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Ocular Manifestations of Hospitalized Patients with COVID-19 in Northeast of Iran.
Ocul Immunol Inflamm. 2020 Jul 03; 28(5):739-744.OI

Abstract

PURPOSE

To evaluate ocular findings in patients with Coronavirus Disease 2019 (COVID-19) in the Northeast of Iran.

METHODS

In a cross-sectional, observational study all consecutive patients with confirmed COVID-19 diagnosis at the central referral center of these patients in northeast of Iran were included. Ocular examinations (external and slit) were randomly performed for the patients who were admitted to the Intensive Care Unit (ICU) and six COVID wards of the hospital. Moreover, Chart records and serum chemistry results were collected.

RESULTS

A total of 142 patients with the mean age of 62.6 ± 15 years (range: 23-96 years) and almost equal gender distribution (male: N = 77, 54.2%) were included in the study. During the initial external examination by the ophthalmologist, 44 (31%) patients were found to have conjunctival hyperemia and 22 (15.5%) patients had chemosis. Consecutive slit examination showed 41 (28.9%) conjunctival hyperemia, 22 (15.5%) chemosis, 11 (7.7%) cataract, and 9 (6.3%) diabetic retinopathy. The patients with at least one ocular manifestation had significantly higher blood urea levels at the time of admission compared to those with no obvious ocular involvement (median: 41.5, IQR: 28-66.3 vs. median: 33, IQR: 23.8-51.8, P = .023). Moreover, a significant difference was observed in the total white blood cell count, lymphocyte percent, neutrophil count, Erythrocyte Sedimentation Rate (ESR), and blood urea level between patients with positive and negative Polymerase Chain Reaction (PCR) for SARS-CoV-2 virus. None of the patients reported ocular symptoms prior to systemic involvement. The proportion of patients with at least one ocular manifestation was significantly higher in those admitted in the ICU compared to the non-ICU wards. wards. While conjunctival hyperemia was the most prevalent ocular finding in all patients, chemosis was the most common ocular manifestation in ICU admitted patients.

CONCLUSION

Ocular manifestation was observed in more than half of our COVID-19 patients. Hence, it seems important to involve ophthalmologist in the diagnosis and management of these patients.

Authors+Show Affiliations

Eye Research Center, Mashhad University of Medical Sciences , Mashhad, Iran.Department of Medical Informatics, Mashhad University of Medical Sciences , Mashhad, Iran.Eye Research Center, Mashhad University of Medical Sciences , Mashhad, Iran.Eye Research Center, Mashhad University of Medical Sciences , Mashhad, Iran.Lung Diseases Research Center, Mashhad University of Medical Sciences , Mashhad, Iran. Division of Sleep Medicine, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences , Mashhad, Iran.Lung Diseases Research Center, Mashhad University of Medical Sciences , Mashhad, Iran.Division of Sleep Medicine, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences , Mashhad, Iran.Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences , Mashhad, Iran.Department of Hematology Oncology, Faculty of Medicine, Mashhad University of Medical Sciences , Mashhad, Iran.Department of Hematology Oncology, Faculty of Medicine, Mashhad University of Medical Sciences , Mashhad, Iran.Department of Cardiology, Faculty of Medicine, Mashhad University of Medical Sciences , Mashhad, Iran.Department of Infectious Diseases and Tropical Medicine, Faculty of Medicine, Mashhad University of Medical Sciences , Mashhad, Iran.Department of Infectious Diseases and Tropical Medicine, Faculty of Medicine, Mashhad University of Medical Sciences , Mashhad, Iran.Department of Infectious Diseases and Tropical Medicine, Faculty of Medicine, Mashhad University of Medical Sciences , Mashhad, Iran.Department of Medical Informatics, Mashhad University of Medical Sciences , Mashhad, Iran. Pharmaceutical Research Center, School of Pharmacy, Mashhad University of Medical Sciences , Mashhad, Iran. Department of Medical Informatics, Amsterdam UMC, University of Amsterdam , Amsterdam, The Netherlands.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32569494

Citation

Abrishami, Mojtaba, et al. "Ocular Manifestations of Hospitalized Patients With COVID-19 in Northeast of Iran." Ocular Immunology and Inflammation, vol. 28, no. 5, 2020, pp. 739-744.
Abrishami M, Tohidinezhad F, Daneshvar R, et al. Ocular Manifestations of Hospitalized Patients with COVID-19 in Northeast of Iran. Ocul Immunol Inflamm. 2020;28(5):739-744.
Abrishami, M., Tohidinezhad, F., Daneshvar, R., Omidtabrizi, A., Amini, M., Sedaghat, A., Amini, S., Reihani, H., Allahyari, A., Seddigh-Shamsi, M., Tayyebi, M., Naderi, H., Bojdy, A., Khodashahi, R., & Eslami, S. (2020). Ocular Manifestations of Hospitalized Patients with COVID-19 in Northeast of Iran. Ocular Immunology and Inflammation, 28(5), 739-744. https://doi.org/10.1080/09273948.2020.1773868
Abrishami M, et al. Ocular Manifestations of Hospitalized Patients With COVID-19 in Northeast of Iran. Ocul Immunol Inflamm. 2020 Jul 3;28(5):739-744. PubMed PMID: 32569494.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ocular Manifestations of Hospitalized Patients with COVID-19 in Northeast of Iran. AU - Abrishami,Mojtaba, AU - Tohidinezhad,Fariba, AU - Daneshvar,Ramin, AU - Omidtabrizi,Arash, AU - Amini,Mahnaz, AU - Sedaghat,Alireza, AU - Amini,Shahram, AU - Reihani,Hamidreza, AU - Allahyari,Abolghasem, AU - Seddigh-Shamsi,Mohsen, AU - Tayyebi,Mohammad, AU - Naderi,Hamidreza, AU - Bojdy,Amin, AU - Khodashahi,Rozita, AU - Eslami,Saeid, Y1 - 2020/06/22/ PY - 2020/6/23/pubmed PY - 2020/8/7/medline PY - 2020/6/23/entrez KW - COVID-19 KW - Coronavirus disease 2019 KW - SARS-CoV-2 KW - chemosis KW - conjunctival hyperemia SP - 739 EP - 744 JF - Ocular immunology and inflammation JO - Ocul Immunol Inflamm VL - 28 IS - 5 N2 - PURPOSE: To evaluate ocular findings in patients with Coronavirus Disease 2019 (COVID-19) in the Northeast of Iran. METHODS: In a cross-sectional, observational study all consecutive patients with confirmed COVID-19 diagnosis at the central referral center of these patients in northeast of Iran were included. Ocular examinations (external and slit) were randomly performed for the patients who were admitted to the Intensive Care Unit (ICU) and six COVID wards of the hospital. Moreover, Chart records and serum chemistry results were collected. RESULTS: A total of 142 patients with the mean age of 62.6 ± 15 years (range: 23-96 years) and almost equal gender distribution (male: N = 77, 54.2%) were included in the study. During the initial external examination by the ophthalmologist, 44 (31%) patients were found to have conjunctival hyperemia and 22 (15.5%) patients had chemosis. Consecutive slit examination showed 41 (28.9%) conjunctival hyperemia, 22 (15.5%) chemosis, 11 (7.7%) cataract, and 9 (6.3%) diabetic retinopathy. The patients with at least one ocular manifestation had significantly higher blood urea levels at the time of admission compared to those with no obvious ocular involvement (median: 41.5, IQR: 28-66.3 vs. median: 33, IQR: 23.8-51.8, P = .023). Moreover, a significant difference was observed in the total white blood cell count, lymphocyte percent, neutrophil count, Erythrocyte Sedimentation Rate (ESR), and blood urea level between patients with positive and negative Polymerase Chain Reaction (PCR) for SARS-CoV-2 virus. None of the patients reported ocular symptoms prior to systemic involvement. The proportion of patients with at least one ocular manifestation was significantly higher in those admitted in the ICU compared to the non-ICU wards. wards. While conjunctival hyperemia was the most prevalent ocular finding in all patients, chemosis was the most common ocular manifestation in ICU admitted patients. CONCLUSION: Ocular manifestation was observed in more than half of our COVID-19 patients. Hence, it seems important to involve ophthalmologist in the diagnosis and management of these patients. SN - 1744-5078 UR - https://www.unboundmedicine.com/medline/citation/32569494/Ocular_Manifestations_of_Hospitalized_Patients_with_COVID_19_in_Northeast_of_Iran_ L2 - https://www.tandfonline.com/doi/full/10.1080/09273948.2020.1773868 DB - PRIME DP - Unbound Medicine ER -