Ophthalmological findings in patients suspected with COVID-19 at a tertiary hospital in Pernambuco, Brazil / Achados oftalmológicos em pacientes com suspeita de COVID-19 atendidos na triagem do HC-UFPE

ABSTRACT Purpose: This study evaluated the frequency of the most common ophthalmological, neurological, and systemic findings in symptomatic patients seen at a COVID-19 screening service at Hospital das Clínicas - Universidade Federal de Pernambuco. Methods: A total of 104 patients under clinical suspicion of SARS-CoV-2 infection underwent medical evaluation through an ophthalmological and systemic symptoms survey. All participants selected for the study underwent COVID-19 RT-PCR testing. Results: The mean age was 38.8 years, with 44.23% between 31 and 40 years old, 68.27% female, and 31.73% male. The most common symptoms in patients with a positive RT-PCR test were cough (69.23%), fever (42.3%), hyposmia (38.46%), myalgia (38.46%), and ageusia (30.77%). In the positive group, 34.61% presented with ophthalmological symptoms: burning (19.23%), eye pain (11.54%), foreign body sensation (7.7%), hyperemia (7.7%), and tearing (3.84%). Conclusions: Systemic clinical features were characteristic of upper respiratory infection, but neurological findings of hyposmia and anosmia proved to be important markers for suspicion of SARS-CoV-2 infection. Ophthalmic symptoms in patients with COVID-19 were similar to those observed in other viral conditions and may precede systemic conditions. A high rate of self-medication was observed for general symptoms compared with ophthalmological conditions.

RESUMO Objetivo: Avaliar a frequência dos sintomas oftalmológicos, neurológicos e sistêmicos mais comuns em pacientes sintomáticos atendidos no serviço de triagem de COVID-19 do Hospital das Clínicas da UFPE. Métodos: Cento e quatro pacientes com suspeita clínica de infecção por Sars-Cov-2 foram submetidos a avaliação médica e aplicação de questionário sobre a sintomatologia oftalmológica, neurológica e sistêmica. Todos os participantes do estudo tiveram exame de RT-PCR para COVID-19 solicitado. Resultados: A média de idade foi de 38,8 anos, com 44,23% entre 31 e 40 anos. Mulheres corresponderam a 68,27% dos atendimentos e homens a 31,73%. Os sintomas mais frequentes nos pacientes com RT-PCR positivo foram: tosse (69,23%), febre (42,3%), mialgia (38,46%), hiposmia (38,46%), e ageusia (30,77%). Neste grupo, os sintomas oftalmológicos estiveram presentes em 34,61%, sendo: ardor (19,23%), dor ocular (11,54%), sensação de corpo estranho (7,7%), hiperemia (7,7%) e lacrimejamento (3,84%) os mais encontrados. Conclusões: O quadro clínico sistêmico foi característico de infecção respiratória alta, porém os achados neurológicos de hiposmia e anosmia mostraram-se importantes marcadores para a suspeição dos casos de infecção por COVID-19. Os sintomas oftalmológicos dos pacientes com COVID-19 foram semelhantes aos presentes em outros quadros virais, podendo preceder o quadro sistêmico. Houve uma alta taxa de automedicação para os sintomas gerais quando comparado ao quadro oftalmológico.

Ophthalmological findings in patients suspected with COVID-19 at a tertiary hospital in Pernambuco, Brazil.

PURPOSE: This study evaluated the frequency of the most common ophthalmological, neurological, and systemic findings in symptomatic patients seen at a COVID-19 screening service at Hospital das Clínicas - Universidade Federal de Pernambuco. METHODS: A total of 104 patients under clinical suspicion of SARS-CoV-2 infection underwent medical evaluation through an ophthalmological and systemic symptoms survey. All participants selected for the study underwent COVID-19 RT-PCR testing. RESULTS: The mean age was 38.8 years, with 44.23% between 31 and 40 years old, 68.27% female, and 31.73% male. The most common symptoms in patients with a positive RT-PCR test were cough (69.23%), fever (42.3%), hyposmia (38.46%), myalgia (38.46%), and ageusia (30.77%). In the positive group, 34.61% presented with ophthalmological symptoms: burning (19.23%), eye pain (11.54%), foreign body sensation (7.7%), hyperemia (7.7%), and tearing (3.84%). CONCLUSIONS: Systemic clinical features were characteristic of upper respiratory infection, but neurological findings of hyposmia and anosmia proved to be important markers for suspicion of SARS-CoV-2 infection. Ophthalmic symptoms in patients with COVID-19 were similar to those observed in other viral conditions and may precede systemic conditions. A high rate of self-medication was observed for general symptoms compared with ophthalmological conditions.

Intermittent fasting, adipokines, insulin sensitivity, and hypothalamic neuropeptides in a dietary overload with high-fat or high-fructose diet in mice.

The intermittent fasting (IF) might have benefits on metabolism and food intake. Twelve-week old C57BL/6 J mice were fed a control diet (C, 10% kcal fat), a high-fat diet (HF, 50% kcal fat) or a high-fructose diet (HFru, 50% kcal fructose) for 8 weeks, then half of the animals in each group underwent IF (24 h fed, 24 h fasting) for an additional 4 weeks. Although food intake on the fed day remained the same for all groups, all fasting groups showed a reduction in body mass compared to their counterparts. IF reduced total cholesterol, triacylglycerol, fasting glucose, fasting insulin resistance index, and plasma leptin, but increased plasma adiponectin. IF reduced Leptin gene expression in the HF-IF group, but increased proinflammatory markers in the hypothalamus, also in the C-IF group. Both groups HFru-IF and C-IF, showed alterations in the leptin signaling pathway (Leptin, OBRb, and SOCS3), mainly in the HFru-IF group, suggesting leptin resistance. NPY and POMC neuropeptides labeled the neurons of the hypothalamus by immunofluorescence, corroborating qualitatively other quantitative findings of the study. In conclusion, current results are convincing in demonstrating the IF effect on central regulation of food intake control, as shown by NPY and POMC neuropeptide expressions, resulting in a lower weight gain. Besides, IF improves glycemia, lipid metabolism, and consequently insulin and leptin resistance. However, there is increased expression of inflammatory markers in mouse hypothalamus challenged by the HF and HFru diets, which in the long term may induce adverse effects.