Technology, 150001, Harbin, HeiLongJiang, China; Zhengzhou Research Institute, Harbin Institute of Technology, 450000, Zhengzhou, Henan, China
| | - Guanghui Dong
- College of Computer and Control Engineering, Northeast Forestry University, 150040, Harbin, HeiLongJiang, China
| | - Chang Hou
- College of Computer and Control Engineering, Northeast Forestry University, 150040, Harbin, HeiLongJiang, China
| | - Yang Li
- College of Computer and Control Engineering, Northeast Forestry University, 150040, Harbin, HeiLongJiang, China.
| | - Yuming Zhao
- College of Computer and Control Engineering, Northeast Forestry University, 150040, Harbin, HeiLongJiang, China; College of Life Science, Northeast Forestry University, 150040, Harbin, HeiLongJiang, China.
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Angelidis CD, Georgalas I, Giachos I, Symeonidis C, Mani A, Rotsos T. A 30-Year-Old Man with a Recent History of COVID-19 Requiring Treatment with Corticosteroids Who Developed Bilateral Central Serous Chorioretinopathy During 7-Month Follow-Up. AMERICAN JOURNAL OF CASE REPORTS 2023; 24:e940241. [PMID: 38007612 PMCID: PMC10687741 DOI: 10.12659/ajcr.940241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 10/24/2023] [Accepted: 08/23/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND Central serous chorioretinopathy (CSCR) involves a localized serous macular detachment, secondary to retinal pigment epithelial and choroidal vascular changes, which can be an adverse effect of corticosteroid use. Most CSCR cases resolve spontaneously, and normal vision returns, while some chronic cases can result in blindness. This report is of a 30-year-old man with a recent history of Corona virus disease (COVID)-19 requiring corticosteroid treatment who developed bilateral CSCR with unilateral fibrin and a 7-month follow-up. CASE REPORT A 30-year-old male patient presented with malaise and high fever. The patient tested positive for COVID-19, caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus and was admitted. During hospitalization, he received intravenous (IV) corticosteroids for 1 week (6 mg dexamethasone IV once daily). Following hospitalization, the patient received per os methylprednisolone 16 mg (16 mg once daily for 3 days, 8 mg once daily for 3 days, 4 mg once daily for 3 days, and 2 mg once daily for 3 days). One month later, the patient presented with bilateral visual acuity (VA) deterioration and acute CSCR. The diagnosis and follow-up were performed by optical coherence tomography (OCT) and fundus fluorescein angiography (FFA). The patient was followed-up for a period of 7 months, during which, although the VA improved and remained stable, the OCT findings were changing. CONCLUSIONS This report highlights the importance of timely ophthalmological examination in patients with sudden vision loss and identification of the association between corticosteroid use and CSCR, as well as the importance of a longer follow-up period.
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Affiliation(s)
| | - Ilias Georgalas
- 1 Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Giachos
- 1 Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Aikaterini Mani
- 1 Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece
| | - Tryfon Rotsos
- 1 Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece
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Sharifi A, Daneshtalab A, Zand A. Bilateral Central Serous Chorioretinopathy After Treatment of COVID-19 Infection. Cureus 2022; 14:e23446. [PMID: 35494916 PMCID: PMC9038508 DOI: 10.7759/cureus.23446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2022] [Indexed: 11/05/2022] Open
Abstract
We report a rare case of bilateral central serous chorioretinopathy (CSCR) after COVID-19 management with steroids. The patient was a 49-year-old female who presented with bilateral blurred vision three months after the COVID-19 infection. She had been treated with intravenous Remdesivir and Dexamethasone. After her recovery from the disease, she developed gradual visual impairment in both her eyes. Upon examinations and optical coherence tomography, bilateral CSCR was revealed. She was treated with eplerenone (25 mg/day) and propranolol (20 mg/day), and the symptoms were improved after two months. Post-COVID-19 associated CSCR can occur due to steroids administration. Therefore, patients and physicians should be aware of these possible complications and seek an ophthalmology consultation as early as possible.
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