Sight-threatening intraocular infection in patients with COVID-19 in India

Autor: Sameera Nayak, Taraprasad Das, Deepika Parameswarappa, Savitri Sharma, Saumya Jakati, Subhadra Jalali, Raja Narayanan, Soumyava Basu, Mudit Tyagi, Vivek Pravin Dave, Rajeev Reddy Pappuru, Avinash Pathengay, Hrishikesh Kaza, Padmaja Kumari Rani, Shashwat Behera, Niroj Kumar Sahoo, Aditya Kapoor, Hitesh Agrawal, Komal Agarwal, Brijesh Takkar, Vishal Ramesh Raval
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Indian Journal of Ophthalmology, Vol 69, Iss 12, Pp 3664-3676 (2021)
Druh dokumentu: article
ISSN: 0301-4738
1998-3689
DOI: 10.4103/ijo.IJO_1474_21
Popis: Purpose: Intraocular infection in patients with COVID-19 could be different in the presence of treatment with systemic corticosteroid and immunosuppressive agents. We describe the epidemiology and microbiological profile of intraocular infection in COVID-19 patients after their release from the hospital. Methods: We analyzed the clinical and microbiological data of laboratory-confirmed COVID-19 patients from April 2020 to January 2021 presenting with features of endogenous endophthalmitis within 12 weeks of their discharge from the hospital in two neighboring states in South India. The data included demography, systemic comorbidities, COVID-19 treatment details, time interval to visual symptoms, the microbiology of systemic and ocular findings, ophthalmic management, and outcomes. Results: The mean age of 24 patients (33 eyes) was 53.6 ± 13.5 (range: 5–72) years; 17 (70.83%) patients were male. Twenty-two (91.6%) patients had systemic comorbidities, and the median period of hospitalization for COVID-19 treatment was 14.5 ± 0.7 (range: 7–63) days. Infection was bilateral in nine patients. COVID-19 treatment included broad-spectrum systemic antibiotics (all), antiviral drugs (22, 91.66% of patients), systemic corticosteroid (21, 87.5% of patients), supplemental oxygen (18, 75% of patients), low molecular weight heparin (17, 70.8% of patients), admission in intensive care units (16, 66.6% of patients), and interleukin-6 inhibitor (tocilizumab) (14, 58.3% of patients). Five (20.8%) patients died of COVID-19-related complications during treatment for endophthalmitis; one eye progressed to pan ophthalmitis and orbital cellulitis; eight eyes regained vision >20/400. Fourteen of 19 (73.7%) vitreous biopsies were microbiologically positive (culture, PCR, and microscopy), and the majority (11 patients, 78.5%) were fungi. Conclusion: Intraocular infection in COVID-19 patients is predominantly caused by fungi. We suggest a routine eye examination be included as a standard of care of COVID-19.
Databáze: Directory of Open Access Journals
Externí odkaz: