Ocular surface disturbance in patients after acute COVID‐19
Background We investigated the ocular surface disturbances in COVID‐19 patients discharged from the hospital. Methods One hundred and seventy‐nine eyes of 109 healthy participants and 456 eyes of 228 post‐COVID‐19 patients received comprehensive eye examinations; the latter were interviewed with que...
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| Veröffentlicht in: | Clinical & experimental ophthalmology 2022-05, Vol.50 (4), p.398-406 |
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| creator | Wan, Kelvin H. Lui, Grace C. Y. Poon, Ken C. F. Ng, Susanna S. S. Young, Alvin L. Hui, David S. C. Tham, Clement C. Y. Chan, Paul K. S. Pang, Chi Pui Chong, Kelvin K. L. |
| description | Background
We investigated the ocular surface disturbances in COVID‐19 patients discharged from the hospital.
Methods
One hundred and seventy‐nine eyes of 109 healthy participants and 456 eyes of 228 post‐COVID‐19 patients received comprehensive eye examinations; the latter were interviewed with questionnaires on ocular symptoms before and after COVID‐19 diagnosis. Associations of ocular surface manifestations with virological and ophthalmic parameters were evaluated by multivariable mixed linear or logistic regression models.
Results
Mean interval between COVID‐19 diagnosis and ophthalmic evaluation was 52.23 ± 16.12 days. The severity of meibomian gland dysfunction (MGD) based on clinical staging was higher in post‐COVID‐19 than healthy eyes (1.14 ± 0.67 vs. 0.92 ± 0.68, p = 0.002) and so was ocular surface staining score (0.60 ± 0.69 vs. 0.49 ± 0.68, p = 0.044). Patients requiring supplementary oxygen during hospitalisation had shorter tear break‐up time (β −1.63, 95% CI ‐2.61 to −0.65). Cycle threshold (Ct) value from upper respiratory samples (inversely correlated with viral load) at diagnosis had an OR = 0.91 (95% CI 0.84–0.98) with new ocular surface symptoms 4 weeks after diagnosis. The presence of ocular surface symptoms 1 week prior to COVID‐19 diagnosis showed an OR of 20.89 (95% CI 6.35–68.66) of persistent or new ocular symptoms 4 weeks afterward.
Conclusions
MGD and ocular surface staining are more common and severe in post‐COVID‐19 patients. Patients with higher viral loads have greater risks of ocular surface symptoms. Patients requiring supplementary oxygen are more likely to show tear film instability. Ocular surface evaluation should be considered 1–3 months following hospital discharge for any COVID‐19 patient. |
| doi_str_mv | 10.1111/ceo.14066 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9111848</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2633896501</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4436-5c23d6ddee1b6a02eeeb734e41ce04e3117fac0e43594ec36443ab76ce9338053</originalsourceid><addsrcrecordid>eNp1kUFOwzAQRS0EoqWw4AIoEhtYpLVjx0kWIKFQoFKlboCt5TgTcJUmxU5A3XEEzshJMKRUgIQ3M5Kf_3zPR-iQ4CFxZ6SgHhKGOd9CfcJY4Cc4ItvrnjPMemjP2jnGOAwo30U9GgYkJpT10dlMtaU0nm1NIRV4ubZNazJZuV5X3lI2GqrGerJowHhStQ146ex-cvn--kaSfbRTyNLCwboO0N3V-Da98aez60l6MfUVY5T7oQpozvMcgGRc4gAAsogyYEQBZkAJidxwDIyGCQNFuXsls4grSCiNcUgH6LzTXbbZAnLlLBlZiqXRC2lWopZa_L6p9KN4qJ9F4tYTs9gJnKwFTP3Ugm3EQlsFZSkrqFsrAu4GJTzExKHHf9B53ZrKfc9RUUQoxiRw1GlHKVNba6DYmCFYfIYiXCjiKxTHHv10vyG_U3DAqANedAmr_5VEOp51kh8O0ZXK</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2677130012</pqid></control><display><type>article</type><title>Ocular surface disturbance in patients after acute COVID‐19</title><source>Access via Wiley Online Library</source><creator>Wan, Kelvin H. ; Lui, Grace C. Y. ; Poon, Ken C. F. ; Ng, Susanna S. S. ; Young, Alvin L. ; Hui, David S. C. ; Tham, Clement C. Y. ; Chan, Paul K. S. ; Pang, Chi Pui ; Chong, Kelvin K. L.</creator><creatorcontrib>Wan, Kelvin H. ; Lui, Grace C. Y. ; Poon, Ken C. F. ; Ng, Susanna S. S. ; Young, Alvin L. ; Hui, David S. C. ; Tham, Clement C. Y. ; Chan, Paul K. S. ; Pang, Chi Pui ; Chong, Kelvin K. L.</creatorcontrib><description>Background
We investigated the ocular surface disturbances in COVID‐19 patients discharged from the hospital.
Methods
One hundred and seventy‐nine eyes of 109 healthy participants and 456 eyes of 228 post‐COVID‐19 patients received comprehensive eye examinations; the latter were interviewed with questionnaires on ocular symptoms before and after COVID‐19 diagnosis. Associations of ocular surface manifestations with virological and ophthalmic parameters were evaluated by multivariable mixed linear or logistic regression models.
Results
Mean interval between COVID‐19 diagnosis and ophthalmic evaluation was 52.23 ± 16.12 days. The severity of meibomian gland dysfunction (MGD) based on clinical staging was higher in post‐COVID‐19 than healthy eyes (1.14 ± 0.67 vs. 0.92 ± 0.68, p = 0.002) and so was ocular surface staining score (0.60 ± 0.69 vs. 0.49 ± 0.68, p = 0.044). Patients requiring supplementary oxygen during hospitalisation had shorter tear break‐up time (β −1.63, 95% CI ‐2.61 to −0.65). Cycle threshold (Ct) value from upper respiratory samples (inversely correlated with viral load) at diagnosis had an OR = 0.91 (95% CI 0.84–0.98) with new ocular surface symptoms 4 weeks after diagnosis. The presence of ocular surface symptoms 1 week prior to COVID‐19 diagnosis showed an OR of 20.89 (95% CI 6.35–68.66) of persistent or new ocular symptoms 4 weeks afterward.
Conclusions
MGD and ocular surface staining are more common and severe in post‐COVID‐19 patients. Patients with higher viral loads have greater risks of ocular surface symptoms. Patients requiring supplementary oxygen are more likely to show tear film instability. Ocular surface evaluation should be considered 1–3 months following hospital discharge for any COVID‐19 patient.</description><identifier>ISSN: 1442-6404</identifier><identifier>EISSN: 1442-9071</identifier><identifier>DOI: 10.1111/ceo.14066</identifier><identifier>PMID: 35218134</identifier><language>eng</language><publisher>Melbourne: John Wiley & Sons Australia, Ltd</publisher><subject>COVID-19 ; Diagnosis ; Eye ; Eye examinations ; meibomian gland dysfunction ; ocular surface ; Original ; ORIGINAL ARTICLES ; Oxygen ; Patients ; Regression analysis ; tear break up time</subject><ispartof>Clinical & experimental ophthalmology, 2022-05, Vol.50 (4), p.398-406</ispartof><rights>2022 Royal Australian and New Zealand College of Ophthalmologists.</rights><rights>2022 Royal Australian and New Zealand College of Ophthalmologists</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4436-5c23d6ddee1b6a02eeeb734e41ce04e3117fac0e43594ec36443ab76ce9338053</citedby><cites>FETCH-LOGICAL-c4436-5c23d6ddee1b6a02eeeb734e41ce04e3117fac0e43594ec36443ab76ce9338053</cites><orcidid>0000-0003-0307-2256 ; 0000-0003-2587-1323</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fceo.14066$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fceo.14066$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,315,782,786,887,1419,27931,27932,45581,45582</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35218134$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wan, Kelvin H.</creatorcontrib><creatorcontrib>Lui, Grace C. Y.</creatorcontrib><creatorcontrib>Poon, Ken C. F.</creatorcontrib><creatorcontrib>Ng, Susanna S. S.</creatorcontrib><creatorcontrib>Young, Alvin L.</creatorcontrib><creatorcontrib>Hui, David S. C.</creatorcontrib><creatorcontrib>Tham, Clement C. Y.</creatorcontrib><creatorcontrib>Chan, Paul K. S.</creatorcontrib><creatorcontrib>Pang, Chi Pui</creatorcontrib><creatorcontrib>Chong, Kelvin K. L.</creatorcontrib><title>Ocular surface disturbance in patients after acute COVID‐19</title><title>Clinical & experimental ophthalmology</title><addtitle>Clin Exp Ophthalmol</addtitle><description>Background
We investigated the ocular surface disturbances in COVID‐19 patients discharged from the hospital.
Methods
One hundred and seventy‐nine eyes of 109 healthy participants and 456 eyes of 228 post‐COVID‐19 patients received comprehensive eye examinations; the latter were interviewed with questionnaires on ocular symptoms before and after COVID‐19 diagnosis. Associations of ocular surface manifestations with virological and ophthalmic parameters were evaluated by multivariable mixed linear or logistic regression models.
Results
Mean interval between COVID‐19 diagnosis and ophthalmic evaluation was 52.23 ± 16.12 days. The severity of meibomian gland dysfunction (MGD) based on clinical staging was higher in post‐COVID‐19 than healthy eyes (1.14 ± 0.67 vs. 0.92 ± 0.68, p = 0.002) and so was ocular surface staining score (0.60 ± 0.69 vs. 0.49 ± 0.68, p = 0.044). Patients requiring supplementary oxygen during hospitalisation had shorter tear break‐up time (β −1.63, 95% CI ‐2.61 to −0.65). Cycle threshold (Ct) value from upper respiratory samples (inversely correlated with viral load) at diagnosis had an OR = 0.91 (95% CI 0.84–0.98) with new ocular surface symptoms 4 weeks after diagnosis. The presence of ocular surface symptoms 1 week prior to COVID‐19 diagnosis showed an OR of 20.89 (95% CI 6.35–68.66) of persistent or new ocular symptoms 4 weeks afterward.
Conclusions
MGD and ocular surface staining are more common and severe in post‐COVID‐19 patients. Patients with higher viral loads have greater risks of ocular surface symptoms. Patients requiring supplementary oxygen are more likely to show tear film instability. Ocular surface evaluation should be considered 1–3 months following hospital discharge for any COVID‐19 patient.</description><subject>COVID-19</subject><subject>Diagnosis</subject><subject>Eye</subject><subject>Eye examinations</subject><subject>meibomian gland dysfunction</subject><subject>ocular surface</subject><subject>Original</subject><subject>ORIGINAL ARTICLES</subject><subject>Oxygen</subject><subject>Patients</subject><subject>Regression analysis</subject><subject>tear break up time</subject><issn>1442-6404</issn><issn>1442-9071</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp1kUFOwzAQRS0EoqWw4AIoEhtYpLVjx0kWIKFQoFKlboCt5TgTcJUmxU5A3XEEzshJMKRUgIQ3M5Kf_3zPR-iQ4CFxZ6SgHhKGOd9CfcJY4Cc4ItvrnjPMemjP2jnGOAwo30U9GgYkJpT10dlMtaU0nm1NIRV4ubZNazJZuV5X3lI2GqrGerJowHhStQ146ex-cvn--kaSfbRTyNLCwboO0N3V-Da98aez60l6MfUVY5T7oQpozvMcgGRc4gAAsogyYEQBZkAJidxwDIyGCQNFuXsls4grSCiNcUgH6LzTXbbZAnLlLBlZiqXRC2lWopZa_L6p9KN4qJ9F4tYTs9gJnKwFTP3Ugm3EQlsFZSkrqFsrAu4GJTzExKHHf9B53ZrKfc9RUUQoxiRw1GlHKVNba6DYmCFYfIYiXCjiKxTHHv10vyG_U3DAqANedAmr_5VEOp51kh8O0ZXK</recordid><startdate>202205</startdate><enddate>202205</enddate><creator>Wan, Kelvin H.</creator><creator>Lui, Grace C. Y.</creator><creator>Poon, Ken C. F.</creator><creator>Ng, Susanna S. S.</creator><creator>Young, Alvin L.</creator><creator>Hui, David S. C.</creator><creator>Tham, Clement C. Y.</creator><creator>Chan, Paul K. S.</creator><creator>Pang, Chi Pui</creator><creator>Chong, Kelvin K. L.</creator><general>John Wiley & Sons Australia, Ltd</general><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-0307-2256</orcidid><orcidid>https://orcid.org/0000-0003-2587-1323</orcidid></search><sort><creationdate>202205</creationdate><title>Ocular surface disturbance in patients after acute COVID‐19</title><author>Wan, Kelvin H. ; Lui, Grace C. Y. ; Poon, Ken C. F. ; Ng, Susanna S. S. ; Young, Alvin L. ; Hui, David S. C. ; Tham, Clement C. Y. ; Chan, Paul K. S. ; Pang, Chi Pui ; Chong, Kelvin K. L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4436-5c23d6ddee1b6a02eeeb734e41ce04e3117fac0e43594ec36443ab76ce9338053</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>COVID-19</topic><topic>Diagnosis</topic><topic>Eye</topic><topic>Eye examinations</topic><topic>meibomian gland dysfunction</topic><topic>ocular surface</topic><topic>Original</topic><topic>ORIGINAL ARTICLES</topic><topic>Oxygen</topic><topic>Patients</topic><topic>Regression analysis</topic><topic>tear break up time</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wan, Kelvin H.</creatorcontrib><creatorcontrib>Lui, Grace C. Y.</creatorcontrib><creatorcontrib>Poon, Ken C. F.</creatorcontrib><creatorcontrib>Ng, Susanna S. S.</creatorcontrib><creatorcontrib>Young, Alvin L.</creatorcontrib><creatorcontrib>Hui, David S. C.</creatorcontrib><creatorcontrib>Tham, Clement C. Y.</creatorcontrib><creatorcontrib>Chan, Paul K. S.</creatorcontrib><creatorcontrib>Pang, Chi Pui</creatorcontrib><creatorcontrib>Chong, Kelvin K. L.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical & experimental ophthalmology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wan, Kelvin H.</au><au>Lui, Grace C. Y.</au><au>Poon, Ken C. F.</au><au>Ng, Susanna S. S.</au><au>Young, Alvin L.</au><au>Hui, David S. C.</au><au>Tham, Clement C. Y.</au><au>Chan, Paul K. S.</au><au>Pang, Chi Pui</au><au>Chong, Kelvin K. L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ocular surface disturbance in patients after acute COVID‐19</atitle><jtitle>Clinical & experimental ophthalmology</jtitle><addtitle>Clin Exp Ophthalmol</addtitle><date>2022-05</date><risdate>2022</risdate><volume>50</volume><issue>4</issue><spage>398</spage><epage>406</epage><pages>398-406</pages><issn>1442-6404</issn><eissn>1442-9071</eissn><abstract>Background
We investigated the ocular surface disturbances in COVID‐19 patients discharged from the hospital.
Methods
One hundred and seventy‐nine eyes of 109 healthy participants and 456 eyes of 228 post‐COVID‐19 patients received comprehensive eye examinations; the latter were interviewed with questionnaires on ocular symptoms before and after COVID‐19 diagnosis. Associations of ocular surface manifestations with virological and ophthalmic parameters were evaluated by multivariable mixed linear or logistic regression models.
Results
Mean interval between COVID‐19 diagnosis and ophthalmic evaluation was 52.23 ± 16.12 days. The severity of meibomian gland dysfunction (MGD) based on clinical staging was higher in post‐COVID‐19 than healthy eyes (1.14 ± 0.67 vs. 0.92 ± 0.68, p = 0.002) and so was ocular surface staining score (0.60 ± 0.69 vs. 0.49 ± 0.68, p = 0.044). Patients requiring supplementary oxygen during hospitalisation had shorter tear break‐up time (β −1.63, 95% CI ‐2.61 to −0.65). Cycle threshold (Ct) value from upper respiratory samples (inversely correlated with viral load) at diagnosis had an OR = 0.91 (95% CI 0.84–0.98) with new ocular surface symptoms 4 weeks after diagnosis. The presence of ocular surface symptoms 1 week prior to COVID‐19 diagnosis showed an OR of 20.89 (95% CI 6.35–68.66) of persistent or new ocular symptoms 4 weeks afterward.
Conclusions
MGD and ocular surface staining are more common and severe in post‐COVID‐19 patients. Patients with higher viral loads have greater risks of ocular surface symptoms. Patients requiring supplementary oxygen are more likely to show tear film instability. Ocular surface evaluation should be considered 1–3 months following hospital discharge for any COVID‐19 patient.</abstract><cop>Melbourne</cop><pub>John Wiley & Sons Australia, Ltd</pub><pmid>35218134</pmid><doi>10.1111/ceo.14066</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-0307-2256</orcidid><orcidid>https://orcid.org/0000-0003-2587-1323</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Clinical & experimental ophthalmology, 2022-05, Vol.50 (4), p.398-406 |
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| source | Access via Wiley Online Library |
| subjects | COVID-19 Diagnosis Eye Eye examinations meibomian gland dysfunction ocular surface Original ORIGINAL ARTICLES Oxygen Patients Regression analysis tear break up time |
| title | Ocular surface disturbance in patients after acute COVID‐19 |
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