June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Systemic and Laboratory Risk Factors for Retinopathy and Detection of Tear Film SARS-CoV-2 RNA
Author Affiliations & Notes
  • Jessica Shantha
    Ophthalmology, University of California San Francisco, San Francisco, California, United States
  • Tolulope Fashina
    University of Nebraska Omaha, Omaha, Nebraska, United States
  • Victoria Simmons
    Emory University, Atlanta, Georgia, United States
  • Casey Randleman
    Emory University, Atlanta, Georgia, United States
  • Laura Ward
    Emory University, Atlanta, Georgia, United States
  • Matthew Regueiro
    Emory University, Atlanta, Georgia, United States
  • Susanne Linderman
    Emory University, Atlanta, Georgia, United States
  • Carolyn Drews-Botsch
    The George Washington University Milken Institute of Public Health, Washington, District of Columbia, United States
  • Rafi Ahmed
    Emory University, Atlanta, Georgia, United States
  • Jesse Waggoner
    Emory University, Atlanta, Georgia, United States
  • Steven Yeh
    University of Nebraska Omaha, Omaha, Nebraska, United States
  • Footnotes
    Commercial Relationships   Jessica Shantha None; Tolulope Fashina None; Victoria Simmons None; Casey Randleman None; Laura Ward None; Matthew Regueiro None; Susanne Linderman None; Carolyn Drews-Botsch None; Rafi Ahmed None; Jesse Waggoner None; Steven Yeh Clearside Biomedical, Code C (Consultant/Contractor), Bausch and Lomb, Code C (Consultant/Contractor)
  • Footnotes
    Support  K23 EY030158, R01 EY029594, P30-EY06360, Emory University Robert W. Woodruff Health Sciences Center Fund Inc. COVID-19 Synergy Award, Macula Society Retina Research Foundation, Association for Research in Vision and Ophthalmology Mallinckrodt Young Investigator Grant, and the Stanley M. Truhlsen Family Foundation
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 2676. doi:
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    • Get Citation

      Jessica Shantha, Tolulope Fashina, Victoria Simmons, Casey Randleman, Laura Ward, Matthew Regueiro, Susanne Linderman, Carolyn Drews-Botsch, Rafi Ahmed, Jesse Waggoner, Steven Yeh; Systemic and Laboratory Risk Factors for Retinopathy and Detection of Tear Film SARS-CoV-2 RNA. Invest. Ophthalmol. Vis. Sci. 2022;63(7):2676.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Coronavirus-19 (COVID-19) has been associated with ophthalmic manifestations. The relationship between tear film SARS-CoV-2 RNA, timing of illness and eye disease are unknown. We evaluated hospitalized COVID-19 inpatients for retinopathy and tear film viral RNA.

Methods : Hospitalized COVID-19 inpatients were offered enrollment from January-June 2021. Full dilated ophthalmic examination and conjunctival swabs were taken for triplex RT-PCR for SARS-CoV-2 RNA targeting N2, E and RNAse P. Demographic, clinical outcomes and laboratory data were collected. Univariate and multivariate analyses of systemic disease and laboratory risk factors for retinopathy and SARS-CoV-2 RNA detection were assessed.

Results : Sixty patients were prospectively enrolled in this cross-sectional, observational study. The mean age was 58.8 years (Standard deviation [SD] 15.2 years) and 29 (48%) were female. Retinopathy associated with COVID-19 in 12 of 60 patients (20%). Univariate analyses revealed that younger age, greater body mass index (BMI) and extracorporeal membrane (ECMO) requirement were associated with increased odds of COVID-19 retinopathy. The mean age (SD) of patients with COVID-19 retinopathy was 49.0. (11.6) compared to 61.2 (15.1) years in individuals without retinopathy (p=0.01). The mean BMI was 38.8 (9.8) in patients with retinopathy compared to 31.8 (9.0) in those without retinal disease findings (p=0.04). ECMO requirement was observed in 33% of patients with retinopathy compared to 8% in those without retinopathy (p=0.04). Multivariate analyses trended towards increased risk of retinopathy with younger age (aOR 0.95 (95% CI 0.90-1.01, p=0.095) and with increased BMI (aOR. 1.08, 95% CI 1.00-1.18, p=0.056). Fifteen of 60 patients (25%) tested positive in their tear film for SARS-CoV-2 RNA with a trend towards a shorter length of illness and hospitalization in patients who were positive. The N2 gene was particularly sensitive with 18 of 19 eyes (94.7%) showing N2-positivity (with or without E gene detection), including 2 patients in whom the B.117 / B.1.525 alpha or “United Kingdom” variant was detected.

Conclusions : A 20% rate of retinopathy was observed and SARS-CoV-2 RNA within tear film was detected in 25% of hospitalized COVID-19 patients. Continued infection control precautions are required given the risk of viral RNA in tear film, which may also be sensitive for the detection of COVID-19 variants.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

 

 

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