Evaluation of acute effects of pulmonary involvement and hypoxia on retina and choroid in coronavirus disease 2019: An optic coherence tomography study.

PURPOSE: We investigated the acute subclinical choroidal and retinal changes caused by Coronavirus Disease 2019 (COVID-19) in patients with and without pulmonary involvement, using spectral domain optic coherence tomography. METHODS: This prospective case-control study included COVID-19 patients: 50 with pulmonary involvement and 118 with non-pulmonary involvement. All patients were examined 1 month after recovering from COVID-19. The changes were followed using optic coherence tomography parameters such as choroidal and macular thickness and retinal nerve fibre layer and ganglion cell complex measurements. RESULTS: All choroidal thicknesses in the pulmonary involvement group were lower than in the non-pulmonary involvement group and the subfoveal choroidal thickness differed significantly (p=0.036). Although there were no significant differences between the central and average macular thicknesses in the two groups, they were slightly thicker in the pulmonary involvement group (p=0.152 and p=0.180, respectively). A significant decrease was detected in the pulmonary involvement group in all ganglion cell complex segments, except for the outer nasal inferior segment (p<0.05). In addition, a thinning tendency was observed in all retinal nerve fibre layer quadrants in the pulmonary involvement group compared to the non-pulmonary involvement group. CONCLUSION: In COVID-19 patients with pulmonary involvement, subclinical choroidal and retinal changes may occur due to hypoxia and ischemia in the acute period. These patients may be predisposed to ischemic retinal and optic nerve diseases in the future. Therefore, COVID-19 patients with pulmonary involvement should be followed for ophthalmological diseases.

Risk factors predicting hospital length of stay in older patients with type 2 diabetes with Covid-19.

Background: Patients with Covid-19 disease could present with flu-like symptoms. However, nearly half of the subjects with positive test results for Covid-19 remain asymptomatic. Data on factors related to the duration of hospital stay in Covid-19 patients with diabetes mellitus remain limited. Objective: We aimed to identify risk factors predicting prolonged hospital length of stay (LOS) among diabetic patients hospitalized with Covid-19. Methods: This cohort study involved patients with type 2 diabetes (T2D) admitted to a tertiary hospital with mild or moderate Covid-19 between August 1 and November 31, 2020. Data on demographics, laboratory parameters, and clinical treatments were extracted from the medical records. Prolonged LOS was defined as equal to or greater than the median hospitable stay time. We used univariate and multivariate logistic regression analyses to explore risk factors associated with LOS. Results: We included 87 hospitalized T2D patients with mild or moderate Covid-19. The mean age was 69.5 ± 6.9 years, and 59.8% were female. In the unadjusted analysis, factors influencing the length of hospitalization were as follows: undertreatment of diabetes, high procalcitonin level, glycated hemoglobin, and low lymphocyte count. After adjustment for all covariates, subjects with a low lymphocyte had a 3.9 fold increased risk of prolonged LOS (OR:3.925 CI:1.044-14.755 p = 0.043). Conclusions: A lower lymphocyte count on admission was associated with prolonged hospital LOS in older T2D patients with Covid-19, suggesting this marker could help clinicians predict complications for an adverse outcome.