COVID-19 and the eye: Systemic and laboratory risk factors for retinopathy and detection of tear film SARS-CoV-2 RNA with a triplex RT-PCR assay

• Published in: PloS one 2022-11, Vol.17 (11), p.e0277301
• Main Authors: Shantha, Jessica G, Fashina, Tolulope, Stittleburg, Victoria, Randleman, Casey, Ward, Laura, Regueiro, Matt, Krakow, David, Linderman, Susanne L, Drews-Botsch, Carolyn, Ahmed, Rafi, Waggoner, Jesse, Yeh, Steven
• Format: Article
• Language: English
• Subjects: Age; Asymptomatic; Biology and life sciences; Care and treatment; Coronaviruses; Cotton; COVID-19; COVID-19 - diagnosis; Data collection; Diabetes; Diabetic retinopathy; Diagnosis; Disease transmission; Ethnicity; Female; Hemorrhage; Hospital patients; Hospitalization; Hospitals; Humans; Hypertension; Illnesses; Informed consent; Intensive care; Laboratories; Male; Medicine and Health Sciences; Middle Aged; Patients; Personal protective equipment; Photography; Polymerase chain reaction; Research and Analysis Methods; Retinal Diseases; Retinopathy; Reverse Transcriptase Polymerase Chain Reaction; Ribonucleic acid; Risk analysis; Risk Factors; RNA; RNA, Viral - analysis; RNA, Viral - genetics; SARS-CoV-2 - genetics; Severe acute respiratory syndrome coronavirus 2; Systemic diseases; Testing; Veins & arteries; Viruses; Wool
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0277301

To assess hospitalized COVID-19 inpatients for the prevalence of retinopathy and tear film SARS-CoV-2 RNA, and associated risk factors for their detection. Hospitalized COVID-19 patients underwent dilated ophthalmic examination and fundus photography. Conjunctival swabs were assessed for SARS-CoV-2 RT-PCR via a triple target assay. We assessed the relationships of retinopathy with clinical outcomes, systemic risk factors and laboratory data. The median age was 59.5 years and 29 (48%) were female. Retinopathy associated with COVID-19 was observed in 12 of 60 patients (20%). The median age of patients with COVID-19 retinopathy was 51.5 compared to 62.5 years in individuals without retinopathy (p = 0.01). Median BMI was 34.3 in patients with retinopathy versus 30.9 in those without retinopathy (p = 0.04). Fifteen of 60 patients (25%) tested SARS-CoV-2 RNA-positive in their tear film without a relationship with timing of illness and hospitalization. The N2 gene was particularly sensitive with 18 of 19 eyes (94.7%) showing N2-positivity, including 2 patients with alpha variant-positivity (B.1.1.7). Retinopathy was observed in 20% of patients hospitalized for COVID-19. Patients with retinopathy were more likely to be younger and have higher BMI than hospitalized patients without retinopathy. Tear film SARS-CoV-2 RNA was detected in 25% of patients. The relationship of obesity and age with retinopathy requires further investigation.