ABSTRACT
The COVID-19 pandemic has led to a significant increase in the immunosuppressed population worldwide due to the disease pathology and extensive use of corticosteroids. This has subsequently increased the risk of opportunistic parasitic infections such as Toxoplasma gondii, Strongyloides stercoralis and other parasites in these patients. The reactivation of such parasites may remain unnoticed due to overlapping symptoms, the difficulty of diagnosis and lack of guidelines for opportunistic parasitic infections in COVID-19 management. Therefore, recommendations for systematic screening of high-risk patients in endemic regions and active research and surveillance to estimate the impact of these infections are required in COVID-19 policy guidelines.
Subject(s)
COVID-19 , Parasites , Parasitic Diseases , Animals , Humans , Pandemics , Parasitic Diseases/epidemiology , Policy , SARS-CoV-2ABSTRACT
Objective: To detect retinal involvement in coronavirus disease 2019 (COVID-19) patients in acute and convalescent phase by their fundus screening. Methods: In a prospective, cross-sectional, observational study (July-November 2020), 235 patients (142 acute and 93 convalescent phase) underwent fundus screening in a tertiary care center in North India. For convalescent phase, "hospitalized" patients (73) were screened at least 2 weeks after hospital discharge, and "home-isolated" patients (20) were screened 17 days after symptom onset/COVID-19 testing. Results: None in acute phase showed any retinal lesion that could be attributed exclusively to COVID-19. Five patients (5.38%) in convalescent phase had cotton wool spots (CWSs) with/without retinal hemorrhage, with no other retinal finding, and no visual symptoms, seen at a median of 30 days from COVID-19 diagnosis. Conclusions: CWSs (and retinal hemorrhages) were an incidental finding in COVID-19, detected only in the convalescent phase. These patients were much older (median age = 69 years) than the average age of our sample and had systemic comorbidities (diabetes mellitus, hypertension, etc.). We propose the term "COVID-19 retinopathy" to denote the presence of CWSs at the posterior pole, occasionally associated with intraretinal hemorrhages, in the absence of ocular inflammation in patients with a history of COVID-19 disease.