Vogt-Koyanagi-Harada disease following ChAdOx1 nCoV-19 and mRNA-1273 vaccination.

Almost all vaccines have been reported to be associated with ocular inflammation, which has caused some concern regarding global mass COVID-19 vaccination efforts. Vogt-Koyanagi-Harada disease (VKHD) is a granulomatous inflammation caused by an autoimmune response against antigens in melanocytes, including those in the eyes. The mechanism by which COVID-19 vaccines are associated with VKHD is still unclear. Here, we report two cases of VKHD following COVID-19 vaccination. The first is a case of probable VKHD that presented with bilateral vision loss after administration of the adenovirus-vectored vaccine ChAdOx1 nCoV-19 (AstraZeneca). The condition improved after intravenous methylprednisolone 1g daily for 3days, followed by oral methotrexate and a slow taper of oral corticosteroids. The second case is a patient with an established diagnosis of well-controlled VKHD who developed a reactivation of the disease after receiving the mRNA-based vaccine (mRNA-1273, Moderna). VKHD is a potential ocular event that could follow COVID-19 vaccination. Awareness of this association is key to early detection and treatment to prevent loss of vision.

Positive Concordance between Commercially Available SARS-CoV-2 Rapid Antigen Test and RT-PCR during the Omicron Wave in Thailand

Background: Rapid SARS-CoV-2 antigen tests are widely used throughout the world. False positive antigen tests have been reported. Objective(s): To evaluate the positive percentage concordance (PPC) between a rapid antigen test and the nucleic acid amplification testing (NAAT). Material(s) and Method(s): The present study was a retrospective laboratory-based study on rapid antigen test-positive nasopharyngeal or throat swabs sent for confirmation by real-time reverse transcriptase polymerase chain reaction (rRT-PCR) between January 1 and April 8, 2022. The primary outcome was a PPC between antigen-positive samples and PCR-positive samples. Result(s): Of the 22,808 samples received, there were 3,656 or 16.04% of the samples with documented positive rapid antigen tests sent for confirmation by rRT-PCR. Overall, PPC was 92.67%, 95% CI 91.82 to 93.51. A higher PPC was found during the BA.2-dominant Omicron variant period at 96.08% (95% CI 95.2 to 96.95). Conclusion(s): The PPC between the rapid antigen test used and rRT-PCR was very high, especially during the BA.2-dominant period. Copyright © 2022 JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND.

Incidence of SARS-CoV-2 Infection among Healthcare Personnel after Restarting an Elective Cataract Surgery during the First COVID-19 Wave

Background: During the COVID-19 pandemic, most elective surgeries were postponed, including cataract surgery. However, patients with severe and disabling visual impairment may have required urgent correction. Objective: To report the incidence of SARS-CoV-2 infection among healthcare personnel working with the patients requiring cataract surgery, under a pre-operative screening protocol. Materials and Methods: A retrospective observational study was conducted in the Suddhavej Hospital, Mahasarakham University, Mahasarakham, Thailand during the early unlocked phase in May 2020. The local pre-operative screening protocol used during the period included questionnaires and pre-operative nucleic acid testing to screen for COVID-19 infection among patients. A combination of serial single nucleic acid test and SARSCoV-2 IgG antibody testing were used to screen SARS-CoV-2 infection among healthcare personnel. Mask wearing and physical distancing were required during hospitalization. Results: One hundred fifty-eight patients underwent cataract surgery under local anesthesia. Thirty-three healthcare personnel were included. All tests for SARS-CoV-2 were negative for both patients and healthcare personnel. The incidence rate of COVID-19 infection among healthcare personnel was 0 (95% CI 0.000 to 0.003) per 100 person-hours. There were no reported symptoms compatible with COVID-19 during the observed period and follow-up. Conclusion: Due to a very low incidence rate of hospital-acquired SARS-CoV-2 infection among healthcare personnel, elective cataract surgery under local anesthesia could be continued during COVID-19 pandemic with strict adherence to screening protocol and other preventive measures. SARS-CoV-2 screening method by questionnaire alone may be feasible in a low COVID-19 incidence rate. © 2022 JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND