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Kurysheva NI, Pererva OA, Nikitina AD. Eye damage in COVID-19. Part 1: Involvement of the eye in SARS-CoV-2 virus transmission and anterior segment complications. RUSSIAN OPHTHALMOLOGICAL JOURNAL 2022. [DOI: 10.21516/2072-0076-2022-15-4-156-165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In COVID-19, eye damage may develop at any stage of the disease. Viral ribonucleic acid has been found in ocular tissues, but the role of the eye as a route of infection is yet to be substantiated. Ophthalmic manifestations may be a typical feature of COVID-19 infection or they may develop several weeks after recovery. Ophthalmologists should be aware of possible relationships of an ophthalmic pathology with SARS-CoV-2 in order to obtain targeted case history, detect the specific signs, prescribe the necessary tests and thereby reduce the spread of the infection. These relationships are also important for early diagnosis and treatment of complications that threaten the patients’ life and vision. The first part of the review focuses on the possible involvement of the eye in SARS-CoV-2 infection and the spread of infection. Clinical manifestations of the anterior segment damage are considered.
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Affiliation(s)
- N. I. Kurysheva
- Medical Biological University of Innovations and Continuing Education — A.I. Burnazyan Medical Biophysical Center; Ophthalmological Center, Federal Medical and Biological Agency
| | - O. A. Pererva
- Medical Biological University of Innovations and Continuing Education — A.I. Burnazyan Medical Biophysical Center; Ophthalmological Center, Federal Medical and Biological Agency
| | - A. D. Nikitina
- Medical Biological University of Innovations and Continuing Education — A.I. Burnazyan Medical Biophysical Center; Ophthalmological Center, Federal Medical and Biological Agency
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Zhong W, Yin R, Pan Y, Zhang X, Renzaho AMN, Ling L, Li X, Chen W. Long-Term Impact of COVID-19 on Hospital Visits of Rural Residents in Guangdong, China: A Controlled Interrupted Time Series Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13259. [PMID: 36293836 PMCID: PMC9603214 DOI: 10.3390/ijerph192013259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
To date, there is a lack of comprehensive understanding regarding the effect of coronavirus disease 2019 (COVID-19) on the healthcare-seeking behavior and utilization of health services in rural areas where healthcare resources are scarce. We aimed to quantify the long-term impact of COVID-19 on hospital visits of rural residents in China. We collected data on the hospitalization of all residents covered by national health insurance schemes in a county in southern China from April 2017 to March 2021. We analyzed changes in residents' hospitalization visits in different areas, i.e., within-county, out-of-county but within-city, and out-of-city, via a controlled interrupted time series approach. Subgroup analyses based on gender, age, hospital levels, and ICD-10 classifications for hospital visits were examined. After experiencing a significant decline in hospitalization cases after the COVID-19 outbreak in early 2020, the pattern of rural residents' hospitalization utilization differed markedly by disease classification. Notably, we found that the overall demand for hospitalization utilization of mental and neurological illness among rural residents in China has been suppressed during the pandemic, while the utilization of inpatient services for other common chronic diseases was redistributed across regions. Our findings suggest that in resource-poor areas, focused strategies are urgently needed to ensure that people have access to adequate healthcare services, particularly mental and neurological healthcare, during the COVID-19 pandemic.
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Affiliation(s)
- Wenfang Zhong
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Rong Yin
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yan Pan
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Xiangliang Zhang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Andre M. N. Renzaho
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown 2560, Australia
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne 3004, Australia
| | - Li Ling
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
- Sun Yat-sen Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou 510080, China
| | - Xingge Li
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Wen Chen
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
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Akbari M, Dourandeesh M. Update on overview of ocular manifestations of COVID-19. Front Med (Lausanne) 2022; 9:877023. [PMID: 36177323 PMCID: PMC9513125 DOI: 10.3389/fmed.2022.877023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 08/08/2022] [Indexed: 01/08/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) has become the most critical health crisis at present, and research is continued about the exact pathophysiology, presentations, and complications of this pandemic. It influences several organs, and many studies have addressed the organs, the involvement of which during the COVID-19 results in patients' death. One of the important organs that can be involved during COVID-19, which is also a transmission route of the disease, is the eye. According to the evidence, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can have ocular manifestations and complications. According to the literature, conjunctivitis is the most common presentation, which can develop at any stage of COVID-19 (during and even after the disease), and the major pathophysiology of the eye involvement during the disease is attributed to the direct effect of the virus on the eyes, tissue damage caused by inflammation, underlying diseases, and the adverse effect of the medications prescribed. There are also reports of life-threatening complications, such as rhino-orbital cerebral mucormycosis, which require urgent treatment and are associated with a great mortality rate. Ocular manifestations may also be the presentation of a life-threatening event, such as stroke; therefore, it is necessary to pay great attention to the ocular manifestations during COVID-19. In this review, after about 2 years of the pandemic started, we present a narrative review on ocular manifestations during COVID-19, categorized into three main categories; ophthalmic, orbital, and neuro-ophthalmological manifestations with a detailed description of the presenting symptoms, risk factor, diagnostic, and therapeutic strategies suggested for each.
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Kohmarn T, Srisurattanamethakul N, Watcharapalakorn A, Poyomtip T, Poolsanam C. Outbreak of COVID-19-Related Myopia Progression in Adults: A Preliminary Study. CLINICAL OPTOMETRY 2022; 14:125-131. [PMID: 35959467 PMCID: PMC9359493 DOI: 10.2147/opto.s374155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/28/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE The COVID-19 pandemic has necessitated specific public health measures, resulting in the alteration of lifestyles, such as increased digital screen time and fewer outdoor activities. Such conditions have increased the progression of myopia in children. However, no investigation of myopia progression in early adulthood has been conducted during this period. Consequently, this study aimed to evaluate the outbreak of COVID-19-related myopia progression among adults at an optometry clinic during the COVID-19 pandemic. MATERIALS AND METHODS This was a retrospective cohort study in which participants aged 18-25 years who first visited (baseline) the optometry clinic between June 2019 and March 2020 were recruited for follow-up from November 2021 to March 2022. Spherical equivalent refraction (SER), uncorrected distance visual acuity (UCDVA), and binocular cross cylinder (BCC) were recorded at baseline and a follow-up visit. Using questionnaires, a survey was conducted to assess the lifestyle changes that transpired during the COVID-19 pandemic. RESULTS In total, 37 participants with a mean age of 22.5±1.4 years were enrolled, of which 89.2% were female. Following the outbreak of the COVID-19 pandemic, most participants self-reported increased daily use of digital devices (89.2%), online education (86.5%), and spending more time at home (94.6%), which increased by approximately 7.6±3.2 hours, 5.9±1.7 hours, and 13.2±7.5 hours, respectively. There were statistically significant differences between SER and BCC at baseline and after approximately 2 years of the COVID-19 pandemic (p < 0.05). The mean two-year myopia progression was -0.59±0.67 D (Maximum = 0.00 D, Minimum = -3.38 D). CONCLUSION This study revealed that myopia could progress during adulthood among those who have lived under public health measures intended to address the COVID-19 pandemic.
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Affiliation(s)
- Thitika Kohmarn
- Faculty of Optometry, Ramkhamhaeng University, Bangkok, Thailand
| | | | | | - Teera Poyomtip
- Faculty of Optometry, Ramkhamhaeng University, Bangkok, Thailand
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Medical Liability of the Vaccinating Doctor: Comparing Policies in European Union Countries during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127191. [PMID: 35742438 PMCID: PMC9223467 DOI: 10.3390/ijerph19127191] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 11/28/2022]
Abstract
In 2020, the COVID-19 pandemic exhausted healthcare systems around the world, including European Union countries, with healthcare workers at the frontline. Therefore, new health laws and policies have been introduced at the national level in order to offer greater legal protection for health workers. Since the introduction of COVID-19 vaccination, it has led to the development of specific laws to define the compulsoriness for particular categories. This review aimed to evaluate the system of medical liability, focusing on the ten countries of the European Union with the highest rate of vaccination coverage against SARS-CoV-2. A country-by-country analysis was conducted on the different medical liability systems of individual professionals, in general, and with specific focus on the vaccinating doctors. Additional search was conducted to investigate which European states have introduced specific policies in this field, to identify the implementation of any new laws alongside the COVID-19 vaccination campaigns, and to assess which countries have adopted the European Digital COVID Certificate and funded specific compensation programs for COVID-19 vaccination. Our results highlight an extremely fragmented European scenario; therefore, this work could be a starting point to define a common approach for medical liability and related policies in the COVID-19 pandemic.
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Maiassi N, Xanthopoulou K, Löw U, Seitz B. The Impact of the First COVID-19 Lockdown Period on the Inpatient and Outpatient Volume of a University Based Tertiary Referral Center with Corneal Subspecialization in Germany. Clin Ophthalmol 2022; 16:1795-1805. [PMID: 35706685 PMCID: PMC9191194 DOI: 10.2147/opth.s335551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 04/19/2022] [Indexed: 11/23/2022] Open
Abstract
Background/Aims To determine the impact of COVID-19 on the number of in- and outpatients surgical and diagnostic procedures performed at a southwestern German university hospital with corneal subspecialization. Methods A retrospective examination of the number of inpatients, several outpatients subunits, in- and outpatient surgeries as well as diagnostic procedures at the Department of Ophthalmology, Saarland University Medical Centre during the COVID-19 pandemic "lockdown period" from 18 March until 8 May 2020 in comparison with the corresponding period in 2019 (source: SAP database and electronic patient record FIDUS). Results The year 2020 showed a significant decrease in the number of inpatient surgeries with a total number of 285 vs 412 in 2019. However, the number of corneal transplantations increased significantly (60 in 2020 vs 54 in 2019, p=0.0089). In the various outpatient units of our department, we observed a significant decrease in the number of consultations (1.711 in 2020 vs 3.194 in 2019), especially for cataract surgery consultations (34 vs 137, p<0.0001). The number of outpatient surgeries was significantly reduced in 2020, especially for cataract surgery (64 vs 216, p=0.007) and intravitreal injections (577 vs 768, p<0.0001). Conclusion Despite taking all the necessary precautions to ensure that our medical care can continue to be available reliably and completely safe during the "Corona lockdown period", the number of in- and outpatient surgeries and the number of outpatient consultations decreased significantly. However, the number of corneal transplantations still increased.
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Affiliation(s)
- Nadir Maiassi
- Department of Ophthalmology, Saarland University Medical Center UKS, Homburg/Saar, Saarland, Germany
| | - Kassandra Xanthopoulou
- Department of Ophthalmology, Saarland University Medical Center UKS, Homburg/Saar, Saarland, Germany
| | - Ursula Löw
- Department of Ophthalmology, Saarland University Medical Center UKS, Homburg/Saar, Saarland, Germany
| | - Berthold Seitz
- Department of Ophthalmology, Saarland University Medical Center UKS, Homburg/Saar, Saarland, Germany
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Singh S, Kishore D, Singh RK. Potential for Further Mismanagement of Fever During COVID-19 Pandemic: Possible Causes and Impacts. Front Med (Lausanne) 2022; 9:751929. [PMID: 35308547 PMCID: PMC8924660 DOI: 10.3389/fmed.2022.751929] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 01/26/2022] [Indexed: 01/01/2023] Open
Abstract
Fever remains an integral part of acute infectious diseases management, especially for those without effective therapeutics, but the widespread myths about "fevers" and the presence of confusing guidelines from different agencies, which have heightened during the coronavirus disease 2019 (COVID-19) pandemic and are open to alternate interpretation, could deny whole populations the benefits of fever. Guidelines suggesting antipyresis for 37.8-39°C fever are concerning as 39°C boosts the protective heat-shock and immune response (humoral, cell-mediated, and nutritional) whereas ≥40°C initiates/enhances the antiviral responses and restricts high-temperature adapted pathogens, e.g., severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), strains of influenza, and measles. Urgent attention is accordingly needed to address the situation because of the potential public health consequences of the existence of conflicting guidelines in the public domain. We have in this article attempted to restate the benefits of fever in disease resolution, dispel myths, and underline the need for alignment of national treatment guidelines with that of the WHO, to promote appropriate practices and reduce the morbidity and mortality from infectious diseases, such as COVID-19.
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Affiliation(s)
- Samer Singh
- Centre of Experimental Medicine and Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Dhiraj Kishore
- Department of General Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Rakesh K. Singh
- Department of Biochemistry, Institute of Science, Banaras Hindu University, Varanasi, India
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Brodin AC, Tamhankar MA, Whitehead G, MacKay D, Kim BJ, O’Brien JM. Approach of an Academic Ophthalmology Department to Recovery During the Coronavirus Pandemic. Clin Ophthalmol 2022; 16:695-704. [PMID: 35300030 PMCID: PMC8921828 DOI: 10.2147/opth.s342300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 01/18/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction A methodology for safe recovery of an ophthalmology department during a pandemic does not currently exist. This study describes successful recovery strategies for an urban, multi-specialty ophthalmology department serving a high-risk patient population. Methods The study took place at a large multi-specialty tertiary care academic ophthalmology department in a metropolitan city during a seven-month period (March–October 2020). Five recovery ad hoc committees were charged with formulating metrics and initiatives to manage clinical volumes while maintaining safe practices, providing patient access, and minimizing financial damage. A six-tier system was created to resume non-urgent appointments in May 2020. Educational and research activities were maintained through the development of virtual curricula and research platforms. Results The number of clinical and surgical visits per month in 2020 compared to 2019 and the time to reach ≥95% of pre-COVID patient volumes were monitored. In October 2020, ≥95% of pre-COVID volumes were attained (11,975 vs 12,337 patient visits in October 2019; 266 vs 272 surgical cases in October 2019). Despite significant financial losses, the department surpassed December 2019 collections in December 2020. No faculty, staff, or trainees received furloughs or pay cuts. There was no COVID-19 transmission between faculty, staff, and patients. Discussion With strategic implementation of recovery strategies following CDC safety measures, it was possible to safely deliver care to patients with urgent and non-urgent eye conditions. Patient volumes were fully recovered in an ambulatory urban healthcare setting within a high-risk COVID-19 population within seven months while educational and research missions were successfully sustained.
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Affiliation(s)
- Alexandra C Brodin
- Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA, USA
| | - Madhura A Tamhankar
- Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA, USA
| | - Gideon Whitehead
- Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA, USA
| | - David MacKay
- Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA, USA
| | - Benjamin J Kim
- Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA, USA
- Correspondence: Benjamin J Kim, Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania, 51 N 39th Street, Philadelphia, PA, 19104, USA, Tel +1 215-662-8675, Email
| | - Joan M O’Brien
- Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA, USA
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Leung EH, Fan J, Flynn HW, Albini TA. Ocular and Systemic Complications of COVID-19: Impact on Patients and Healthcare. Clin Ophthalmol 2022; 16:1-13. [PMID: 35018092 PMCID: PMC8742614 DOI: 10.2147/opth.s336963] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 11/23/2021] [Indexed: 12/11/2022] Open
Abstract
There is increasing information available about the effects of the SARS-CoV-2 virus on the systemic and ocular health of patients, as well as the effects of delayed health care. This mini-review summarizes the potential complications and treatments of COVID-19. Systemic findings include respiratory illness, risk of thromboembolic events, and neurologic findings. Some patients may develop persistent symptoms even after the infection resolves. Effective treatment options include glucocorticoids, antivirals, interleukin-6 antagonists, monoclonal antibodies, Janus kinase inhibitors and vaccines. Potential ocular findings of COVID-19 include conjunctivitis, cranial nerve palsies, and microvascular changes in the retina; most symptoms resolved over time. During the lockdown periods, teleophthalmology was utilized to triage non-urgent issues; patients who did present to emergency departments tended to have more severe disease with worse visual prognoses. While transient delays in outpatient ophthalmic care may be tolerated in some patients, others experienced significant vision loss with interruptions in treatments. Resumption of ophthalmic care as soon as possible may help mitigate the effects of delayed care due to the pandemic.
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Affiliation(s)
| | - Jason Fan
- Bascom Palmer Eye Institute/University of Miami, Miami, FL, USA
| | - Harry W Flynn
- Bascom Palmer Eye Institute/University of Miami, Miami, FL, USA
| | - Thomas A Albini
- Bascom Palmer Eye Institute/University of Miami, Miami, FL, USA
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Nioi M, d’Aloja E, Fossarello M, Napoli PE. Dual Corneal-Graft Rejection after mRNA Vaccine (BNT162b2) for COVID-19 during the First Six Months of Follow-Up: Case Report, State of the Art and Ethical Concerns. Vaccines (Basel) 2021; 9:1274. [PMID: 34835205 PMCID: PMC8620000 DOI: 10.3390/vaccines9111274] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 01/08/2023] Open
Abstract
Present mass vaccination against Coronavirus Disease-19 (COVID-19) is the most widely used health policy and the most promising approach to curb the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic globally. However, new side effects are emerging from the mass vaccination not described during the experimental stages. In the present study, we discuss a case of acute corneal graft rejection, which has occurred 25 years after transplantation and 13 days after the administration of the BNT162b2 vaccine (Comirnaty, BioNTech/Pfizer), which was followed-up for a period of six months. In this period, the corneal inflammation appeared twice but was successfully managed with topical therapy and supplementation of Vitamin D. A risk of corneal graft rejection must be included in the list of potential vaccine complications, in order to inform the transplanted patient to undergo a preliminary and a follow-up ocular examination, and eventually to include corneal graft in the list of contraindications to vaccination.
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Affiliation(s)
- Matteo Nioi
- Forensic Medicine Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09040 Cagliari, Italy;
| | - Ernesto d’Aloja
- Forensic Medicine Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09040 Cagliari, Italy;
| | - Maurizio Fossarello
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, 09124 Cagliari, Italy;
| | - Pietro Emanuele Napoli
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, 09124 Cagliari, Italy;
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Felfeli T, Ximenes R, Naimark DMJ, Hooper PL, Campbell RJ, El-Defrawy SR, Sander B. The ophthalmic surgical backlog associated with the COVID-19 pandemic: a population-based and microsimulation modelling study. CMAJ Open 2021; 9:E1063-E1072. [PMID: 34815262 PMCID: PMC8612655 DOI: 10.9778/cmajo.20210145] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Jurisdictions worldwide ramped down ophthalmic surgeries to mitigate the effects of COVID-19, creating a global surgical backlog. We sought to predict the long-term impact of COVID-19 on the timely delivery of non-emergent ophthalmology sub-specialty surgical care in Ontario. METHODS This is a microsimulation modelling study. We used provincial population-based administrative data from the Wait Time Information System database in Ontario for January 2019 to May 2021 and facility-level data for March 2018 to May 2021 to estimate the backlog size and wait times associated with the COVID-19 pandemic. For the postpandemic recovery phase, we estimated the resources required to clear the backlog of patients accumulated on the wait-list during the pandemic. Outcomes were accrued over a time horizon of 3 years. RESULTS A total of 56 923 patients were on the wait-list in the province of Ontario awaiting non-emergency ophthalmic surgery as of Mar. 15, 2020. The number of non-emergency surgeries performed in the province decreased by 97% in May 2020 and by 80% in May 2021 compared with the same months in 2019. By 2 years and 3 years since the start of the pandemic, the overall estimated number of patients awaiting surgery grew by 129% and 150%, respectively. The estimated mean wait time for patients for all subspecialty surgeries increased to 282 (standard deviation [SD] 91) days in March 2023 compared with 94 (SD 97) days in 2019. The provincial monthly additional resources required to clear the backlog by March 2023 was estimated to be a 34% escalation from the prepandemic volumes (4626 additional surgeries). INTERPRETATION The estimates from this microsimulation modelling study suggest that the magnitude of the ophthalmic surgical backlog from the COVID-19 pandemic has important implications for the recovery phase. This model can be adapted to other jurisdictions to assist with recovery planning for vision-saving surgeries.
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Affiliation(s)
- Tina Felfeli
- Department of Ophthalmology and Vision Sciences (Felfeli), University of Toronto; Toronto Health Economics and Technology Assessment (THETA) Collaborative (Ximenes), University Health Network; Sunnybrook Health Sciences Centre (Naimark), Toronto, Ont.; Ivey Eye Institute (Hooper), Western University, London, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Kensington Vision and Research Centre (El-Defrawy), Kensington Eye Institute, and Institute of Health Policy, Management and Evaluation (Sander), University of Toronto, Toronto, Ont.
| | - Raphael Ximenes
- Department of Ophthalmology and Vision Sciences (Felfeli), University of Toronto; Toronto Health Economics and Technology Assessment (THETA) Collaborative (Ximenes), University Health Network; Sunnybrook Health Sciences Centre (Naimark), Toronto, Ont.; Ivey Eye Institute (Hooper), Western University, London, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Kensington Vision and Research Centre (El-Defrawy), Kensington Eye Institute, and Institute of Health Policy, Management and Evaluation (Sander), University of Toronto, Toronto, Ont
| | - David M J Naimark
- Department of Ophthalmology and Vision Sciences (Felfeli), University of Toronto; Toronto Health Economics and Technology Assessment (THETA) Collaborative (Ximenes), University Health Network; Sunnybrook Health Sciences Centre (Naimark), Toronto, Ont.; Ivey Eye Institute (Hooper), Western University, London, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Kensington Vision and Research Centre (El-Defrawy), Kensington Eye Institute, and Institute of Health Policy, Management and Evaluation (Sander), University of Toronto, Toronto, Ont
| | - Philip L Hooper
- Department of Ophthalmology and Vision Sciences (Felfeli), University of Toronto; Toronto Health Economics and Technology Assessment (THETA) Collaborative (Ximenes), University Health Network; Sunnybrook Health Sciences Centre (Naimark), Toronto, Ont.; Ivey Eye Institute (Hooper), Western University, London, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Kensington Vision and Research Centre (El-Defrawy), Kensington Eye Institute, and Institute of Health Policy, Management and Evaluation (Sander), University of Toronto, Toronto, Ont
| | - Robert J Campbell
- Department of Ophthalmology and Vision Sciences (Felfeli), University of Toronto; Toronto Health Economics and Technology Assessment (THETA) Collaborative (Ximenes), University Health Network; Sunnybrook Health Sciences Centre (Naimark), Toronto, Ont.; Ivey Eye Institute (Hooper), Western University, London, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Kensington Vision and Research Centre (El-Defrawy), Kensington Eye Institute, and Institute of Health Policy, Management and Evaluation (Sander), University of Toronto, Toronto, Ont
| | - Sherif R El-Defrawy
- Department of Ophthalmology and Vision Sciences (Felfeli), University of Toronto; Toronto Health Economics and Technology Assessment (THETA) Collaborative (Ximenes), University Health Network; Sunnybrook Health Sciences Centre (Naimark), Toronto, Ont.; Ivey Eye Institute (Hooper), Western University, London, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Kensington Vision and Research Centre (El-Defrawy), Kensington Eye Institute, and Institute of Health Policy, Management and Evaluation (Sander), University of Toronto, Toronto, Ont
| | - Beate Sander
- Department of Ophthalmology and Vision Sciences (Felfeli), University of Toronto; Toronto Health Economics and Technology Assessment (THETA) Collaborative (Ximenes), University Health Network; Sunnybrook Health Sciences Centre (Naimark), Toronto, Ont.; Ivey Eye Institute (Hooper), Western University, London, Ont.; Department of Ophthalmology (Campbell), Queen's University, Kingston, Ont.; Kensington Vision and Research Centre (El-Defrawy), Kensington Eye Institute, and Institute of Health Policy, Management and Evaluation (Sander), University of Toronto, Toronto, Ont
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Malani M, Salunke P, Kulkarni S, Jain GK, Sheikh A, Kesharwani P, Nirmal J. Repurposing pharmaceutical excipients as an antiviral agent against SARS-CoV-2. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2021; 33:110-136. [PMID: 34464232 DOI: 10.1080/09205063.2021.1975020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The limited time indorsed to face the COVID-19 emergency and large number of deaths across the globe, poses an unrelenting challenge to find apt therapeutic approaches. However, lead candidate selection to phase III trials of new chemical entity is a time-consuming procedure, and not feasible in pandemic, such as the one we are facing. Drug repositioning, an exploration of existing drug for new therapeutic use, could be an effective alternative as it allows fast-track estimation in phase II-III trials, or even forthright compassionate use. Although, drugs repurposed for COVID-19 pandemic are commercially available, yet the evaluation of their safety and efficacy is tiresome and painstaking. In absence of any specific treatment the easy alternatives such as over the counter products, phytotherapies and home remedies have been largely adopted for prophylaxis and therapy as well. In recent years, it has been demonstrated that several pharmaceutical excipients possess antiviral properties making them prospective candidates against SARS-CoV-2. This review highlights the mechanism of action of various antiviral excipients and their propensity to act against SARs-CoV2. Though, repurposing of pharmaceutical excipients against COVID-19 has the edge over therapeutic agents in terms of safety, cost and fast-track approval trial burdened, this hypothesis needs to be experimentally verified for COVID-19 patients.
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Affiliation(s)
- Manisha Malani
- Translational Pharmaceutics Research Laboratory, Department of Pharmacy, Birla Institute of Technology and Science (BITS)-Pilani, Hyderabad, India
| | - Prerana Salunke
- Translational Pharmaceutics Research Laboratory, Department of Pharmacy, Birla Institute of Technology and Science (BITS)-Pilani, Hyderabad, India
| | - Shraddha Kulkarni
- Translational Pharmaceutics Research Laboratory, Department of Pharmacy, Birla Institute of Technology and Science (BITS)-Pilani, Hyderabad, India
| | - Gaurav K Jain
- Department of Pharmaceutics, School of Pharmaceutical Sciences, Delhi Pharmaceutical Sciences and Research University, New Delhi, India
| | - Afsana Sheikh
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, New Delhi, India
| | - Prashant Kesharwani
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, New Delhi, India
| | - Jayabalan Nirmal
- Translational Pharmaceutics Research Laboratory, Department of Pharmacy, Birla Institute of Technology and Science (BITS)-Pilani, Hyderabad, India
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13
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Singh M, Sethi HS, Gupta S, Duvesh RK, Naik M. Preoperative COVID-19 Testing for Elective Ophthalmological Procedure in a Tertiary Health Care Centre: Our Experience During the Pandemic. Clin Ophthalmol 2021; 15:3841-3845. [PMID: 34548780 PMCID: PMC8449681 DOI: 10.2147/opth.s319173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/11/2021] [Indexed: 12/13/2022] Open
Abstract
Background To study the prevalence of coronavirus infection among asymptomatic patients requiring eye surgery and the role of screening in prevention of spread of infection among the healthcare workers. Design The prospective observational study was conducted in the Ophthalmology department of a tertiary care center in Delhi from September 2020 to December 2020. Setting Patients requiring elective ophthalmological procedures in a tertiary care hospital were screened for coronavirus using the RT-PCR method. Testing methods and results were documented. Results Among the 218 asymptomatic patients posted for elective surgery in that period, 16 (7.3%) were found to be positive for COVID-19. Those who tested positive were advised home isolation and surgery was postponed for the next 14 days. No complications were reported in these patients. One health-care worker also tested positive for COVID-19 during our study period. Conclusion In our study, 1 out of 14 asymptomatic patients were found to be carriers for the novel virus. Asymptomatic COVID-infected patients may lead to transmission of the virus inside the hospital among the visiting patients and hospital staff while they have no adverse effect on the surgery and its outcome.
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Affiliation(s)
- Mrityunjay Singh
- Department of Ophthalmology, VMMC and Safdarjung Hospital, New Delhi, India
| | | | - Sukriti Gupta
- Department of Ophthalmology, VMMC and Safdarjung Hospital, New Delhi, India
| | - Ram Kishan Duvesh
- Department of Ophthalmology, VMMC and Safdarjung Hospital, New Delhi, India
| | - Mayuresh Naik
- Department of Ophthalmology, VMMC and Safdarjung Hospital, New Delhi, India
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14
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Tesfaw LM, Kassie AB, Flatie BT. Sexual Violence and Other Complications of Corona Virus in Amhara Metropolitan Cities, Ethiopia. Risk Manag Healthc Policy 2021; 14:3563-3573. [PMID: 34471394 PMCID: PMC8403671 DOI: 10.2147/rmhp.s297148] [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] [Received: 04/15/2021] [Accepted: 07/13/2021] [Indexed: 12/23/2022] Open
Abstract
Background The onset of corona virus (COVID-19) pandemic brought about multiple crises with financial, social, and political dimensions, and problems involving absence or scarcity of medication, food, and other amenities. COVID led to reports of severe hunger, stress, sexual violence, and associated complications. This study was aimed at assessing the prevalence of sexual violence, hunger, stress, indoor fighting, and related complications caused by the corona virus, and determining factors associated with it. Methods A cross-sectional design study involving a total of 1288 participants recruited from Amhara Metropolitan cities was implemented. Each participant completed a questionnaire regarding experience of sexual violence, hunger, stress, indoor fighting, and other complications faced due to COVID-19. A statistical analysis was done by fitting binary logistic regression model, independent t-test and Chi-squared test. Results From the total participants, 1288 (26.2%) were displaced, while 39.9% were unemployed due COVID-19. About half of the participants (48.8%) experienced general distress, 33.8% faced sexual violence, 18.2% experienced hunger, 8.4% faced indoor fighting. The majority (81.7%) of non-corona virus patients in government health-care institutions faced lack of treatment. For every unit increase of monthly income during COVID-19, the estimated odds of participants experiencing sexual violence decreased by 31.3% (aOR=0.687). Educational level, work status, and monthly salary before and during corona virus were important factors of hunger. Conclusion COVID-19 pandemic led to considerably high prevalence of sexual violence, hunger, stress, and indoor fighting. Work status of participants was an important associated factor of hunger, stress, and indoor fighting. Sex of participants and their monthly income were significantly associated with increase in sexual violence during COVID-19. In addition to a general economic recession, a decrease in treatment of non-COVID-19 patients was noticed, particularly in government hospitals.
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Affiliation(s)
- Lijalem Melie Tesfaw
- Department of Statistics, Bahir Dar University, Bahir Dar, Amhara Region, Ethiopia
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15
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Dmuchowska D, Cwalina I, Krasnicki P, Konopinska J, Saeed E, Mariak Z, Obuchowska I. The Impact of Three Waves of the COVID-19 Pandemic on the Characteristics of Primary Rhegmatogenous Retinal Detachments at a Tertiary Referral Centre. Clin Ophthalmol 2021; 15:3481-3491. [PMID: 34429580 PMCID: PMC8378894 DOI: 10.2147/opth.s323998] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 07/26/2021] [Indexed: 01/10/2023] Open
Abstract
Purpose This study assessed the effect of three waves of the COVID-19 pandemic primarily on the number and timing of referrals due to rhegmatogenous retinal detachment (RRD) and secondarily on the demographic or clinical characteristics of patients. Patients and Methods A retrospective single-centre analysis of medical records included 247 eyes from 247 patients who underwent primary RRD repair with (phaco) vitrectomy between January 1, 2019, and May 31, 2021. Results The percentage of referrals due to primary RRD during the first year of pandemic (March 2020–February 2021) was 16.5% (p=0.179) lower than a year earlier. The percentage of referrals during the first, second and third wave of the pandemic was 48.4%, 18.5% and 26.1% (p=0.029, 0.475, 0.343) lower than in the corresponding months of 2019. A rebound effect was observed only after the first wave. The numbers of referrals in April and May 2021 were similar as in the corresponding months of 2019. No significant differences were observed in the demographic and clinical characteristics of patients admitted before and during the COVID-19 pandemic, other than a tendency towards a higher representation of women, younger persons, longer duration of symptoms but better visual acuity in the latter group. Silicone oil tamponade was used more frequently during the pandemic than before. Conclusion In this study, the COVID-19 pandemic affected the number and timing of referrals due to RRD and the clinical but not demographic characteristics of the patients. The effect lessened with the duration of the pandemic. Previously raised concerns regarding the delay in RRD referrals may no longer be valid during a potential fourth wave of the pandemic. The impact of the pandemic’s waves should be analysed separately, as such an approach provides a better insight into the fluctuations in the number of referrals due to RRD than a year-to-year comparison.
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Affiliation(s)
- Diana Dmuchowska
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, 15-276, Poland
| | - Izabela Cwalina
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, 15-276, Poland
| | - Pawel Krasnicki
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, 15-276, Poland
| | - Joanna Konopinska
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, 15-276, Poland
| | - Emil Saeed
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, 15-276, Poland
| | - Zofia Mariak
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, 15-276, Poland
| | - Iwona Obuchowska
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, 15-276, Poland
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16
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Li L, Cao Y, Fan J, Li T, Lang J, Zhang H, Lv J, Zhu L. Impact of COVID-19 Pandemic on the Clinical Activities in Obstetrics and Gynecology: A National Survey in China. Front Med (Lausanne) 2021; 8:633477. [PMID: 34395457 PMCID: PMC8360866 DOI: 10.3389/fmed.2021.633477] [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: 12/02/2020] [Accepted: 07/06/2021] [Indexed: 11/30/2022] Open
Abstract
Objective: Few studies have quantified the influence of coronavirus disease 2019 (COVID-19) pandemic on medical providers. This is the first national study to investigate the impact of the pandemic on physicians practicing obstetrics and gynecology in China. Methods: A two-stage, stratified, cluster sampling method was performed based on the city categories (category 1, fewer than 10,000 beds; category 2, 10,000–30,000; and category 3, more than 30,000) and public hospital levels (primary, secondary, and tertiary). Physicians practicing obstetrics and gynecology reported the relevant changes in their general clinical activities and changes in the management of specific diseases or conditions occurring during the periods that they were most strongly affected. These changes were compared by municipal and hospital characteristics. Results: Questionnaires were collected from a representative sample of 11,806 physicians actively practicing obstetrics and gynecology in 779 hospitals from 157 cities of 31 provinces. Except emergency visits and online consultations, category 3 cities, tertiary hospitals and general hospitals had greater reductions in overall clinical activities than category 1 cities, primary hospitals and specialized hospitals (all adjusted p < 0.05), respectively. The differences also existed in the management of specific diseases and conditions, especially for less urgent conditions, including cervical cancer screening, instructions regarding contraception and miscarriage, and assisted reproduction (all p < 0.05). Conclusions: During the COVID-19 pandemic, the clinical obstetrics and gynecology activities in China markedly decreased, with significant differences across municipal and hospital characteristics. Trial Registration: This study was registered with ClinicalTrials.gov on July 27, 2020 (NCT04491201).
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Affiliation(s)
- Lei Li
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China
| | - Yang Cao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China
| | - Junning Fan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Ting Li
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China
| | - Jinghe Lang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China
| | - Heping Zhang
- Department of Biostatistics, Yale University School of Public Health, New Haven, CT, United States
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Lan Zhu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China
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17
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Tohamy D, Sharaf M, Abdelazeem K, Saleh MGA, Rateb MF, Soliman W, Kedwany SM, Omar Abdelmalek M, Medhat MA, Tohamy AM, Mahmoud H. Ocular Manifestations of Post-Acute COVID-19 Syndrome, Upper Egypt Early Report. J Multidiscip Healthc 2021; 14:1935-1944. [PMID: 34326644 PMCID: PMC8315779 DOI: 10.2147/jmdh.s323582] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 07/08/2021] [Indexed: 12/14/2022] Open
Abstract
Purpose To evaluate the ocular manifestations of post-acute COVID-19 syndrome. Methods A retrospective, comparative study included 100 patients who had recovered from COVID-19 and 100 controls who were recruited by stratified randomization from hospital registration system and analyzed regarding history, full ophthalmological examination, general examination including internal medicine and neurological evaluation. Laboratory tests were done. Results Mean±SD of age were 55.5 ± 6.2 in COVID group vs 56.5 ± 5.8 in control group; P value = 0.7. In COVID group, 57 patients (57%) were males vs 51 patients (51%) in control group (P value = 0.39), the other compared parameters including history and risk factors showed non-significant difference except for ESR and D-dimer which were elevated in COVID group. In COVID group, 5 patients (5%) were having retinal vascular occlusion, 2 patients (2%) were having anterior ischemic optic neuropathy AION, 3 patients (3%) were having uveitis and 2 patients (2%) were having central serous chorioretinopathy CSCR. While in control group, 2 patients (2%) were having retinal vascular occlusion, and none had AION, uveitis or CSCR (P value = 0.006). Conclusion Post-acute COVID-19 syndrome could affect the eyes in the form of coagulation problems, neurological morbidities, and other manifestations. This necessitates meticulous follow-up of recovered patients from COVID-19.
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Affiliation(s)
- Dalia Tohamy
- Ophthalmology Department, Assiut University, Assiut, Egypt
| | - Mohamed Sharaf
- Ophthalmology Department, Assiut University, Assiut, Egypt
| | | | | | | | - Wael Soliman
- Ophthalmology Department, Assiut University, Assiut, Egypt
| | | | | | - Mohammed A Medhat
- Tropical Medicine and Gastroenterology Department, Assiut University, Assiut, Egypt
| | - Amal M Tohamy
- Neuology Department, Assiut University, Assiut, Egypt
| | - Hany Mahmoud
- Ophthalmology Department, Sohag University, Sohag, Egypt
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18
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Barabino S. A Narrative Review of Current Understanding and Classification of Dry Eye Disease with New Insights on the Impact of Dry Eye during the COVID-19 Pandemic. Ophthalmol Ther 2021; 10:495-507. [PMID: 34275088 PMCID: PMC8286160 DOI: 10.1007/s40123-021-00373-y] [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: 05/11/2021] [Accepted: 07/01/2021] [Indexed: 01/18/2023] Open
Abstract
Dry eye disease (DED) is a complex, progressive and multifactorial condition that is commonly seen in clinical practice and can be challenging to accurately diagnose. Untreated or suboptimally managed dry eye can progress to severe, chronic disease which may become resistant to treatment. Symptoms include ocular irritation and visual impairment. Patients frequently report negative consequences regarding quality of life (QoL), productivity and psychological wellbeing. Certain lifestyle factors (e.g. use of screen-based devices, air conditioning) can induce or exacerbate symptoms of DED, leading to progressive and debilitating complications. Exposures to such triggers are likely to have increased significantly during the ongoing COVID-19 pandemic with people across the globe living with heightened levels of stress/anxiety while being forced to adapt most aspects of their daily lives (from work and education through to social activities) to accommodate social distancing, primarily through the use digital technologies. This review aims to provide a concise and practical overview of current understanding regarding DED, highlighting proposals for refined diagnostic categories and therapeutic terminologies that are designed to improve identification and management of dry eye as well as reduce or slow disease progression. Finally, the findings of a European survey are shared to illustrate the impact of the COVID-19 pandemic on the lives of people with DED. The survey was conducted during the first lockdown period (March–September 2020) and explored issues relating to psychological wellbeing, QoL and engagement with healthcare services. The results demonstrate the ways in which the pandemic amplified the impact of dry eye on daily life and may be valuable in enhancing understanding among clinicians of the challenges faced by people with DED, which extend beyond the signs and symptoms of disease.
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Affiliation(s)
- Stefano Barabino
- Centro Superficie Oculare e Occhio Secco, ASST Fatebenefratelli-Sacco, Ospedale L. Sacco, Università di Milano, via G.B. Grassi 74, 20157, Milan, Italy.
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19
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Affiliation(s)
| | - Anthony John Avery
- Division of Primary Care, School of Medicine, University of Nottingham, UK
| | | | - Darren Shu Jeng Ting
- Department of Ophthalmology, Queen's Medical Centre, Nottingham, UK
- Academic Ophthalmology, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
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20
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Hadrawi M, Malak M, Almahmoudi F, Mogharbel A, Rozy O, Hanafi S, Ali B, Nabeel S, Faqieha F, Alzahrani K. Testing the Sensitivity of Conjunctival Swabs from Confirmed COVID-19 Patients. Clin Ophthalmol 2021; 15:2489-2496. [PMID: 34163132 PMCID: PMC8214568 DOI: 10.2147/opth.s313721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/03/2021] [Indexed: 11/23/2022] Open
Abstract
Objective To investigate the incidence of COVID-19 viral RNA in the conjunctiva of patients priorly confirmed to have COVID-19, using a conjunctival swab and to determine swab sensitivity. Methods This cross-sectional study enrolled patients who tested positive for COVID-19 with PCR via nasopharyngeal swabs. Conjunctival swabs were collected for each patient and subjected to RT-PCR assay. Demographic data and clinical history of patients were investigated and analysed. Results In this study, 4.9% of the patients tested positive with conjunctival swabs for COVID-19; 29.9%, 28.7%, 20.1%, and 12.2% of the patients had fever, shortness of breath, cough, and red eye, respectively. Among all patients, 18.9% and 73.2% had a history of traveling and contact with positive COVID-19 cases, respectively. There were significant correlations between the conjunctival results and diabetes (P=0.049) and hypertension (P=0.002). Traveling was a risk factor for positive conjunctival swab testing (P=0.016). The sensitivity of the conjunctival swab was 4.8%. Conclusion Among all positive cases of COVID-19, a small percentage had positive results when tested using a conjunctival swab. Conjunctival swabs have very low sensitivity for the detection of COVID-19. However, tears could still be a mode of disease transmission, especially from patients to eye care specialists.
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Affiliation(s)
- Manal Hadrawi
- Department of Ophthalmology, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Mohammad Malak
- Department of Ophthalmology, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Faeeqah Almahmoudi
- Department of Ophthalmology, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Ahmed Mogharbel
- Faculty of Medicine, King Abdulalziz University, Jeddah, Saudi Arabia
| | - Omar Rozy
- Department of Ophthalmology, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Somaya Hanafi
- Department of Ophthalmology, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Batool Ali
- Department of Infectious Diseases, East Jeddah Hospital, Ministry of Health, Jeddah, Saudi Arabia
| | - Sanaa Nabeel
- Department of Infectious Diseases, East Jeddah Hospital, Ministry of Health, Jeddah, Saudi Arabia
| | - Fatimah Faqieha
- Department of Public Health, Ministry of Health, Jeddah, Saudi Arabia
| | - Khaled Alzahrani
- Department of Ophthalmology, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
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21
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Mahmoud H, Hamody A, M Hefny H, Tohamy D, Awny I. Evaluation of Anti-SARS-CoV-2 IgA in the Conjunctival Secretions of COVID-19 Patients. Clin Ophthalmol 2021; 15:1933-1937. [PMID: 34007145 PMCID: PMC8121674 DOI: 10.2147/opth.s312942] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 04/14/2021] [Indexed: 12/25/2022] Open
Abstract
Purpose To assess the presence of anti-SARS-CoV-2 IgA in the conjunctival secretions of confirmed COVID-19 patients by nasopharyngeal swabs and correlate its presence with the severity of the disease, patient's age, sex and ocular symptoms. Methods This study included 44 positive COVID-19 patients confirmed with nasopharyngeal swabs during the period 17-28 February 2021 at Sohag Tropical Medicine Hospital. Tears and conjunctival secretions were examined for the presence of anti-SARS-CoV-2 IgA. Results While non-reactive results are strongly correlated to low titre and vice versa, severity showed significant correlation with neither IgA reactivity nor titre. Meanwhile, IgA reactivity did not show significant correlation with either age or sex. The reactivity and IgA titre are correlated with ocular symptoms. Conclusion The anti-SARS-CoV-2 IgA could be found in ocular secretions in SARS-CoV-2 patients. There is no correlation with age or sex or severity of the disease; however, they are correlated with ocular symptoms.
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Affiliation(s)
- Hany Mahmoud
- Department of Ophthalmology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Ahmed Hamody
- Anesthesia Department, Sohag University, Sohag, Egypt
| | - Hesham M Hefny
- Clinical Pathology Department, Sohag University, Sohag, Egypt
| | - Dalia Tohamy
- Ophthalmology Department, Assiut University, Assiut, Egypt
| | - Islam Awny
- Department of Ophthalmology, Sohag University, Sohag, Egypt
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22
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Din N, Phylactou M, Fajardo-Sanchez J, Watson M, Ahmad S. The Impact of COVID-19 on Acute and Elective Corneal Surgery at Moorfields Eye Hospital London. Clin Ophthalmol 2021; 15:1639-1645. [PMID: 33986586 PMCID: PMC8110251 DOI: 10.2147/opth.s302576] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 04/07/2021] [Indexed: 01/27/2023] Open
Abstract
Purpose Moorfields Eye Hospital sits as a major tertiary centre for ophthalmic care in the United Kingdom and became a central hub to provide safe and effective ophthalmic care across London and surrounding regions during the COVID-19 pandemic. We explore the impact on both the acute and elective corneal services during the first wave of this pandemic. Methods A retrospective review of the proportion of corneal transplants and anterior segment trauma repairs was performed during the period of March 23rd to July 1st 2020 compared with an identical period in 2019. Data were acquired from our in-house electronic patient records. Results A 92% reduction in corneal elective work was observed during the lockdown period compared with an identical period in 2019, with only 10 elective cases in total being performed. In addition, 91 corneal cross-linking and 76 therapeutic lasers were cancelled. There were 15 cases of primary repair for anterior segment trauma compared with 6 cases pre-COVID-19. A similar scenario occurs with removal of foreign body (4 cases during COVID-19 period versus no cases during pre-COVID-19 era) and with traumatic lens aspirations (6 cases during COVID-19 compared with 2 pre-COVID-19). Interestingly, a statistical difference (p=0.03) was found in the time interval from presentation of symptoms to emergency corneal surgery. During the COVID-19 period, a delay of 1.5 days ± 2.29 (range 0–10 days) occurred compared with 0.8 days ± 1.54 (range 0–6 days) pre-COVID-19. Conclusion Stringent risk stratification reduced elective corneal surgery capacity during the lockdown thereby preserving social distancing requirements. However, an apparent increase in emergency corneal surgery seen is likely attributed to centralisation of ophthalmic services during the pandemic crisis, alongside increased domestic injuries. Despite the challenges posed, successful delivery of corneal surgery occurred whilst helping to identify lessons in preparations for future pandemics and current inefficiencies in healthcare delivery.
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Affiliation(s)
- Nizar Din
- Cornea and External Eye Disease Service, Moorfields Eye Hospital, London, UK
| | - Maria Phylactou
- Cornea and External Eye Disease Service, Moorfields Eye Hospital, London, UK
| | | | - Martin Watson
- Cornea and External Eye Disease Service, Moorfields Eye Hospital, London, UK
| | - Sajjad Ahmad
- Cornea and External Eye Disease Service, Moorfields Eye Hospital, London, UK.,Institute of Ophthalmology, University College London, London, UK
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23
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Napolitano F, Di Giuseppe G, Montemurro MV, Molinari AM, Donnarumma G, Arnese A, Pavia M, Angelillo IF. Seroprevalence of SARS-CoV-2 Antibodies in Adults and Healthcare Workers in Southern Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4761. [PMID: 33947008 PMCID: PMC8125185 DOI: 10.3390/ijerph18094761] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/20/2021] [Accepted: 04/26/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND This study was carried out to estimate the seroprevalence of SARS-CoV-2 antibodies in a Southern Italian population. METHODS The study was performed among students and workers of the University of Campania "Luigi Vanvitelli" and the relative Teaching Hospital. Participants were invited to undergo a blood sampling, an interview or to complete a self-administered questionnaire. RESULTS A total of 140 participants (5.8%) tested positive for SARS-CoV-2 antibodies. Positive SARS-CoV-2 test results increased significantly during the months of testing, and those who had had at least one symptom among fever, cough, dyspnea, loss of taste or smell and who had had contact with a family member/cohabitant with confirmed COVID-19 were more likely to test positive. Faculty members were less likely to have a positive test result compared to the healthcare workers (HCWs). Among HCWs, physicians showed the lowest rate of seroconversion (5.2%) compared to nurses (8.9%) and other categories (10%). Nurses and other HCWs compared to the physicians, those who had had at least one symptom among fever, cough, dyspnea, loss of taste or smell, and who had had contact with a family member/cohabitant with confirmed COVID-19 were more likely to test positive. CONCLUSIONS The results have demonstrated that SARS-CoV-2 infection is rapidly spreading even in Southern Italy and confirm the substantial role of seroprevalence studies for the assessment of SARS-CoV-2 infection circulation and potential for further spreading.
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Affiliation(s)
- Francesco Napolitano
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Via L. Armanni, 5 80138 Naples, Italy; (F.N.); (G.D.G.); (G.D.); (A.A.); (M.P.)
| | - Gabriella Di Giuseppe
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Via L. Armanni, 5 80138 Naples, Italy; (F.N.); (G.D.G.); (G.D.); (A.A.); (M.P.)
| | - Maria Vittoria Montemurro
- Health Direction, Teaching Hospital of the University of Campania “Luigi Vanvitelli”, Via Santa Maria di Costantinopoli, 104 80138 Naples, Italy;
| | - Anna Maria Molinari
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Via L. De Crecchio, 7 80138 Naples, Italy;
| | - Giovanna Donnarumma
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Via L. Armanni, 5 80138 Naples, Italy; (F.N.); (G.D.G.); (G.D.); (A.A.); (M.P.)
| | - Antonio Arnese
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Via L. Armanni, 5 80138 Naples, Italy; (F.N.); (G.D.G.); (G.D.); (A.A.); (M.P.)
| | - Maria Pavia
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Via L. Armanni, 5 80138 Naples, Italy; (F.N.); (G.D.G.); (G.D.); (A.A.); (M.P.)
| | - Italo Francesco Angelillo
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Via L. Armanni, 5 80138 Naples, Italy; (F.N.); (G.D.G.); (G.D.); (A.A.); (M.P.)
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24
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The Transmission of SARS-CoV-2 Infection on the Ocular Surface and Prevention Strategies. Cells 2021; 10:cells10040796. [PMID: 33918318 PMCID: PMC8065845 DOI: 10.3390/cells10040796] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/27/2021] [Accepted: 03/31/2021] [Indexed: 01/08/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a global health problem. Although the respiratory system is the main impaired organ, conjunctivitis is one of its common findings. However, it is not yet understood if SARS-CoV-2 can infect the eye and if the ocular surface can be a potential route of SARS-CoV-2 transmissions. Our review focuses on the viral entry mechanisms to give a better understanding of the interaction between SARS-CoV-2 and the eye. We highlighted findings that give evidence for multiple potential receptors of SARS-CoV-2 on the ocular surface. Additionally, we focused on data concerning the detection of viral RNA and its spike protein in the various ocular tissues from patients. However, the expression level seemed to be relatively low compared to the respiratory tissues as a result of a unique environment surrounding the ocular surface and the innate immune response of SARS-CoV-2. Nevertheless, our review suggests the ocular surface as a potential route for SARS-CoV-2 transmission, and as a result of this study we strongly recommend the protection of the eyes for ophthalmologists and patients at risk.
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25
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Dolar-Szczasny J, Toro MD, Dworzańska A, Wójtowicz T, Korona-Glowniak I, Sawicki R, Boguszewska A, Polz-Dacewicz M, Tomasiewicz K, Załuska W, Rejdak R, Bagnoli P, Rusciano D. Ocular Involvement of SARS-CoV-2 in a Polish Cohort of COVID-19-Positive Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2916. [PMID: 33809199 PMCID: PMC8001647 DOI: 10.3390/ijerph18062916] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/01/2021] [Accepted: 03/08/2021] [Indexed: 12/25/2022]
Abstract
The coronavirus SARS-CoV-2 responsible for the current human COVID-19 pandemic has shown tropism toward different organs with variable efficiency, eyes included. The purpose of this study has been to investigate the presence of detectable SARS-CoV-2 infection in ocular swabs in patients affected by COVID-19. A consecutive series of 74 COVID-19-positive patients (age 21-89) were enrolled at two Polish COVID-19 hospitals for 4 months and were characterized by PCR for the presence of the SARS-CoV-2 genetic material in nasopharyngeal (NP) and ocular swabs, while their respiratory and ocular symptoms were noted. Almost 50% of them presented with severe/critical respiratory involvement, and some degree of eye disease. No tight correlation was observed between the presence of ocular and respiratory symptoms. Three male patients presenting with severe/critical lung disease tested positive in ocular swab, however with mild/moderate ocular symptoms. In conclusion, our study lends further support to the view that overt ocular infection by the SARS-CoV-2 virus is not such a frequent occurrence.
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Affiliation(s)
- Joanna Dolar-Szczasny
- Department of General Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland; (J.D.-S.); (M.D.T.); (R.R.)
| | - Mario D. Toro
- Department of General Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland; (J.D.-S.); (M.D.T.); (R.R.)
- Faculty of Medical Sciences, Collegium Medicum, Cardinal Stefan Wyszyński University, 01-815 Warsaw, Poland
| | - Anna Dworzańska
- Department of Infectious Diseases, Medical University of Lublin, 20-059 Lublin, Poland; (A.D.); (K.T.)
| | - Tomasz Wójtowicz
- Department of Ophthalmology, Specialist Hospital of Radom, 26-610 Radom, Poland;
| | - Izabela Korona-Glowniak
- Department of Pharmaceutical Microbiology, Medical University of Lublin, 20-059 Lublin, Poland;
| | - Rafał Sawicki
- Department of Biochemistry and Biotechnology, Medical University of Lublin, 20-059 Lublin, Poland;
| | - Anastazja Boguszewska
- Department of Virology with SARS Laboratory, Medical University of Lublin, 20-059 Lublin, Poland; (A.B.); (M.P.-D.)
| | - Małgorzata Polz-Dacewicz
- Department of Virology with SARS Laboratory, Medical University of Lublin, 20-059 Lublin, Poland; (A.B.); (M.P.-D.)
| | - Krzysztof Tomasiewicz
- Department of Infectious Diseases, Medical University of Lublin, 20-059 Lublin, Poland; (A.D.); (K.T.)
| | - Wojciech Załuska
- Department of Nephrology, Medical University of Lublin, 20-059 Lublin, Poland;
| | - Robert Rejdak
- Department of General Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland; (J.D.-S.); (M.D.T.); (R.R.)
| | - Paola Bagnoli
- Department of Biology, University of Pisa, 56126 Pisa, Italy;
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26
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Sen N. Transmission and evaporation of cough droplets in an elevator: Numerical simulations of some possible scenarios. PHYSICS OF FLUIDS (WOODBURY, N.Y. : 1994) 2021; 33:033311. [PMID: 33746494 PMCID: PMC7976048 DOI: 10.1063/5.0039559] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 01/12/2021] [Indexed: 05/13/2023]
Abstract
As the world learns to live with COVID-19 and activities/business open up, the use of elevators becomes frequent. A pertinent question is what happens if someone accidentally coughs inside the elevator. In this work, a three dimensional Euler-Lagrangian model is used to understand the transmission and evaporation of micrometer-sized droplets in such cases. The effect of turbulence created by the air puff associated with coughing has been considered. Different possible scenarios varying in the presence of air ventilation within the elevator, number of persons coughing, direction of ejection of cough droplets, and ambient relative humidity and temperature have been postulated and simulated. The results obtained show that in the presence of proper ventilation within the elevator, most of the ejected cough droplets fall to the ground before impacting other persons traveling in the same elevator. However, in the absence of proper ventilation, the turbulence created during coughing transmits the particles all across the elevator enclosure.
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Affiliation(s)
- Nirvik Sen
- Chemical Engineering Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India
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27
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Gulias-Cañizo R, Ruíz-Leyja ED, Sánchez-Huerta V, Ochoa-de la Paz L. SARS-CoV-2 and the Eye: A Relationship for a Possible Prognostic Tool in COVID-19 Patients. Clin Ophthalmol 2021; 15:707-712. [PMID: 33658751 PMCID: PMC7917349 DOI: 10.2147/opth.s284191] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 12/04/2020] [Indexed: 01/08/2023] Open
Abstract
PURPOSE In December 2019 there was the first report about a new viral infection in Wuhan, China. The new virus was taxonomically designed as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) causing the coronavirus disease 2019 (COVID-19). SARS-CoV-2 uses the angiotensin-converting enzyme 2 (ACE2) receptor for cell invasion, which is expressed in different tissues including lungs, small intestine, testicles, kidneys, brain, and the eye. The purpose of this article is to review the available information on the relationship of COVID-19 with the eye, as well as evaluating the possible usefulness of ocular diagnostic tests to help in the diagnosis and/or monitoring of patients with this disease. METHODS We performed a retrospective review of relevant articles from November 2019 to April 2020. RESULTS Ocular infection by SARS-CoV-2 is still controversial; nevertheless, the possibility of being a viral reservoir has been suggested, increasing the likelihood of infection. Some reports demonstrated the presence of SARS-CoV-2 in tears, and previously published data suggest a pathological increase of cytokine concentrations in COVID-19 patients; the cytokine release syndrome or cytokine storm contributes to lung and central nervous system damage. The usefulness of tears for the measurement of inflammatory cytokines in various diseases is well known, in particular IL-6, which has been correlated to the severity of COVID-19. CONCLUSION Considering that the IL-6 signaling cascade may be activated in patients with COVID-19, makes it an excellent target for diagnostic and/or monitoring purposes.
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Affiliation(s)
- Rosario Gulias-Cañizo
- Facultad de Ciencias de la Salud, Universidad Anáhuac México, Huixquilucan, Edo. de México, México
| | - Estela D’Abril Ruíz-Leyja
- Asociación Para Evitar la Ceguera en México I.A.P. Hospital Dr. Luis Sánchez Bulnes, Mexico City, 04020, Mexico
| | - Valeria Sánchez-Huerta
- Asociación Para Evitar la Ceguera en México I.A.P. Hospital Dr. Luis Sánchez Bulnes, Mexico City, 04020, Mexico
| | - Lenin Ochoa-de la Paz
- Asociación Para Evitar la Ceguera en México I.A.P. Hospital Dr. Luis Sánchez Bulnes, Mexico City, 04020, Mexico
- Departamento de Bioquímica, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, 04510, Mexico
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28
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Kam AW, Gunasekaran N, Chaudhry SG, Vukasovic M, White AJR, Fung AT. Reduction in Ophthalmic Presentations to Australian Emergency Departments During the COVID-19 Period: Are We Seeing the Full Picture? Clin Ophthalmol 2021; 15:341-346. [PMID: 33542617 PMCID: PMC7853628 DOI: 10.2147/opth.s289467] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 11/19/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To examine changing patterns of ophthalmic presentations to emergency departments (EDs) during the lockdowns associated with the first wave of the COVID-19 pandemic in Australia and the two months immediately following lockdown relaxation. Patients and Methods This was a retrospective audit of triage coding and ICD-10-AM coding for all patient presentations to four Australian EDs from March 29 to May 31 in 2019 and 2020 (the COVID-19 lockdown period and the corresponding period in 2019), and from June 1 to July 31 in 2019 and 2020 (the post-lockdown period and the corresponding period in 2019). Number of ophthalmic presentations triaged per day and number of seven common and/or time-sensitive, vision threatening ophthalmic diagnoses were examined. Differences in mean daily presentation numbers were assessed with non-paired Student’s t-test with Bonferroni correction. Results Total ophthalmic presentations per day during COVID-19 lockdowns fell by 16% compared to the corresponding period in 2019 (13.0 ± 4.0 in 2019 vs 10.8 ± 3.3 in 2020, mean ± standard deviation; p=0.01). There was also a significant decrease in presentations of atraumatic retinal detachment, conjunctivitis, and eye pain. In the two months following easing of lockdown restrictions, total ophthalmic presentations per day returned to the same level as that of the corresponding period in 2019 (12.2 ± 4.3 in 2019 vs 12.3 ± 4.1 in 2020, p=0.97). Conclusion Total ophthalmic presentations and presentations of atraumatic retinal detachment, conjunctivitis and, eye pain to EDs fell during the lockdowns associated with the first wave of COVID-19 in Australia. These may represent delays in patients seeking appropriate medical attention and may have implications on patient morbidity long after the COVID-19 pandemic.
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Affiliation(s)
- Andrew W Kam
- Department of Ophthalmology, Westmead Hospital, Westmead, New South Wales, Australia.,Executive Unit, Westmead Hospital, Westmead, New South Wales, Australia.,Westmead and Central Clinical Schools, Discipline of Clinical Ophthalmology and Eye Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Nathan Gunasekaran
- Department of Ophthalmology, Westmead Hospital, Westmead, New South Wales, Australia
| | - Sarah G Chaudhry
- Department of Ophthalmology, Westmead Hospital, Westmead, New South Wales, Australia
| | - Matthew Vukasovic
- Department of Emergency Medicine, Westmead Hospital, Westmead, New South Wales, Australia
| | - Andrew J R White
- Department of Ophthalmology, Westmead Hospital, Westmead, New South Wales, Australia.,Westmead and Central Clinical Schools, Discipline of Clinical Ophthalmology and Eye Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,The Westmead Institute for Medical Research, Westmead Hospital, Westmead, New South Wales, Australia
| | - Adrian T Fung
- Department of Ophthalmology, Westmead Hospital, Westmead, New South Wales, Australia.,Westmead and Central Clinical Schools, Discipline of Clinical Ophthalmology and Eye Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,The Westmead Institute for Medical Research, Westmead Hospital, Westmead, New South Wales, Australia.,Department of Ophthalmology, Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park, New South Wales, Australia
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29
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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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30
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Nioi M, Napoli PE, Lobina J, Fossarello M, d'Aloja E. COVID-19 and Italian Healthcare Workers From the Initial Sacrifice to the mRNA Vaccine: Pandemic Chrono-History, Epidemiological Data, Ethical Dilemmas, and Future Challenges. Front Public Health 2021; 8:591900. [PMID: 33553091 PMCID: PMC7859528 DOI: 10.3389/fpubh.2020.591900] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 12/15/2020] [Indexed: 12/22/2022] Open
Abstract
On March 11, 2020, the World Health Organization (WHO) declared the coronavirus disease 2019 (COVID-19) outbreak a pandemic. Simultaneously, in Italy, in which the first case had occurred on February 18, the rigid phase of the lockdown began. The country has attracted worldwide attention, becoming at the same time a field of study both concerning the spread of the pandemic and advanced assessments of the effectiveness of political, public health, and therapeutic measures. The protagonists of the Italian crisis were the healthcare workers (HCWs) who were exposed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) without having any perception of what they were facing, courageously contributing to the containment of the epidemic to be defined by the media as “heroes.” However, in the first phase of the pandemic (March–May 2020), the price that the Italian Public Health System had to pay both in terms of the number of positive virus cases and deaths among the HCWs was beyond and represented a peculiarity compared to what happened in other countries. In the current study, after a summary of the evolution of the pandemic in Italy, we offer an analysis of the statistical data concerning contagions and deaths among healthcare workers (physicians in particular). In conclusion, we describe the critical issues that still need to be resolved and the future challenges facing healthcare workers and the general population.
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Affiliation(s)
- Matteo Nioi
- Department of Medical Sciences and Public Health, Forensic Medicine Unit, University of Cagliari, Cagliari, Italy
| | | | - Jessica Lobina
- Department of Medical Sciences and Public Health, Forensic Medicine Unit, University of Cagliari, Cagliari, Italy
| | - Maurizio Fossarello
- Department of Surgical Science, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Ernesto d'Aloja
- Department of Medical Sciences and Public Health, Forensic Medicine Unit, University of Cagliari, Cagliari, Italy
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31
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Kangbai JB, Babawo LS, Kaitibi D, Sandi AA, George AM, Sahr F. Re-reading ACT, BCG, and Low COVID-19 in Africa. SN COMPREHENSIVE CLINICAL MEDICINE 2021; 3:11-15. [PMID: 33458569 PMCID: PMC7801564 DOI: 10.1007/s42399-020-00704-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/09/2020] [Indexed: 12/28/2022]
Abstract
October 11, 2020, marks the seventh month since the World Health Organization (WHO) officially declared COVID-19 a pandemic. Unlike other coronavirus diseases, there is a geographically disproportionate distribution of the incidence of COVID-19 cases around the world. We observed a significantly high COVID-19 cases and deaths in countries and territories with no or very small number of malaria cases or no or low national TB cases in 2018. We speculate that the high incidence of COVID-19 cases and deaths in countries less affected by malaria is partly due to overexposure to malaria which led to the regular use of the artemisinin anti-malaria drugs as well as the regular use of bacillus Calmette-Guérin (BCG) vaccine for TB prevention. The vaccine produced an almost life-long immunity to TB and meningitis to its recipients. We are thus calling for a COVID-19 containment and clinical management protocol that will incorporate the use of the anti-malaria ACT drug cocktail and BCG vaccine on compassionate ground.
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Affiliation(s)
- Jia Bainga Kangbai
- Center for International Health, University of Munich (LMU), Munich, Germany
- Department of Environmental Health Sciences, Njala University, Freetown, Sierra Leone
- The National COVID Emergency Response Centre (NACOVERC), Freetown, Sierra Leone
| | - Lawrence Sao Babawo
- The National COVID Emergency Response Centre (NACOVERC), Freetown, Sierra Leone
- Department of Nursing, Njala University, Freetown, Sierra Leone
| | | | | | | | - Foday Sahr
- The National COVID Emergency Response Centre (NACOVERC), Freetown, Sierra Leone
- Department of Microbiology, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
- The 34 Military Hospital, Wilberforce, Freetown, Sierra Leone
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32
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Berkenstock MK, Ishii L, Giessler B, Quaty J, Biggs M, Buck P, Ebrado A, Kalendek L, Lazoff K, Martin M, McCullough C, Jampel H, Scott AW. Implementation of Novel Protocols in an Ophthalmic Ambulatory Surgical Center to Resume Surgical Procedures During COVID-19. Qual Manag Health Care 2021; 30:69-73. [PMID: 33165236 DOI: 10.1097/qmh.0000000000000285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND OBJECTIVES With the resumption of elective ophthalmic surgery during COVID-19, revised protocols were mandated to protect both staff and patients from transmission while increasing case numbers. We discuss a widely generalizable and in-depth protocol intended to safely allow the restart of elective procedures in 2 dedicated ophthalmic ambulatory surgical centers (ASCs) using monitored anesthesia care. METHODS A single-center review of protocols and practices designed to limit COVID-19 transmission. RESULTS All patients were tested within 72 hours prior to the procedure with a COVID-19 nasal swab to assess for active disease. A distance of 6 ft between each stretcher and the staff within the ASC was maintained when possible. Preoperative anesthetizing and dilating eye drops were administered from multiuse bottles without contact with surfaces. Surgical cases were restarted at a reduced capacity of a maximum of 7 per day to distance patient arrivals. Removal of waiting room chairs and the creation of new break areas allowed for social distancing. CONCLUSION As recommendations change on the basis of an increased understanding of the COVID-19 virus, ophthalmologists and ASC staff need to tailor protocols and workflows to limit transmission of virus with resumption of ocular surgery.
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Affiliation(s)
- Meghan K Berkenstock
- Wilmer Eye Institute Ambulatory Surgical Centers, Johns Hopkins Surgical Center Series, Bel Air, Maryland
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33
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Pérez González D, Loewenstein A, Gaton DD. Avoiding Diagnostic Lens Fogging During the COVID-19 Era. Clin Ophthalmol 2020; 14:4507-4509. [PMID: 33384557 PMCID: PMC7769927 DOI: 10.2147/opth.s286736] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 11/24/2020] [Indexed: 01/08/2023] Open
Abstract
Since the advent of COVID-19, the patient’s use of a face mask hampers our visibility because there is a marked fogging in our view produced by the warm breath that escapes from the top of the patient’s mask and lands on the cooler surface of the lens. This panorama is sometimes so frustrating that we have been forced to ask our patients to remove their facemasks while examined, increasing the risk of being infected. We consider it essential to share this small pearl technique that we can apply in order to avoid fogging during the examination; it is easy, and most importantly, without putting at risk the patient or doctor’s health. In our opinion, this is the first material to propose this technique. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/6ixfruTlcqs
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Affiliation(s)
- David Pérez González
- Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv, Israel
| | - Anat Loewenstein
- Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv, Israel
| | - Dan D Gaton
- Department of Ophthalmology, Rabin Medical Center, Sackler Faculty of Medicine, Tel Aviv, Israel
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34
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Tognetto D, Brézin AP, Cummings AB, Malyugin BE, Evren Kemer O, Prieto I, Rejdak R, Teus MA, Törnblom R, Toro MD, Vinciguerra AL, Giglio R, De Giacinto C. Rethinking Elective Cataract Surgery Diagnostics, Assessments, and Tools after the COVID-19 Pandemic Experience and Beyond: Insights from the EUROCOVCAT Group. Diagnostics (Basel) 2020; 10:E1035. [PMID: 33276612 PMCID: PMC7761628 DOI: 10.3390/diagnostics10121035] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/21/2020] [Accepted: 12/01/2020] [Indexed: 01/08/2023] Open
Abstract
The progressive deterioration of the visual function in patients on waiting lists for cataract surgery has a negative impact on their quality of life, especially in the elderly population. Patient waiting times for cataract surgeries in many healthcare settings have increased recently due to the prolonged stop or slowdown of elective cataract surgery as a result of coronavirus disease 19 (COVID-19). The aim of this review is to highlight the impact of such a "de-prioritization" of cataract surgery and to summarize some critical issues and useful hints on how to reorganize cataract pathways, with a special focus on perioperative diagnostic tools during the recovery phase and beyond. The experiences of a group of surgeons originating from nine different countries, named the European COVID-19 Cataract Group (EUROCOVCAT), have been combined with the literature and recommendations from scientific ophthalmic societies and healthcare institutions. Key considerations for elective cataract surgery should include the reduction of the number of unnecessary visits and examinations, adoption of precautionary measures, and implementation of telemedicine instruments. New strategies should be adopted to provide an adequate level of assistance and to guarantee safety conditions. Flexibility will be the watchword and regular updates would be necessary following scientific insights and the development of the pandemic.
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Affiliation(s)
- Daniele Tognetto
- Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, 34134 Trieste, Italy; (A.L.V.); (R.G.); (C.D.G.)
| | | | | | - Boris E. Malyugin
- S. Fyodorov Eye Microsurgery Federal State Institution, Russian Federation, 127486 Moscow, Russia;
| | - Ozlem Evren Kemer
- University of Health Sciences, Ankara City Hospital, 06800 Ankara, Turkey;
| | - Isabel Prieto
- Department of Ophthalmology, Fernando Fonseca Hospital, 2720-276 Amadora, Portugal;
| | - Robert Rejdak
- Department of General Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland;
| | - Miguel A. Teus
- Department of Ophthalmology, University of Alcalá, 28802 Madrid, Spain;
| | - Riikka Törnblom
- Department of Ophthalmology, TYKS Hospital, 20521 Turku, Finland;
| | - Mario D. Toro
- Department of General Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland;
- Faculty of Medical Sciences, Collegium Medicum, Cardinal Stefan Wyszyński University, 01-815 Warsaw, Poland
- Department of Ophthalmology, University Hospital of Zürich, University of Zürich, 8091 Zürich, Switzerland
| | - Alex L. Vinciguerra
- Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, 34134 Trieste, Italy; (A.L.V.); (R.G.); (C.D.G.)
| | - Rosa Giglio
- Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, 34134 Trieste, Italy; (A.L.V.); (R.G.); (C.D.G.)
| | - Chiara De Giacinto
- Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, 34134 Trieste, Italy; (A.L.V.); (R.G.); (C.D.G.)
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35
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Moon JY, Miller JB, Katz R, Ta T, Szypko C, Garg I, Lorch AC, Gardiner MF, Armstrong GW. The Impact of the COVID-19 Pandemic on Ophthalmic Care at an Eye-Specific Emergency Department in an Outbreak Hotspot. Clin Ophthalmol 2020; 14:4155-4163. [PMID: 33293788 PMCID: PMC7718995 DOI: 10.2147/opth.s285223] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 11/02/2020] [Indexed: 01/31/2023] Open
Abstract
PURPOSE During the COVID-19 pandemic, there is growing concern that patients are forgoing necessary care. Emergency departments (ED) represent an important site of eye care. We analyzed patterns of ED visits at an eye-specific ED since the declaration of the public health crisis. MATERIALS AND METHODS In this retrospective, cross-sectional single center study, medical records of 6744 patients who presented to the Massachusetts Eye and Ear ED between March 1st and April 30th in 2018, 2019, and 2020 were studied. The primary outcome measures were total volume of ED visits, proportion of urgent ED visits, and proportion of surgical visits. RESULTS Overall, the median number of daily visits to the ED decreased by 18 visits per day since the declaration of public health guidelines (interquartile range, 9-24, p < 0.001). This accounted for a 32% decrease in the total volume of ED visits in 2020 compared to prior years during the study period (p < 0.001). There was a 9% increase in the proportion of primary diagnoses considered urgent (p = 0.002). The proportion of visits requiring urgent surgery increased by 39% (p = 0.004). CONCLUSION The total number of eye-specific ED visits dropped compared to prior years while the proportion of urgent visits increased. Patients were likely more reluctant to seek eye care, deferring less urgent evaluation.
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Affiliation(s)
- Jade Y Moon
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA
| | - John B Miller
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA
| | - Raviv Katz
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA
| | - Thong Ta
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Colleen Szypko
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Itika Garg
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA
| | - Alice C Lorch
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
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Wang L, Deng Y. The Need for Ocular Protection for Health Care Workers During SARS-CoV-2 Outbreak and a Hypothesis for a Potential Personal Protective Equipment. Front Public Health 2020; 8:599757. [PMID: 33282819 PMCID: PMC7690622 DOI: 10.3389/fpubh.2020.599757] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 10/19/2020] [Indexed: 02/05/2023] Open
Abstract
SARS-CoV-2 is a coronavirus with high infectivity and has caused dramatic pressure on health systems all over the world. Appropriate personal protection for medical staffs is critical. For ocular protection, there is ongoing hot debate and concern for potential ocular transmission of SARS-CoV-2. Ocular manifestations and positive detection of viral RNA in ocular samples were only reported in very small number of patients infected with SARS-CoV-2. However, health care workers need to face patients more closely and have higher risk of aerosol contamination. Thus, appropriate ocular protection for medical workers is still recommended by organizations such as WHO and American Academy of Ophthalmology. Although eye goggles provide excellent protection and are mandatory for medical practitioners with high risk of exposure, they are not ideal for common clinical practice, because they can disturb vision due to extensive formation of water droplets and frequently cause moderate to severe discomfort after longtime wearing, which have been reported to interfere with working status. For the majority of medical workers who don't deal with high risk patients, they are not advised to wear goggles in daily practice. However, they also face the risk of infection due to the presence of asymptomatic carriers. Especially in situations with high risk of ocular exposure, such as close physical examination, eye surgery, dental clinics and surgery, ocular protection may be needed. Griffithsin has been shown to directly bind to spike proteins and has anti-viral activity against a broad spectrum of viruses, including coronavirus. Griffithsin is found to inhibit the entry of SARS-CoV at relatively low concentration and is stable and non-toxic. SARS-CoV-2 and SARS-CoV share the same entry receptors and their spike proteins are similar in conformation. We hypothesize that contact lenses containing nanoparticles loaded with griffithsin may provide sufficient ocular protection for medical staffs without high risk of exposure during the outbreak period of SARS-CoV-2. If proven effective, griffithsin-loaded contact lens can be considered as a supplementary ocular protective equipment for medical workers who can tolerate well. The daily disposable contact lens should be applied as needed and refrain from extended wearing in order to reduce potential side effects.
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Affiliation(s)
- Lixiang Wang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Yingping Deng
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
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37
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Nioi M, Napoli PE, Fossarello M, d'Aloja E. Autopsies and Asymptomatic Patients During the COVID-19 Pandemic: Balancing Risk and Reward. Front Public Health 2020; 8:595405. [PMID: 33240836 PMCID: PMC7680925 DOI: 10.3389/fpubh.2020.595405] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 10/13/2020] [Indexed: 12/23/2022] Open
Affiliation(s)
- Matteo Nioi
- Forensic Medicine Unit, Department of Clinical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Maurizio Fossarello
- Department of Surgical Science, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Ernesto d'Aloja
- Forensic Medicine Unit, Department of Clinical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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38
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Alqudah AA, Al Dwairi RA, Alqudah NM, Abumurad SK. COVID-19 Lockdown and Eye Injury: A Case Series from Jordan. Int Med Case Rep J 2020; 13:493-501. [PMID: 33116940 PMCID: PMC7553262 DOI: 10.2147/imcrj.s274284] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 09/14/2020] [Indexed: 11/23/2022] Open
Abstract
Novel coronavirus or COVID-19 is a viral illness that can cause severe respiratory symptoms. It spreads between people through direct, indirect (through contaminated objects or surfaces), or close contact with infected people via mouth and nose secretions. COVID-19 has caused a worldwide pandemic that necessitated many countries to perform a national lockdown. In Jordan, a complete lockdown was imposed by the government on March 17th, 2020 and continued for more than two months. The lockdown included every single sector in the country. Hospitals were only dealing with outpatient emergency cases, urgent referrals from primary or secondary health institutions and with inpatients whose medical conditions required keeping them admitted. Elective clinics and surgeries were canceled. At the King Abdullah University Hospital (KAUH), which is the only tertiary center in northern Jordan, we dealt with four cases of traumatic eye injury that resulted in a ruptured globe. The four cases were for eyes that had a history of penetrating keratoplasty (PK) and were visually compromised in the involved eye compared to the other eye. The percentage of open globe injuries to the total number of emergency cases presented during the lockdown was significantly higher than the percentage of open globe injuries to the total number of emergency cases presented during the corresponding period in the previous year (p=0.0005). We believe the lockdown inside homes has resulted in higher risk of trauma and rupture globe in this group of patients.
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Affiliation(s)
- Asem A Alqudah
- Ophthalmology Service, Department of Special Surgery, Faculty of Medicine, Jordan University of Science and Technology (JUST), Irbid, Jordan
| | - Rami A Al Dwairi
- Ophthalmology Service, Department of Special Surgery, Faculty of Medicine, Jordan University of Science and Technology (JUST), Irbid, Jordan
| | - Noor M Alqudah
- Ophthalmology Service, Department of Special Surgery, Faculty of Medicine, Jordan University of Science and Technology (JUST), Irbid, Jordan
| | - Sumayyah K Abumurad
- Department of Neurology, The University of Chicago Medicine, Chicago, IL, USA
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Peng M, Dai J, Sugali CK, Rayana NP, Mao W. The Role of the Ocular Tissue in SARS-CoV-2 Transmission. Clin Ophthalmol 2020; 14:3017-3024. [PMID: 33061288 PMCID: PMC7537833 DOI: 10.2147/opth.s269868] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/03/2020] [Indexed: 01/08/2023] Open
Abstract
The current global pandemic of coronavirus disease 2019 (COVID-19) has affected over 21 million people and caused over half a million deaths within a few months. COVID-19 has become one of the most severe public health crises in recent years. Compared to other pathogenic coronaviruses, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is highly infectious. Due to the lack of specific and effective treatment or vaccines, disease prevention and early detection are essential for establishing guidelines to mitigate further spread. The potential role of the ocular system in COVID-19 is still not clear but it has gained increasing attention. Here, we reviewed both clinical and research evidence on the ocular manifestations associated with COVID-19, the presence of SARS-CoV-2 in ocular surface tissues and tears, and the potential role of the eye in contracting SARS-CoV-2.
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Affiliation(s)
- Michael Peng
- Department of Ophthalmology, Eugene & Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Jiannong Dai
- Department of Ophthalmology, Eugene & Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Chenna Kesavulu Sugali
- Department of Ophthalmology, Eugene & Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Naga Pradeep Rayana
- Department of Ophthalmology, Eugene & Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Weiming Mao
- Department of Ophthalmology, Eugene & Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, USA.,Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA
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40
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Parodi A, Cozzani E. Coronavirus disease 2019 (COVID 19) and Malaria: Have anti glycoprotein antibodies a role? Med Hypotheses 2020; 143:110036. [PMID: 32652428 PMCID: PMC7314692 DOI: 10.1016/j.mehy.2020.110036] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/12/2020] [Accepted: 06/22/2020] [Indexed: 11/24/2022]
Affiliation(s)
- Aurora Parodi
- Dermatologic Unit, University of Genoa, DiSSal, Ospedale-Policlinico San Martino, IRCCS, Largo R. Benzi 10, 16132 Genova, Italy
| | - Emanuele Cozzani
- Dermatologic Unit, University of Genoa, DiSSal, Ospedale-Policlinico San Martino, IRCCS, Largo R. Benzi 10, 16132 Genova, Italy.
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Mahmoud H, Ammar H, El Rashidy A, Ali AH, Hefny HM, Mounir A. Assessment of Coronavirus in the Conjunctival Tears and Secretions in Patients with SARS-CoV-2 Infection in Sohag Province, Egypt. Clin Ophthalmol 2020; 14:2701-2708. [PMID: 32982162 PMCID: PMC7508560 DOI: 10.2147/opth.s270006] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 08/31/2020] [Indexed: 01/01/2023] Open
Abstract
Purpose To assess SARS-CoV-2 virus in conjunctival tears and secretions of positive confirmed COVID-19 patients. Methods A case series study that included 28 positive COVID-19 patients confirmed with nasopharyngeal swab in the period 18-28 May 2020 at Sohag Tropical Medicine Hospital. Tears and conjunctival secretions of these confirmed positive cases were collected with disposable sampling swabs at interval of 3 days after admission due to respiratory symptoms. They were examined for the presence of SARS-CoV-2 by reverse transcription-polymerase chain reaction (RT-PCR) assay. Results Thirteen (46.43%) patients were stable, 4 (14.28%) patients suffered from dyspnea, 3 (10.72%) patients suffered from high fever, 5 (17.85%) patients suffered from cough, and 3 (10.72%) patients were on mechanical ventilation. Ten (35.71%) patients suffered from conjunctivitis. Tear and conjunctival swabs were positive in 8 (28.57%) patients, while other patients' swabs were negative (71.43%). Out of 10 patients with conjunctival manifestations, 3 patients had SARS-CoV-2 in their conjunctiva using (RT-PCR) test. Out of the 18 patients with no conjunctival manifestations, 5 patients had positive SARS-CoV-2 in their conjunctiva using (RT-PCR) test. Conclusion The SARS-CoV-2 virus could be found in tears and conjunctival secretions in SARS-CoV-2 patients with or without conjunctivitis.
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Affiliation(s)
- Hany Mahmoud
- Sohag Faculty of Medicine, Ophthalmology Department, Sohag University, Sohag, Egypt
| | - Hatem Ammar
- Sohag Faculty of Medicine, Ophthalmology Department, Sohag University, Sohag, Egypt
| | - Amr El Rashidy
- Tropical Medicine, Sohag Tropical Medicine Hospital, Sohag, Egypt
| | - Amal H Ali
- Microbiology and Immunology, Department of Microbiology, Aswan University, Aswan, Egypt
| | - Hesham M Hefny
- Clinical Pathology Department, Sohag University, Sohag, Egypt
| | - Amr Mounir
- Sohag Faculty of Medicine, Ophthalmology Department, Sohag University, Sohag, Egypt
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Antaki F, Milad D, Javidi S, Dirani A. Vitreoretinal Surgery in the Post-Lockdown Era: Making the Case for Combined Phacovitrectomy. Clin Ophthalmol 2020; 14:2307-2309. [PMID: 32884232 PMCID: PMC7440631 DOI: 10.2147/opth.s270934] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 07/30/2020] [Indexed: 11/23/2022] Open
Abstract
The coronavirus disease (COVID-19) pandemic has significantly limited the capacity of healthcare systems to provide elective services like cataract surgery. Cataract formation is a frequent complication after pars plana vitrectomy. In this paper, we review the pros and cons of combined phacovitrectomy as opposed to sequential surgery in the post-pandemic era. In particular, we discuss the patient-level visual benefits and societal economic advantages of this procedure.
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Affiliation(s)
- Fares Antaki
- Department of Ophthalmology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Daniel Milad
- Faculty of Medicine, Université Laval, Québec, QC, Canada
| | - Simon Javidi
- Department of Ophthalmology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Ali Dirani
- Department of Ophthalmology, Centre Universitaire d'Ophtalmologie, Hôpital du Saint-Sacrement, CHU de Québec - Université Laval, Québec, QC, Canada
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43
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d'Aloja E, Finco G, Demontis R, Napoli PE, Fossarello M, Nioi M. COVID-19 and medical liability: Italy denies the shield to its heroes. EClinicalMedicine 2020; 25:100470. [PMID: 32734174 PMCID: PMC7378462 DOI: 10.1016/j.eclinm.2020.100470] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/06/2020] [Accepted: 07/08/2020] [Indexed: 11/21/2022] Open
Affiliation(s)
- Ernesto d'Aloja
- Department of Clinical Sciences and Public Health, University of Cagliari, Forensic Medicine Unit, Cagliari, Italy
| | - Gabriele Finco
- Department of Clinical Sciences and Public Health, University of Cagliari, Anesthesiology Unit, Cagliari, Italy
| | - Roberto Demontis
- Department of Clinical Sciences and Public Health, University of Cagliari, Forensic Medicine Unit, Cagliari, Italy
| | | | - Maurizio Fossarello
- Department of Surgical Science, University of Cagliari, Eye Clinic, Cagliari, Italy
| | - Matteo Nioi
- Department of Clinical Sciences and Public Health, University of Cagliari, Forensic Medicine Unit, Cagliari, Italy
- Correspondence to: Policlinico Universitario “Duilio Casula”, Dipartimento di Scienze Mediche e Sanità Pubblica, Unità di Medicina Legale. SS. 554 km 4.5, Bivio per Sestu, 09042 Monserrato, CA, Italy.
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44
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A Panel of Broad-Spectrum Antivirals in Topical Ophthalmic Medications from the Drug Repurposing Approach during and after the Coronavirus Disease 2019 Era. J Clin Med 2020; 9:jcm9082441. [PMID: 32751615 PMCID: PMC7463888 DOI: 10.3390/jcm9082441] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/15/2020] [Accepted: 07/27/2020] [Indexed: 01/08/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) represents a global concern of public health caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Its clinical manifestations are characterized by a heterogeneous group of symptoms and pictures (ranging from asymptomatic to lethal courses). The prevalence of conjunctivitis in patients with COVID-19 is at present controversial. Although it has been reported that only 0.9% developed signs of conjunctivitis, other report indicates that up to 31.6% of hospitalized patients had conjunctivitis. Considering the widespread use of topical ophthalmic medications (e.g., eye drops) by the general population, for various reasons (e.g., artificial tears, anti-glaucoma medications, topical antibiotics, etc.), the existence of their side effects as antiviral action should be investigated in-depth because it could possibly explain the aforementioned controversial data and represent a potential antiviral treatment for SARS-CoV-2 replication/diffusion on the ocular surface. Here, we discuss and elucidate the antiviral side effect of many eye drops and ophthalmic ointments commonly used for others purposes, thus showing that these secondary effects (not to be confused with the ‘adverse effects’) might be of primary importance in a number of viral infections (e.g., those for which there is no validated treatment protocol), according to a drug repurposing approach. Some active ingredients or excipients described here have activity against other types of viruses, thus suggesting potential broad-spectrum applications.
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45
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Mike EV, Laroche D. Preserving Vision in the COVID-19 Pandemic: Focus on Health Equity. Clin Ophthalmol 2020; 14:2073-2077. [PMID: 32801615 PMCID: PMC7383103 DOI: 10.2147/opth.s262586] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 07/03/2020] [Indexed: 12/12/2022] Open
Abstract
The coronavirus 19 (COVID-19) pandemic has overwhelmed our healthcare systems and caused the deaths of tens of thousands of Americans. Black and Hispanic individuals comprise a disproportionate number of those deaths, primarily because of pre-existing health conditions such as hypertension, obesity, and asthma. Health inequities that underlie these disparities also exist within ophthalmology around the world, and more ophthalmologists should advocate for healthcare reform that advances health equity. Immediate actions to reduce health disparities in ophthalmology during the pandemic include taking time to ensure all ophthalmology leadership and industry is diversified with people reflecting the fabric of their countries, embracing telemedicine to increase access to medical care, and advocating for legislation that will increase health insurance coverage during this unprecedented time. Longitudinal actions include recognizing structural racism as a root cause of health inequity and actively rejecting it through addressing modifiable risk factors, increasing cultural competency training, promoting diversity in the workforce, and global leadership.
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Affiliation(s)
- Elise V Mike
- Medical Scientist Training Program, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Daniel Laroche
- Department of Ophthalmology, New York Eye and Ear Infirmary, Icahn School of Medicine of Mount Sinai, New York, NY, USA
- Department of Ophthalmology, Advanced Eyecare of New York, New York, NY, USA
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46
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Koh AHC, Koh LRS, Sheu SJ, Sakamoto T. What COVID-19 has taught us: lessons from around the globe. Graefes Arch Clin Exp Ophthalmol 2020; 258:2091-2094. [PMID: 32535670 PMCID: PMC7293166 DOI: 10.1007/s00417-020-04791-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/03/2020] [Accepted: 06/06/2020] [Indexed: 11/06/2022] Open
Affiliation(s)
- Adrian H C Koh
- Eye & Retina Surgeons, #13-03 Camden Medical Centre, 1 Orchard Boulevard, Singapore, 248649, Singapore.
| | - Luke R S Koh
- Eye & Retina Surgeons, #13-03 Camden Medical Centre, 1 Orchard Boulevard, Singapore, 248649, Singapore
| | | | - Taiji Sakamoto
- Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
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