The aim of this study was to investigate potential pathological findings in the eye, especially in the retina, after recovery from an infection with SARS-CoV-2. The ACE2 receptor is found in many different tissues such as nasal mucosa, lung, stomach colon and many more showing the multiple points to attack during infection [21]. Arq. Bining Z, Qun W, Ting L, Shengqian D, Xia Q, Hui J, et al. The authors declare no competing interests. People talk about its impact on their mental health, their ability to breathe and their ability to make it through the day without a nap. 2020;26(5):6817. S. Michalakis Co-founder and shareholder of ViGeneron GmbH. Vis. Prim. Napoli PE, Nioi M. Global spread of coronavirus disease 2019 and malaria: an epidemiological paradox in the early stage of a pandemic. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Costa, .F., Bonifcio, L.P., Bellissimo-Rodrigues, F. et al. Regarding refractive errors, as the Pearson correlation between RE and LE was 0.85, we used only the RE for the refractive error data analysis. Hospital of the Ludwig Maximilians University, Munich. V. Brantl and B. Schworm wrote the paper, G. Weber, J. Schiefelbein examined patients, V. Brantl prepared figures and tables, T. Kreutzer, S. Michalakis, J. Siedlecki and S. Priglinger gave final supportive assistance. Two eyes in the hospitalised group were excluded because of epiretinal Membranes. 2020;8:591900. https://doi.org/10.3389/fpubh.2020.591900. How often do you feel your eyes irritated? Ocul Immunol Inflamm. Global and regional estimates of prevalence of refractive errors: Systematic review and meta-analysis. and transmitted securely. Springer Nature. Gascon P, Briantais A, Bertrand E, Ramtohul P, Comet A, Beylerian M, et al. Dry eye disease was defined when the positivity in the dry eye short questionnaire defined above was associated with positivity in at least one of the three dry eye tests mentioned above in at least one eye. 2020;92(6):58994. Expression analysis of 2019-nCoV related ACE2 and TMPRSS2 in eye tissues. Although, the World Health Organization does list conjunctivitis as a "less common symptom" of the virus. 2003;362(9393):13538. : conception and design, analysis and interpretation of data; drafting the manuscript, critical revision for intellectual content. In conclusion, 51.5% of patients surviving the acute phase of COVID-19 were clinically classified as severe and 37.5% as critical. Video transcript. What are the specific eye symptoms that may arise after the COVID-19 vaccine? From 21 patients with a mean (SD) age of 48.7years (18.3), 10 (48.3%) were male and 14 (66.6%) had been hospitalized in our Department of Internal Medicine of the University because of COVID-19 for (SD) mean 9.4 (6.1) days. We would like to thank all patients and the study team of our Clinic of Ophthalmology. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Bining Z, Qun W, Ting L, Shengqian D, Xia Q, Hui J, Benxiang Q, Bin Z, Qingjun Z. C. S. G. Symptoms in patients after acute COVID-19. I was lethargic for months after my illness; my eyes began to hurt and were extremely sensitive to light. Opt. Further studies with more participants with and without acute ocular symptoms are necessary for final evidence. 2023 BioMed Central Ltd unless otherwise stated. Symptoms may include: Tearing or watery eyes Secondly, in the acute phase of COVID-19, some patients show ocular symptoms including keratoconjunctivitis, epiphora and chemosis [14, 15]. Of these, 14 (66.6%) were hospitalized and 7 (33.3) were discharged home. Middle East respiratory syndrome coronavirus (MERS-CoV): announcement of the coronavirus study group. Lin Y, Jiang H, Liu Y, Rosa Gameiro G, Gregori G, Dong C, Rundek T, Wang J. Age-related alterations in retinal tissue perfusion and volumetric vessel density. https://www.nejm.org/doi/full/10.1056/nejmoa1211721 (Accessed 22 8 2020 ). Lung recovery after COVID-19 is possible, but takes time. Article And it can be spread by coughs and sneezes. Coronavirus patient unable to work six months on. Emanuel EJ, Persad G, Upshur R, Thome B, Parker M, Glickman A, et al. 2020;111(1):102. In our study we did not see more dilated vessels, microaneurysms, areas of non-perfusion or other microvascular anomalies. Casari, I., Manfredi, M., Metharom, P. & Falasca, M. Dissecting lipid metabolism alterations in SARS-CoV-2. https://doi.org/10.7196/SAMJ.2020.v111i11.15433. https://doi.org/10.1002/path.1570. CAS We looked for correlation between right and left eyes refractive errors using Pearson coefficient. 16, 103112. Eye Lond Engl. Age-related alterations in retinal tissue perfusion and volumetric vessel density. volume11, Articlenumber:11085 (2021) Hyperinflammation with cytokine storm and stasis with hypoxia that activates coagulation mechanisms could very well cause retinal vasculitis, thromboembolic events or venous congestion resulting in a COVID-19 associated retinal vein occlusion, papillophlebitis or retinopathy [30, 38, 39]. Have you ever been diagnosed (by a clinician) as having dry eye syndrome? contracts here. They were also asked about the presence of blurry vision and ocular pain at the moment of the ophthalmologic examination and if these symptoms were previous to COVID-19 diagnosis or if they appeared simultaneously with COVID-19 and persisted until the exam day. J Virol. Personal consultation fees from Novartis Pharma GmbH and Bayer AG. Invernizzi A, Torre A, Parrulli S, Zicarelli F, Schiuma M, Colombo V, Giacomelli A, Cigada M, Milazzo L, Ridolfo A, Faggion I, Cordier L, Oldani M, Marini S, Villa P, Rizzardini G, Galli M, Antinori S, Staurenghi G, Meroni L. Retinal findings in patients with COVID-19: results from the SERPICO-19 study. https://doi.org/10.3390/jcm9041138. Never, 1. One year after COVID-19 and fighting for my vision Struggling with symptoms including light sensitivity, pain and poor depth perception, Mark didn't know what was wrong with his eyes. Article Diabetes Care 35, 556564. In conclusion, our results suggest that long-term complications of the eye are unlikely after recovery from COVID-19, although receptors allowing for SARS-CoV-2 entry are present in the conjunctiva, limbal superficial cells, retina and aqueous humor. Coronavirus Recovery: Rate, Time, and Outlook - WebMD Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. SARS-CoV-2 infection can leave some people with heart problems, including inflammation of the heart . HHS Vulnerability Disclosure, Help Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B. Pereira LA, Soares LCM, Nascimento PA, Cirillo LRN, Sakuma HT, Veiga GL d, et al. All authors revied the manuscript. PubMed Central Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Hamming I, Timens W, Bulthuis M, Lely A, Navis G, van Goor H. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. PubMed Central The longer you have diabetes and the less controlled . 80, 1416. A p value of less than 0.05 was considered to be statistically significant. https://doi.org/10.1016/j.cell.2020.02.052. At first, diabetic retinopathy might cause no symptoms or only mild vision problems. CAS volume21, Articlenumber:421 (2021) Ophthalmology 127, 14251427. Regarding oxygen support interface type, the most frequently used was oxygen catheter / nasal cannula interfaces in 56 (87.5%); reservoir mask 15 (23.4%); and continuous positive airway pressure (CPAP) / noninvasive ventilation (NIV) in 11 patients (17.1%). The condition can develop in anyone who has type 1 or type 2 diabetes. Once youve recovered from Covid-19 make sure to get your eyes checked; its an important part of taking care of yourself and getting back to who you were. -Mark from Oregon, When a friend told me they had COVID-19 I said, As soon as youre fine you need to go get your eyes checked. Struggling with the issues with my eyes, and all the things I couldnt do because my vision wasnt the same was frustrating and lonely. Thus, two possible routes of infection emerge by which SARS-CoV 2 can enter the body via the eyes. PubMed Find out about possible causes of post-COVID-19 conditions and ways to manage symptoms. Seah I, Agrawal R. Can the Coronavirus Disease 2019 (COVID-19) affect the eyes? Studies on animal coronavirus infection models have reported retinal involvement evident as retinal vasculitis, retinal degeneration or collapse of the blood-retinal barrier [35, 36]. government site. Fair allocation of scarce medical resources in the time of Covid-19. https://doi.org/10.1038/s41591-020-0868-6. In a Brazilian study, the myopias prevalence varied from 10 to 35% (ages ranging from 30 to 59 years old), and hyperopia varied from 30 to 60%22. Napoli PE, Nioi M, dAloja E, Fossarello M. The ocular surface and the coronavirus disease 2019: does a dual ocular route exist? As a library, NLM provides access to scientific literature. Concerning posterior segment commitment, flame-shaped or microhemorrhages and cotton wool spots in the papillomacular bundle were shown7,8,9. 2020;395(10223):497506. Patients recovered from the acute phase of COVID-19 underwent a complete ophthalmological evaluation, including presenting and best-corrected visual acuity (BCVA), refractometry, biomicroscopy, tonometry, break-up time and Schirmer tests, indirect ophthalmoscopy, color fundus picture, and retinal architecture evaluation using optical coherence tomography. One year after COVID-19 and fighting for my vision | AOA Various ACE and ACE2 polymorphisms in people of African genetic descent are associated with increased plasma levels of angiotensin II, which reduce the erythrocyte colonization by P. falcifarum [1820]. COVID-19 retinal microangiopathy as an in vivo biomarker of systemic vascular disease?. Google Scholar. In the Eye of the Storm: How Covid-19 Impacts the Eye - Forbes We included 64 patients (128 eyes). The Doornik-Hansen for multivariate normality test was used to look for Gaussian distribution. Panuveitis and optic neuritis as a possible initial presentation of the novel coronavirus disease 2019 (COVID-19). Vinores SA, Wang Y, Vinores MA, Derevjanik NL, Shi A, Klein DA, et al. The aim of this study was to investigate potential pathological findings in the eye, especially in the retina, after recovery from an infection with SARS-CoV-2. Visual acuity was the same as pre-COVID-19 in all eyes, and no traces of ocular inflammation, infiltration or microvascular insult could be found on OCT and OCT angiography. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. https://doi.org/10.1016/j.ophtha.2020.04.028 (2020). An official website of the United States government. A., Romano, A. C., Nascimento, H. & Belfort, R. Jr. Retinal findings in patients with COVID-19. Post-acute COVID-19 syndrome. Findings In this prospective cross-sectional study, patients who had suffered from previous COVID-19 had no long-term side effects at 3 months after recovery. Isolation of a Novel Coronavirus from a Man with Pneumonia in Saudi Arabia | NEJM. These symptoms can be the result of problems like retinal tears and retinal detachments; eye strokes, which occur when a blood clot blocks an artery in the retina; or eye infections - all of. Ophthalmol. Wang Y, Detrick B, Yu ZX, Zhang J, Chesky L, Hooks JJ. Learn more recovery and tips for feeling better after COVID-19. 2003;348(20):196776. Look for These Symptoms in the Months After COVID Recovery Rosalia Antunes-Foschini. Visual acuity was the same as pre-COVID-19 in all eyes, and no traces of ocular inflammation, infiltration or microvascular insult could be found on OCT and OCT angiography. N Engl J Med. Napoli PE, Nioi M, Fossarello M. The Quarantine Dry Eye: the lockdown for coronavirus disease 2019 and its implications for ocular surface health. Selective neuronal mitochondrial targeting in SARS-CoV-2 infection affects cognitive processes to induce brain fog and results in behavioral changes that favor viral survival. Cite this article. Article Res. This study is nested within a large cohort study named RECOVIDA, aimed to comprehensively describe the clinical picture of the post-COVID-19 condition. Concerning the posterior pole findings associated with previous comorbidities, the three main findings were: 10 (15.6%) were diagnosed as non-proliferative diabetic retinopathy, 11 (17.2%) presented increased retinal vascular tortuosity and 3 (4.7%) had glaucoma diagnosis. 'Long Covid': Why are some people not recovering? - BBC News Therefore, this prospective cross-sectional study sought to examine potential long-term functional and morphological impairment in eyes of COVID-19 patients 3 months after recovery. The sample size is limited, and the percentage of intensive care patients is low. Front Public Health. Article 2020;9(5):1269. https://doi.org/10.3390/jcm9051269. Yau, J. W. et al. Coronavirus: Can it affect eyesight? - BBC News Before contracting COVID-19 I wore glasses, but the difficulty I had seeing was unlike anything Id experienced before. J. Med. Correspondence to WHO Coronavirus Disease (COVID-19) Dashboard. Marinho PM, Marcos AAA, Romano AC, Nascimento H, Belfort R. Retinal findings in patients with COVID-19. They have me wear paper glasses, kind of like 3-D glasses, and I complete movements while a light is concentrated on the glasses. Using OCT-A to test for microvascular disorders, we did not find any pathologies related to a vascular or inflammatory response (Table (Table1).1). Virology: coronaviruses. But it can lead to blindness. Further studies with a longer follow-up and a larger sample size are warranted. Limitations Lancet Lond Engl. While reports estimate that approximately 1020% of patients experience long-lasting symptoms beyond 4weeks, these symptoms can take on many different forms, including sustained fatigue, brain fog or loss of taste and/or smell [12]. The https:// ensures that you are connecting to the statement and This throws more light on the occurrence of inflammation in people recovering from COVID-19. PubMed Tara Robertson took up gaming after completing her active military service and her new hobby came with a sharp increase in screen time. 15, 539574. These authors contributed equally: Fernando Bellissimo-Rodrigues and Rosalia Antunes-Foschini. Mean visual acuity was 1.040.2 on the right and 1.010.2 on the left eye. Int. Gascon P, Briantais A, Bertrand E, Ramtohul P, Comet A, Beylerian M, Sauvan L, Swiader L, Durand JM, Denis D. Covid-19-associated retinopathy: a case report. Retinal findings in patients with COVID-19: results from the SERPICO-19 study. https://doi.org/10.12659/MSM.930886. To improve the accuracy of OCT data, the automatic delineation of the internal and external limits of the sensorineural retina, generated by the equipment's software, was verified for each of the scans. In very rare cases, acute inflammatory retinal vein occlusion, papillophlebitis or retinopathy have been observed. In some people, post- COVID-19 syndrome lasts months or years or causes disability. Impact of the COVID-19 lockdown on digital device-related ocular health. Dr. Dunn recommended a treatment called Syntonics, a light therapy used to balance the nervous system. Nalbandian, A. et al. The first fundus and optical coherence tomography (OCT) study on the matter reported in 12 adults suffering from an acute COVID-19 infection and showed hyperreflective lesions of ganglions cell and inner plexiform layers as sign for vascular damage [31]. https://doi.org/10.23750/abm.v91i1.9397 (2020). She is passionate about teaching, so in addition to being an assistant professor, she now has fouirth-year optometry students rotating through her clinic. Bilateral anterior uveitis as a part of a multisystem inflammatory syndrome secondary to COVID-19 infection. CAS Article During the infection, 14 of the 21 patients (66.6%) were in regular care whereas 2 patients (9.5%) received intensive care ventilation for 8.5 (SD) (0.7) days on average in the COVID ICU. The tear flow was measured by the Schirmer test without anesthesia and considered positive for dry eye if the worse eye showed5 mm of wetness). Concerns about the interpretation of OCT and fundus findings in COVID-19 patients in recent lancet publication. Sign up for the Nature Briefing newsletter what matters in science, free to your inbox daily. Concerning visual acuity, only two eyes of two patients presented DBCVA>0.5 logMAR, and both had cataracts diagnosis before COVID-19 onset; indeed, it is one of the leading causes of visual impairment at this age range (50 years)21. New concepts in malaria pathogenesis: the role of the renin-angiotensin system. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Characteristics of ocular findings of patients with coronavirus disease 2019 (COVID-19) in Hubei Province, China. An important finding was that the HCW infection rate was 12% by July 2020, showing how highly contagious and how extremely important protective measures are in dealing with COVID-19 patients [9]. A year after recovering, Im working to heal the things that COVID-19 deteriorated. Zago Filho, L. A., Lima, L. H., Melo, G. B., Zett, C. & Farah, M. E. Vitritis and outer retinal abnormalities in a patient with COVID-19. https://doi.org/10.1056/NEJMoa030666. CAS J. Infect. Before JAMA Ophthalmol. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Vinores SA, Wang Y, Vinores MA, Derevjanik NL, Shi A, Klein DA, Detrick B, Hooks JJ. Even the 2 patients with severe ARDS and intubation for 8.5 (0.7) days and extremely high inflammation values (Table2) did not show any signs of ocular manifestations. Does COVID-19 lead to vision loss? - American Academy of Ophthalmology Epidemiology and cause of severe acute respiratory syndrome (SARS) in Guangdong, Peoples republic of China, in February, 2003. For the purpose of this prospective cross-sectional case study, 21 patients who had recovered from a COVID-19 infection were recruited. Napoli PE, Nioi M, Fossarello M. The Quarantine Dry Eye: the lockdown for coronavirus disease 2019 and its implications for ocular surface health. Slit-lamp examination showed normal findings for both anterior and posterior segments of the eye in all patients of both groups, with no signs of inflammation. Bahkir FA, Grandee SS. Theres been a lot of news about the longterm effects of COVID-19. Statistical significance (*** p0.001, ** p0.025) was calculated with two-sample t-test assuming different variances. Using OCT-A to test for microvascular disorders, we did not find any pathologies related to a vascular or inflammatory response (Table 1). My eyesight still varies day to day but its better than it was and Im able to focus my eyes better. Long Covid is not just people taking time to recover from a stay in intensive care. [. You do not have access to this content. My depth perception was so thrown off I could no longer ride my motorcycle, and I love riding my motorcycle. 30, 322. Ferraz, F. H., Corrente, J. E., Opromolla, P., Padovani, C. R. & Schellini, S. A. Refractive errors in a Brazilian population: Age and sex distribution. Visual acuity, slit lamp, bio microscopy and fundoscopy, multimodal imaging findings. The mild but statistically significant increase in the intraocular pressures observed between severe and critical cases might be associated with the systemic use of corticosteroids in a large portion of patients (48.3% used it in this sample)26. Is COVID-19 is affecting your eyes? | Mint PubMed While new information is still being discovered about the disease to this day, one year ago, less than a week after the World Health Organization declared the pandemic, I was dealing with the virus and fear of the unknown. Possibly a percentage of this complaint may be related to previous uncorrected refractive errors since presenting visual acuity and DBCVA statistically improved in all the groups, except for the LE in the mild-to-moderate group. Jakob Siedlecki and Siegfried G. Priglinger contributed equally to this work. Thanks to the experience of the health care workers (HCW) and the constant exchange in the scientific community, any knowledge about patient management, triaging and current therapy recommendations was quickly and adequately accessible and under constant validation [9, 10]. Various ACE and ACE2 polymorphisms in people of African genetic descent are associated with increased plasma levels of angiotensin II, which reduce the erythrocyte colonization by P. falcifarum [18,19,20]. The most commonly used drugs were azithromycin in 29 (45.3%); heparin in 36 (56.2%); ceftriaxone in 33 (51.5%); and prednisone in 28 (43.7%). Follow-up studies in COVID-19 recovered patients - is it mandatory? PubMed EClinicalMedicine. https://doi.org/10.5935/0004-2749.20170005 (2017). Thank you for visiting nature.com. Long COVID: Long-Term Effects of COVID-19 | Johns Hopkins Medicine A small number of COVID-19 patients has been reported to suffer from acute keratoconjunctivitis. OCT Findings in Patients after COVID-19 Disease. Lancet 395, 1610. https://doi.org/10.1016/S0140-6736(20)31014-X (2020). TMPRSS2 is found mainly in the superficial conjunctiva but also together with ACE2 in limbal superficial cells [22]. Identification of a novel coronavirus in patients with severe acute respiratory syndrome. https://www.who.int/publications/i/item/global-covid-19-clinical-platform-case-report-form-(crf)-for-post-covid-conditions-(post-covid-19-crf-) (2021). Can You Develop Eye Issues After the COVID-19 Vaccine? However, patients in studys have severe systemic pre-existing conditions such as diabetes, hypertension, and obesity, which is seems more likely to be the cause, as CWS, hemorrhages and dilated vessels can be triggered by microangiopathies and inflammation. The response to the questionnaire was considered positive for dry eye when the responses for questions 1 and 2 were Often or Constantly or the response for question 3 was Yes"18,19. It's caused by damage to the blood vessels of the light-sensitive tissue at the back of the eye (retina). Among them, 46 (71.8%) used long-term medications. https://doi.org/10.1016/j.survophthal.2020.01.002 (2020). Nioi M, Napoli PE, Lobina J, Fossarello M, dAloja 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. CAS Inflammation in the eye after COVID-19 Landecho MF, Yuste JR, Gndara E, Sunsundegui P, Quiroga J, Alcaide AB, et al. The meanSD duration of hospitalization was 15.010.7 days. First studies on COVID-19 showed that ocular manifestations can occur during an acute infection with signs of keratoconjunctivitis in 15.631.6% and positive conjunctival swabs tests in only 3.35.2% [14, 15]. Patients who had tested positive were either hospitalized or discharged into home quarantine via the emergency room. 2020;395(10237):1610. https://doi.org/10.1016/S0140-6736(20)31014-X. Coronavirus can certainly enter the body through the eyes (as well as the nose and mouth). At about the same time, the first outbreak occurred in Italy, which drew the attention of the scientific community to the political, health and therapeutic management of this crisis [9]. Dis. Tsang KW, Ho PL, Ooi GC, Yee WK, Wang T, Chan-Yeung M, Lam WK, Seto WH, Yam LY, Cheung TM, Wong PC, Lam B, Ip MS, Chan J, Yuen KY, Lai KN. (Fig. Slider with three articles shown per slide. A first step in understanding SARS pathogenesis. The role of apoptosis within the retina of coronavirus-infected mice. All hospitalized Patients except one (7.1%) had characteristic bilateral multifocal ground-glass opacities findings in their lungs (refer to Table1 for their blood results). By using this website, you agree to our Initially not the focus of attention, the eyes have become one of the more interesting organs affected by COVID-19 for three reasons. When I finally went to see Dr. Amber Dunn, my optometrist, she explained that the symptoms and issues I was experiencing were caused by COVID-19. In these first publications about PCS, we did not find any information about ocular manifestations persisting after COVID-19, and it is not possible to know if they were not there or if they were not reported, investigated or documented. Prog. https://doi.org/10.2174/1874364101509010028. For the superior, inferior, nasal and temporal quadrants 48.12.1 vs. 46.13.4, 48.22.5 vs. 48.14.9, 46.61.6 vs 44.33.0 and 46.51.7 vs 44.41.3 (Fig. https://doi.org/10.1016/S0165-5728(01)00374-5. 2020;9(4):E1138. J. Ophthalmol. Regarding data related to dry eye disease and symptoms, Alves et al.18 showed a previous overall diagnosis of dry eye in 10.2% of the sample and the presence of severe symptoms in 4.9%. OCT scans showed no hyperreflective foci in the retina or vitreous. Concerns about the interpretation of OCT and fundus findings in COVID-19 patients in recent lancet publication. Gene polymorphisms in angiotensin I converting enzyme (ACE I/D) and angiotensin II converting enzyme (ACE2 C-->T) protect against cerebral malaria in Indian adults - PubMed https://pubmed.ncbi.nlm.nih.gov/20117248/ (Accessed 11 2 2021).
