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. Continuous variables were analyzed using the one-way ANOVA test, the Wilcoxon rank-sum (MannWhitney test), the KruskalWallis test, and the Wilcoxon matched-pairs signed rank test. 2020. This study has several limitations. When a few weeks passed and I was still struggling, I didnt know what to do. C. S. G. Symptoms in patients after acute COVID-19. https://doi.org/10.2196/19462 (2020). Bras. Laboratory Results of Hospitalized Patients, Abbreviations: WBC Maximum white blood cell count, CRP C-reactive protein, IL-6 Interleukin-6, LDH Lactate dehydrogenase, CK Creatine kinase, a Data from 1 patient missing, b Data from 2 patients missing, c Data from 3 patients missing, CHD Coronary heart disease, COPD Chronic obstructive pulmonary disease. PubMed Ocular Fundus multimodal imaging of a 48-year-old man (critical case) 128 days after first symptoms of COVID-19. Ocul Immunol Inflamm. https://doi.org/10.1002/path.1570. https://doi.org/10.1111/joim.13156. Jakob Siedlecki and Siegfried G. Priglinger contributed equally to this work. Red eyes, ringing ears, sensitivity to light, trouble hearing: although a loss of taste and smell have become well-known sensory symptoms of COVID, accumulating research suggests that vision. All patients showed normal findings for anterior and posterior segment of both eyes. Napoli PE, Nioi M. Global spread of coronavirus disease 2019 and malaria: an epidemiological paradox in the early stage of a pandemic. Marinho, P. M., Marcos, A. CAS Nat. Wolffsohn, J. S. et al. Post-acute COVID-19 syndrome. Patients who had been tested positive for SARS-CoV-2 or for anti-SARS-CoV-2 IgG serum antibodies in the Hospital of the Ludwig Maximilians University, Munich between May and September. Google Scholar. The present study identified higher IOP among critical cases, when compared to severe cases, and discrete outer retina changes 80 days after COVID-19 infection. First, transmission via the eyes has been described via the lacrimal duct into the nose and upper airways [13]. Dr. Dunn provides comprehensive and medical eye exams for the whole family, with a specialty in dry eye disease. Coronavirus can certainly enter the body through the eyes (as well as the nose and mouth). government site. Schellini, S. A. et al. This study has several limitations. 2016;5:103. https://doi.org/10.3389/fcimb.2015.00103. 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]. Among all, 57 (89.0%) required hospitalization and oxygen support, 29 (45.3%) required intensive care, and 23 (35.9%) needed invasive mechanical ventilation. Since COVID-19 shows more severe courses in older patients, findings of decreased vessel density might not be due to past inflammatory processes, but rather represent normal age related alterations [41]. Global COVID-19 Clinical Platform Case Report Form (CRF) for Post COVID condition (Post COVID-19 CRF). Holappa M, Valjakka J, Vaajanen A. Angiotensin (1-7) and ACE2, the hot spots of renin-angiotensin system, detected in the human aqueous humor. https://doi.org/10.2174/1874364101509010028. Three months after recovery, they were invited to participate voluntarily for this study during their follow-up in our clinic. 2020;729:139021. https://doi.org/10.1016/j.scitotenv.2020.139021. Translation and validation of the Portuguese version of a dry eye disease symptom questionnaire. The mean age (SD) of the patients was 48.7 (18.3) years. 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. Call 314.983.4167 for assistance. 2020;68(10):22913. We would like to thank all patients and the study team of our Clinic of Ophthalmology. Non of the patients had initially ocular symptoms. If you find something abusive or that does not comply with our terms or guidelines please flag it as inappropriate. Isolation of a Novel Coronavirus from a Man with Pneumonia in Saudi Arabia | NEJM. https://doi.org/10.1080/09273948.2020.1792512 (2020). Sixty-four patients (128 eyes) were evaluated 8236.4 days after the onset of COVIDs symptoms. PubMedGoogle Scholar. To determine possible long-term effects on the eye, especially on the retina, in patients who had suffered from COVID-19 at least 3months after recovery. Department of Ophthalmology, Ludwig-Maximilians-University, Mathildenstrae 8, 80336, Munich, Germany, Victor Brantl,Benedikt Schworm,Gregor Weber,Johannes Schiefelbein,Thomas C. Kreutzer,Stylianos Michalakis,Jakob Siedlecki&Siegfried G. Priglinger, You can also search for this author in For the purpose of this prospective cross-sectional case study, 21 patients who had recovered from a COVID-19 infection were recruited. Secondly, in the acute phase of COVID-19, some patients show ocular symptoms including keratoconjunctivitis, epiphora and chemosis [14, 15]. Drosten C, Gnther S, Preiser W, van der Werf S, Brodt H-R, Becker S, Rabenau H, Panning M, Kolesnikova L, Fouchier RAM, Berger A, Burguire A-M, Cinatl J, Eickmann M, Escriou N, Grywna K, Kramme S, Manuguerra J-C, Mller S, Rickerts V, Strmer M, Vieth S, Klenk H-D, Osterhaus ADME, Schmitz H, Doerr HW. https://doi.org/10.1186/s12886-021-02179-9, DOI: https://doi.org/10.1186/s12886-021-02179-9. Epidemiology and cause of severe acute respiratory syndrome (SARS) in Guangdong, Peoples republic of China, in February, 2003. https://doi.org/10.1167/iovs.18-25864. Two eyes in the hospitalised group were excluded because of epiretinal Membranes. Article Virol. https://doi.org/10.1136/bjophthalmol-2020-317576 (2020). Greenhalgh et al.15. Visual acuity, slit lamp, bio microscopy and fundoscopy, multimodal imaging findings. CAS Tara Robertson took up gaming after completing her active military service and her new hobby came with a sharp increase in screen time. All patients showed normal findings for anterior and posterior segment of both eyes. Of these, 14 (66.6%) were hospitalized and 7 (33.3) were discharged home. 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. No sign of uveitis was found. South Afr Med J Suid-Afr Tydskr Vir Geneeskd. The intraocular pressure (IOP) was statistically different when comparing severe and critical groups, both in RE (p=0.022) and LE (p=0.038). Siegfried G. Priglinger, Email: ed.nehcneum-inu.dem@regnilgirP.deirfgeiS. Initially not the focus of attention, the eyes have become one of the more interesting organs affected by COVID-19 for three reasons. Ophthalmol. https://doi.org/10.1016/j.joco.2017.08.009 (2018). 80, 1416. Slider with three articles shown per slide. Lancet Lond Engl. Login to gain access to member-only content. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. https://doi.org/10.1038/220650b0. Due to the randomized recruitment of patients, unfortunately no patients with acute phase ocular lesions were included in this study. Napoli PE, Nioi M, dAloja E, Fossarello M. The ocular surface and the coronavirus disease 2019: does a dual ocular route exist? Gangaputra, S. S. & Patel, S. N. Ocular symptoms among nonhospitalized patients who underwent COVID-19 testing. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Bining Z, Qun W, Ting L, Shengqian D, Xia Q, Hui J, Benxiang Q, Bin Z, Qingjun Z. Dr. Dunn recommended a treatment called Syntonics, a light therapy used to balance the nervous system. Nevertheless, we believe that these results are of interest for the scientific community as late retinal damage might be rarely. https://doi.org/10.1038/s41598-021-90482-2, DOI: https://doi.org/10.1038/s41598-021-90482-2. PubMed Zhong NS, Zheng BJ, Li YM, Null P, Xie ZH, Chan KH, Li PH, Tan SY, Chang Q, Xie JP, Liu XQ, Xu J, Li DX, Yuen KY, Null P, Guan Y. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. The site is secure. Invest. 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. Most of the patients attending this ambulatory have been previously hospitalized in Hospital das Clnicas de Ribeiro Preto complex with severe or critical clinical picture. Google Scholar. 2020;27:100550. https://doi.org/10.1016/j.eclinm.2020.100550. Zhong NS, Zheng BJ, Li YM, Null P, Xie ZH, Chan KH, et al. Lancet Lond Engl. Ocular findings among patients surviving COVID-19. N Engl J Med. In March 2020, I was one of the first people diagnosed with COVID-19 in the state of Oregon. J. Siedlecki: Speaker honoraria and travel reimbursement from Carl Zeiss Meditec AG, Novartis Pharma GmbH, Bayer AG, Pharm-Allergan GmbH, Oculentis OSD Medical GmbH. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. 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]. 2020. Struggling with symptoms including light sensitivity, pain and poor depth perception, Mark didnt know what was wrong with his eyes. SARS-CoV-2 entry factors are highly expressed in nasal epithelial cells together with innate immune genes. 61, 29. https://doi.org/10.1167/iovs.61.10.29 (2020). https://doi.org/10.1111/aos.14412. Non of the patients had initially ocular symptoms. Cell. Patients were recruited during follow-up by the infectious disease ambulatory care after the acute phase of the disease. retinal vessels [34]. R.A.F. Google Scholar. Hamming I, Timens W, Bulthuis M, Lely A, Navis G, van Goor H. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. 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]. However, only 31.2% reported that it appeared or worsened simultaneously with the acute phase of COVID-19. The present study aimed to look for visual and ocular manifestations during the recovery phase as possible sequels of the disease. TMPRSS2 is found mainly in the superficial conjunctiva but also together with ACE2 in limbal superficial cells [22]. California Privacy Statement, Not hospitalized patients were examined a mean of 123.444.7days after their first positive COVID-19 test or positive test for IgG against SARS-CoV-2. 2000;41(10):30118. Concerning posterior segment commitment, flame-shaped or microhemorrhages and cotton wool spots in the papillomacular bundle were shown7,8,9. S. Priglinger: Speaker honoraria and travel reimbursement from Carl Zeiss Meditec AG, Novartis Pharma GmbH, Bayer AG, Pharm-Allergan GmbH, Oculentis OSD Medical GmbH, rtli GmbH, B&L, Vitreq. https://doi.org/10.1016/j.jtos.2017.05.001 (2017). Article Until now, it already killed more than 2.7 million people worldwide, including Dr. Li Wenliang, an ophthalmologist in Wuhan, Hubei, China, one of the first doctors to notice and warn for its severity and rapid spread2. https://doi.org/10.1016/j.ophtha.2020.06.037 (2020). PubMed Sci. 16, 103112. https://doi.org/10.1111/opo.12164 (2015). 3. Greenhalgh, T., Knight, M., ACourt, C., Buxton, M. & Husain, L. Management of post-acute covid-19 in primary care. 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]. In younger patients, mild and even asymptomatic courses are frequent. They show milder courses in malaria disease and appear to be protected against SARS-CoV-2. Lvia Pimenta Bonifcio has received a scholarship from the Conselho Nacional de Desenvolvimento Cientfico e Tecnolgico (CNPq) for working with COVID-19 research projects. Silva LS, Silva-Filho JL, Caruso-Neves C, Pinheiro AAS. We looked for correlation between right and left eyes refractive errors using Pearson coefficient. Two hospitalized patients (9.5%) received invasive ventilation. In our study we did not see more dilated vessels, microaneurysms, areas of non-perfusion or other microvascular anomalies. Some people develop headaches that last for months after COVID-19. HCA Lung Biological Network. 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. Landecho MF, Yuste JR, Gndara E, Sunsundegui P, Quiroga J, Alcaide AB, et al. Median [interquartile ranges (IQR)] presenting visual acuity was 0.1 (00.2) and BCVA 0 (00.1). Mendelson M, Nel J, Blumberg L, Madhi SA, Dryden M, Stevens W, et al. And it can be spread by coughs and sneezes. Article 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. Int. T. Kreutzer: Speaker honoraria from Alcon Pharma GmbH. A review of coronaviruses and ocular implications in humans and animals. HCA Lung Biological Network, Sungnak W, Huang N, Bcavin C, Berg M, Queen R, et al. For the purpose of this prospective cross-sectional case study, 21 patients who had recovered from a COVID-19 infection were recruited. Of the seven patients (10.9%) who reported ocular pain at the moment of eye examination, all of them had this complaint previously to the COVID-19, and only one reported worsening pain in the acute phase. This study evaluated the ocular findings of patients who recovered from COVID-19 with a mean time of 8236.4 days after the onset of the disease's first symptoms. 2019;60(2):68593. Although in most patients COVID-19 manifests with fever and respiratory tract symptoms, SARS-CoV-2 infection may also involve other organs [37]. Ocul. Third, we did not control our data for climate factors, which may have influenced the results related to dry eye signs and symptoms. Although, the World Health Organization does list conjunctivitis as a "less common symptom" of the virus. Vis. Visual acuity, slit lamp, bio microscopy and fundoscopy, multimodal imaging findings. They have me wear paper glasses, kind of like 3-D glasses, and I complete movements while a light is concentrated on the glasses. https://doi.org/10.1001/jama.2020.12603 (2020). EClinicalMedicine. In total, 21 patients were examined. Surf. https://doi.org/10.23750/abm.v91i1.9397 (2020). Goldmann tonometry (mmHg) and refractometry with values displayed in spherical equivalent (sph eq), defined as spherical error plus half the cylindrical error, were also registered. We thank all the staff working in the Post-Covid ambulatory care of the University Hospital of Ribeiro Preto Medical School, University of So Paulo, for their unconditional support to the present study implementation. For her, eye health is a necessity to stay at the top of her game. Even beyond acute infection the impact of SARS-CoV-2 on the eyes is enormously [32, 33], but Data on the long-term effect of COVID-19 on visual function and ocular anatomy after infection are lacking at the moment. CAS People talk about brain fog, memory problems, and difficulty exercising. COVID-19 Retinal Microangiopathy as an in Vivo Biomarker of Systemic Vascular Disease? Insausti-Garca A, Reche-Sainz JA, Ruiz-Arranz C, Lpez Vzquez , Ferro-Osuna M. Papillophlebitis in a COVID-19 patient: inflammation and Hypercoagulable state. Inflamm. 2004;203(2):6317. 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Google Scholar. The sample size is limited, and the percentage of intensive care patients is low. A new study suggests that some patients with long COVID have lasting nerve damage that appears to be caused by infection-triggered immune dysfunction, which is potentially treatable. Google Scholar. Most people who get COVID-19 will have mild illness. J. Thromb. If you have COVID-19 and experience any of the following eye symptoms, contact your eye doctor promptly: blurry vision red eyes new floaters in your vision eye pain vision loss It's. Hospital of the Ludwig Maximilians University, Munich. WHO Coronavirus Disease (COVID-19) Dashboard. J. Infect. weight loss or poor appetite. She was discharged from the hospital without answers and bounced around to various specialists to no availuntil she saw a doctor of optometry. For example, in one case . Oftalmol. Hashemi, H. et al. 2023 BioMed Central Ltd unless otherwise stated. https://doi.org/10.4103/ijo.IJO_2380_20. Interestingly, none of our patients reported ocular complaints like conjunctivitis, eye redness or visual impairment during or after COVID-19 infection. Vavvas DG, Sarraf D, Sadda SR, Eliott D, Ehlers JP, Waheed NK, et al. Use the Previous and Next buttons to navigate the slides or the slide controller buttons at the end to navigate through each slide. Among them, 46 (71.8%) used long-term medications. Front Public Health. 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. The author(s) read and approved the final manuscript. 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. Further studies with a longer follow-up and a larger sample size are warranted. Also, the frequency of personal history of dry eye or severe symptoms was statistically different concerning the systemic severity of the disease and sexthe frequency was higher in mild-to-moderate cases (p=0.011, two-tailed Fishers exact test) and in women (males: 4/33 (12.1%); females 12/31 (38.7%), p=0.041, two-tailed Fishers exact test). Mongkolchon Akesin/iStock via Getty Images By now, we all know that COVID-19 affects important organs like the lungs and the heart. Casari, I., Manfredi, M., Metharom, P. & Falasca, M. Dissecting lipid metabolism alterations in SARS-CoV-2. Considering that there were 19 patients with diabetes mellitus, the frequency of non-proliferative diabetic retinopathy in this sample was (10/19) 52.7%. Prior to 2019, coronaviruses, first discovered in 1968 [1], caused two epidemic outbreaks: In Hong Kong in 2003, in the form of the Severe Acute Respiratory Syndrome (SARS) [2,3,4] and in Saudi Arabia in 2012, in form of the Middle East Respiratory Syndrome (MERS) [5, 6]. S. Michalakis Co-founder and shareholder of ViGeneron GmbH. Find out about possible causes of post-COVID-19 conditions and ways to manage symptoms. 10.1177/1120672120947591. https://doi.org/10.1016/S0165-5728(01)00374-5. F.B.R., E.M.R., V.R.B., R.J.: conception and design, analysis and interpretation of data; critical revision for intellectual content. : acquisition of data; analysis and interpretation of data; drafting the manuscript. Senanayake P d S, Drazba J, Shadrach K, Milsted A, Rungger-Brandle E, Nishiyama K, et al. J Neuroimmunol. The virus poses a deadly threat to the elderly, as well as those who have pre-existing conditions. By submitting a comment you agree to abide by our Terms and Community Guidelines. Med. https://doi.org/10.4103/jfmpc.jfmpc_1572_20 (2020). Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Google Scholar. de Groot RJ, Baker SC, Baric RS, Brown CS, Drosten C, Enjuanes L, et al. 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. 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]. Springer Nature. ADS No microaneurysms, areas of non-perfusion or other microvascular anomalies were found in any of the eyes. 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. Statistical significance was calculated with two-sample t-test assuming different variances, Comparison of the parafoveal vessel density a TOPCON Display Grid parafoveal showing 5 parts b+c Box plots showing the comparison of each part of 14 not hospitalised (middle, cross-striped) and 26 hospitalised (right, lengthwise-striped) eyes compared to 50 control eyes (left, clear). Emanuel EJ, Persad G, Upshur R, Thome B, Parker M, Glickman A, et al. A complete ophthalmological exam including functional and imaging end points (including optical coherence tomography (OCT), OCT angiography) was performed. All authors revied the manuscript. In the acute phase of COVID-19 10 of 18 (55%) patients presented flame-shaped hemorrhages and ischemic pattern lesion like CWS and retinal pallor [40]. JAMA 324, 603605. Of these, 14 (66.6%) were hospitalized and 7 (33.3) were discharged home. Senanayake P d S, Drazba J, Shadrach K, Milsted A, Rungger-Brandle E, Nishiyama K, Miura S-I, Karnik S, Sears JE, Hollyfield JG. Either via the tear film and the draining tear ducts into the upper respiratory tract and the gastrointestinal tract, or theoretically via the conjunctiva into limbal superficial cells into the inner eye, where distribution via the blood or nervous system seems possible [26]. We included 64 patients (128 eyes). All authors revied the manuscript. 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. 10.1038/s41433-020-1084-9. 2020:15. Landecho, M. F. et al. 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