Evaluation of dry eye disease after COVID-19 infection

ABSTRACT

Purpose: A prospective observational clinical study was performed to evaluate ocular symptoms related to dry eye disease (DED) in patients infected with COVID-19. Methods: The staff of an University Hospital in Londrina city, Brazil, who presented respiratory symptoms and underwent nasal swab PCR test for SARS-CoV-2 detection at the outpatient unit during November to December 2020 was assessed by electronic messages and separated in two groups (PCR test negative or control group-CG, and PCR test positive or COVID-19 group-COVG). Sociodemographic data, presence of ocular and systemic comorbidities, place of treatment (home, infirmary or intensive care unit), and the Ocular Surface Disease Index (OSDI) questionnaire, translated and validated to Portuguese for DED evaluation were performed. OSDI contains 3 subsections including visual-related function (category A), ocular symptoms (category B) and environmental triggers (category C). Scores range from 0 to 100 with 0 to 12 representing normal, 13 to 22 mild DED, 23 to 32 moderate DED and 33 severe DED. The data was submitted to statistical analysis. Results: From 450 electronic messages sent, 113 patients were included. 62(54,85%) had laboratory-confirmed (RT-PCR) Covid-19. The mean age was 36 years, ranging from 21 to 60 years. 83 (73.4%) patients were female. The main systemic comorbidity was smoking (23%), followed by obesity (3.5%) and hypertension (1.76%). The mean OSDI score was 13.85 in the COVG and 5.37 in the CG (p=0.002). The COVG had a mean score of 3.50 related to category A, 1.05 to category B and 2.13 to category C while the CG presented a mean score of 1.41, 0.39 and 0.80 respectively (p = 0.003;p=0.04;p=0.01). Patients who required hospitalization for treatment presented OSDI score proportionally greater than those who were treated at home (25.67) (p=0.052). Conclusions: OSDI score was higher in the COVG and among patients who required hospitalization for treatment. These results suggest association of COVID infection and DED;and increase of DED according to the severity of respiratory symptoms.