COVID-19 and the Eye: Systemic and Laboratory Risk Factors for Retinopathy and Detection of Tear Film SARS-CoV-2 RNA with a Triplex RT-PCR assay Open Access
Shantha, Jessica (Spring 2022)
Published
Abstract
Coronavirus-19 (COVID-19) has been associated with ophthalmic manifestations primarily involving the anterior segment, but recent studies have suggested retinal vascular findings may be associated with increased severity of systemic disease. In addition, the relationship between tear film SARS-CoV-2 RNA, timing of illness and eye disease are unknown. We evaluated hospitalized COVID-19 inpatients for retinopathy, tear film viral RNA and their relationship with systemic disease factors, laboratory findings, and outcomes. Sixty hospitalized COVID-19 inpatients were offered enrollment. Full ophthalmic examination and conjunctival swabs were taken for SARS-CoV-2 RT-PCR. Demographic, clinical outcomes and laboratory data were collected to assess the relationship of these parameters to retinopathy. Univariate and multivariate analyses of systemic disease and laboratory risk factors for retinopathy and SARS-CoV-2 RNA detection were assessed. The median age was 59.5 years (Interquartile range, Q1, Q3, 47,69.5 years) and 29 (48%) were female. Retinopathy associated with COVID-19 was observed in 12 of 60 patients (20%). The median age (Q1,Q3) of patients with COVID-19 retinopathy was 51.5 (41,56) compared to 62.5 (48.5,72.5) years in individuals without retinopathy (p=0.01). The median BMI was 34.3 (33.3, 42.8) in patients with retinopathy compared to 30.9 (26.0, 36.5) in those without retinal disease findings (p=0.04). ECMO requirement was observed in 33% of patients with retinopathy compared to 8% in those without retinopathy (p=0.04). Multivariate analyses trended towards increased risk of retinopathy with younger age (aOR 0.95 (95% CI 0.90-1.01, p=0.095) and with increased BMI (aOR. 1.08, 95% CI 1.00-1.18, p=0.056). Fifteen of 60 patients (25%) tested positive in their tear film for SARS-CoV-2 RNA with a trend towards a shorter length of illness and hospitalization in patients who were positive. In this series retinopathy was observed in 20% of patients in this hospitalized cohort of COVID-19 patients. Factors independently associated with retinopathy included younger age and increased BMI. SARS-CoV-2 RNA within tear film was detected in 25% of patients and unrelated to ophthalmic signs/symptoms. The precise relationship of obesity and other potential contributing factors such as age with retinal microvascular disease requires further investigation.
Table of Contents
Introduction…………………………………………………………………………………...….1
Methods……………………………………………………………………………………..…....4
Results……………………………………………………………………………..……………...9
Discussion…………………………………………………………………………………….…14
References……………………………………………………………………………………….18
Table1 1 Demographic and Baseline Characteristics …………………………………………..20
Table 2 Ocular Findings in COVID-19 Subjects by Patients and Eyes…………………………22
Table 3 Laboratory findings in COVID-19 subjects…………………………………………….23
Table 4 Interventions in COVID-19 subjects with and without retinopathy…………………….24
Table 5 Multivariable Model Results……………………………………………………………25
Table 6 Retinopathy Classification in Enrolled Patients………………………………………...26
About this Master's Thesis
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COVID-19 and the Eye: Systemic and Laboratory Risk Factors for Retinopathy and Detection of Tear Film SARS-CoV-2 RNA with a Triplex RT-PCR assay () | 2022-04-28 09:26:02 -0400 |
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