Five-year trends in pediatric vision screening and access in the United States.

Analyses of the National Survey of Children's Health (2016-2020) demonstrated a 9.4% decrease in the proportion of children receiving eye screening from a specialist with an 85.7% increase in unmet vision care after the SARS-CoV-2 pandemic.

Corneal Adverse Events Associated with SARS-CoV-2/COVID-19 Vaccination: A Systematic Review.

Vaccines against coronavirus disease 2019 (COVID-19) have played an important global role in reducing morbidity and mortality from COVID-19 infection. While the benefits of vaccination greatly outweigh the risks, adverse events do occur. Non-ocular adverse effects of the vaccines have been well-documented, but descriptions of ophthalmic effects remain limited. This systematic review aims to provide an overview of reported cases of corneal adverse events after receiving vaccination against COVID-19 and to compile existing clinical data to bring attention to these phenomena. Our review discusses corneal graft rejection, including proposed mechanisms, herpetic keratitis, and other reported corneal complications. Ophthalmologists and primary care physicians should be aware of such possible associations.

The impact of aerosol box on tracheal intubation during the COVID-19 pandemic: a systematic review.

INTRODUCTION: This study aimed to summarize the effect of the aerosol box on tracheal intubation in patients with COVID-19. AREAS COVERED: According to the PRISMA guidelines, a systematic search was performed to identify relevant literature on the 'impact of the aerosol box on tracheal intubation during the COVID-19 pandemic' in different electronic databases up to March 2021. Based on a set of predefined inclusion and exclusion criteria, 447 articles were screened. Finally, 20 articles were included in the current systematic review. The findings showed that the use of aerosol box during intubation could reduce droplet contamination on the healthcare workers but not necessarily aerosols. An increase in the time of intubation with the aerosol box was also observed in 9 out of 12 studies (75%); however, three studies reported no significant difference in the time of intubation with and without the aerosol box. Most studies (8 out of 9, 89%) were also shown that intubation with the aerosol box may lead to more difficulty. EXPERT OPINION: The proceduralist and other healthcare workers involved in airway management of COVID-19 infected patients should decide whether to apply the aerosol box with caution, balancing between benefits and risks, especially in difficult airway circumstances.

COVID-19 Vaccine-Associated Optic Neuropathy: A Systematic Review of 45 Patients.

We provide a systematic review of published cases of optic neuropathy following COVID-19 vaccination. We used Ovid MEDLINE, PubMed, and Google Scholar. Search terms included: "COVID-19 vaccination", "optic neuropathy", "optic neuritis", and "ischemic optic neuropathy". The titles and abstracts were screened, then the full texts were reviewed. Sixty eyes from forty-five patients (28 females) were included. Eighteen eyes from fourteen patients (31.1%) were diagnosed with anterior ischemic optic neuropathy (AION), while 34 eyes from 26 patients (57.8%) were diagnosed with optic neuritis (ON). Other conditions included autoimmune optic neuropathy and Leber hereditary optic neuropathy. Fifteen patients (33.3%) had bilateral involvement. The mean age of all patients was 47.4 ± 17.1 years. The mean age of AION patients was 62.9 ± 12.2 years and of ON patients was 39.7 ± 12.8 years (p < 0.001). The mean time from vaccination to ophthalmic symptoms was 9.6 ± 8.7 days. The mean presenting visual acuity (VA) was logMAR 0.990 ± 0.924. For 41 eyes with available follow-up, the mean presenting VA was logMAR 0.842 ± 0.885, which improved to logMAR 0.523 ± 0.860 at final follow-up (p < 0.001). COVID-19 vaccination may be associated with different forms of optic neuropathy. Patients diagnosed with ON were more likely to be younger and to experience visual improvement. More studies are needed to further characterize optic neuropathies associated with COVID-19 vaccination.

Comparison of vaccine-induced antibody neutralization against SARS-CoV-2 variants of concern following primary and booster doses of COVID-19 vaccines.

The SARS-CoV-2 pandemic has, as of July 2022, infected more than 550 million people and caused over 6 million deaths across the world. COVID-19 vaccines were quickly developed to protect against severe disease, hospitalization and death. In the present study, we performed a direct comparative analysis of four COVID-19 vaccines: BNT162b2 (Pfizer/BioNTech), mRNA-1273 (Moderna), ChAdOx1 (Oxford/AstraZeneca) and Ad26.COV2.S (Johnson & Johnson/Janssen), following primary and booster vaccination. We focused on the vaccine-induced antibody-mediated immune response against multiple SARS-CoV-2 variants: wildtype, B.1.1.7 (Alpha), B.1.351 (Beta), B.1.617.2 (Delta) and B.1.1.529 (Omicron). The analysis included the quantification of total IgG levels against SARS-CoV-2 Spike, as well as the quantification of antibody neutralization titers. Furthermore, the study assessed the high-throughput ACE2 competition assay as a surrogate for the traditional pseudovirus neutralization assay. The results demonstrated marked differences in antibody-mediated immune responses. The lowest Spike-specific IgG levels and antibody neutralization titers were induced by one dose of the Ad26.COV2.S vaccine, intermediate levels by two doses of the BNT162b2 vaccine, and the highest levels by two doses of the mRNA-1273 vaccine or heterologous vaccination of one dose of the ChAdOx1 vaccine and a subsequent mRNA vaccine. The study also demonstrated that accumulation of SARS-CoV-2 Spike protein mutations was accompanied by a marked decline in antibody neutralization capacity, especially for B.1.1.529. Administration of a booster dose was shown to significantly increase Spike-specific IgG levels and antibody neutralization titers, erasing the differences between the vaccine-induced antibody-mediated immune response between the four vaccines. The findings of this study highlight the importance of booster vaccines and the potential inclusion of future heterologous vaccination strategies for broad protection against current and emerging SARS-CoV-2 variants.

COVID-19 Vaccine: A Possible Trigger for Pyoderma Gangrenosum.

Pyoderma gangrenosum is an uncommon ulcerative auto-inflammatory dermatosis. Numerous studies suggest cutaneous side effects of the COVID-19 vaccine. Pyoderma gangrenosum has been reported as one of the rare side effects of the COVID-19 vaccine. In this report, a 36-year-old male was admitted to a hospital due to a progression of pyoderma gangrenosum on the lateral aspect of his upper arm which had developed eight months ago, following the first dose of Sinopharm BBIBP COVID-19 vaccine. The reported symptoms included headache, blurred vision, palpitation, fatigue on exertion, documented fever, chills and productive cough with yellow sputum, possibly due to the inflammatory effect of pyoderma gangrenosum. In the past, the patient's face had several abnormal skin lesions similar to the newly developed lesion. In addition, the newly developed lesion did not regress despite using medication. COVID-19 vaccinations could potentially trigger pyoderma gangrenosum, especially in patients with a past medical history of similar lesions in different body parts. Therefore, we recommend inquiring about the past medical history of pyoderma gangrenosum or abnormal skin lesions prior to vaccination.

Co-expression analysis to identify key modules and hub genes associated with COVID-19 in platelets.

Corona virus disease 2019 (COVID-19) increases the risk of cardiovascular occlusive/thrombotic events and is linked to poor outcomes. The underlying pathophysiological processes are complex, and remain poorly understood. To this end, platelets play important roles in regulating the cardiovascular system, including via contributions to coagulation and inflammation. There is ample evidence that circulating platelets are activated in COVID-19 patients, which is a primary driver of the observed thrombotic outcome. However, the comprehensive molecular basis of platelet activation in COVID-19 disease remains elusive, which warrants more investigation. Hence, we employed gene co-expression network analysis combined with pathways enrichment analysis to further investigate the aforementioned issues. Our study revealed three important gene clusters/modules that were closely related to COVID-19. These cluster of genes successfully identify COVID-19 cases, relative to healthy in a separate validation data set using machine learning, thereby validating our findings. Furthermore, enrichment analysis showed that these three modules were mostly related to platelet metabolism, protein translation, mitochondrial activity, and oxidative phosphorylation, as well as regulation of megakaryocyte differentiation, and apoptosis, suggesting a hyperactivation status of platelets in COVID-19. We identified the three hub genes from each of three key modules according to their intramodular connectivity value ranking, namely: COPE, CDC37, CAPNS1, AURKAIP1, LAMTOR2, GABARAP MT-ND1, MT-ND5, and MTRNR2L12. Collectively, our results offer a new and interesting insight into platelet involvement in COVID-19 disease at the molecular level, which might aid in defining new targets for treatment of COVID-19-induced thrombosis.

Non-arteritic Anterior Ischemic Optic Neuropathy with Macular Star following COVID-19 Vaccination.

PURPOSE: To report a case of non-arteritic anterior ischemic optic neuropathy (NAAION) with macular star after receiving the second dose of SARS-CoV-2 vaccination. METHOD: Case report. OBSERVATION: A 51-year-old male presented with acute visual disturbances one day after the second dose of BNT162b2 mRNA SARS-CoV-2 vaccination. At presentation, best corrected visual acuity (BCVA) was 20/25 right eye (OD) and counting fingers at 3 feet left eye (OS). Anterior segment examination was normal in both eyes. Dilated fundoscopy was unremarkable OD, however, it disclosed optic nerve swelling and subretinal fluid OS. Patient was treated with a gradual tapering dose of oral prednisone over 1 month. At the five-week follow-up visit, optic disc swelling and subretinal fluid resolved with minimal improvement in BCVA to 20/400 OS. CONCLUSION: It is unclear whether COVID-19 vaccination was the triggering agent to the NAAION or just a coincidence, yet ophthalmologists should be aware of such a possible association.

A Study of a New Technique of the CT Scan View and Disease Classification Protocol Based on Level Challenges in Cases of Coronavirus Disease.

The chest Computer Tomography (CT scan) is used in the diagnosis of coronavirus disease 2019 (COVID-19) and is an important complement to the Reverse Transcription Polymerase Chain Reaction (RT-PCR) test. The paper aims to improve the radiological diagnosis in the case of coronavirus disease COVID-19 pneumonia on forms of noninvasive approaches with conventional and high-resolution computer tomography (HRCT) scan images upon chest CT images of patients confirmed with mild to severe findings. The preliminary study is to compare the radiological findings of COVID-19 pneumonia in conventional chest CT images with images processed by a new tool and reviewed by expert radiologists. The researchers used a new filter called Golden Key Tool (GK-Tool) which has confirmed the improvement in the quality and diagnostic efficacy of images acquired using our modified images. Further, Convolution Neural Networks (CNNs) architecture called VGG face was used to classify chest CT images. The classification has been performed by using VGG face on various datasets which are considered as a protocol to diagnose COVID-19, Non-COVID-19 (other lung diseases), and normal cases (no findings on chest CT). Accordingly, the performance evaluation of the GK-Tool was fairly good as shown in the first set of results, where 80-95% of participants show a good to excellent assessment of the new images view in the case of COVID-19 patients. The results, in general, illustrate good recognition rates in the diagnosis and, therefore, would be significantly higher in normal cases with COVID-19. These results could reduce the radiologist's workload burden and play a major role in the decision-making process.