COVID-19 Developed During Systemic Steroid Therapy for Vogt-Koyanagi-Harada Disease: A Case Report

• Published in: Ocular immunology and inflammation 2023-08, Vol.ahead-of-print (ahead-of-print), p.1-5
• Main Authors: Niidome, Shoichiro, Usui, Yoshihiko, Tsubota, Kinya, Sugawara, Risa, Goto, Hiroshi
• Format: Article
• Language: English
• Subjects: Adult; Coronavirus disease (COVID-19); COVID-19; Female; Humans; SARS-CoV-2; Steroids - therapeutic use; systemic steroid therapy; Uveitis - diagnosis; Uveitis - drug therapy; Uveomeningoencephalitic Syndrome - complications; Uveomeningoencephalitic Syndrome - diagnosis; Uveomeningoencephalitic Syndrome - drug therapy; Vogt-Koyanagi-Harada disease
• ISSN: 0927-3948; 1744-5078
• DOI: 10.1080/09273948.2023.2200488

The use of immunomodulatory therapy in the setting of coexistence of uveitis and coronavirus disease (COVID-19) remains controversial. We report a case of COVID-19 during systemic steroid therapy for Vogt-Koyanagi-Harada disease (VKH). A 43-year-old female was diagnosed with VKH and started on steroid pulse therapy (1,000 mg/day) followed by high-dose oral corticosteroids. Two weeks after discharge from the hospital, she was readmitted to the intensive care unit with severe acute respiratory syndrome due to SARS-CoV-2 infection confirmed by PCR test, and fortunately both VKH and COVID-19-induced respiratory disease improved. Given the absence of international agreement on how to manage COVID-19 patients with steroid-dependent VKH, existing clinical guidelines should be reviewed thoroughly to formulate useful strategies for managing VKH patients on steroid treatment who contract COVID-19. Furthermore, the outcomes of patients with steroid-dependent autoimmune uveitis including VKH who develop COVID-19 should be analyzed.