Prevalence of SARS-CoV-2 among central retinal artery occlusion patients: A case series-HORA study report No. 3

Abstract

Introduction: COVID-19 patients are susceptible to hypercoagulability, thromboembolic, and vasculitis state; central retinal artery occlusion (CRAO) could be caused by hyperviscosity syndrome, thromboembolic accidents, and vasculitis. Evolving case reports are correlating CRAO with COVID-19 patients. Our case series aims to reveal the prevalence of SARS-CoV-2 among CRAO patients under the COVID-19 pandemic. Methods: Medical records of all CRAO patients who attended our tertiary referral hospital, during COVID-19 local outbreak (March to November 2020), were reviewed. Respiratory tract samples were tested for SARS-CoV-2 by the validated Xpert Xpress SARS-CoV-2 assay. If patients were able to cooperate, oropharyngeal saliva samples were obtained. Otherwise, nasopharyngeal and deep throat swabs were taken by registered nurses. Results: A total of 15 CRAO patients (7 males, 8 females) were identified during the 9-month study period. The mean age was 72.1-years (range 45-88 year). None of the patients were infected by SARS-CoV-2 before their CRAO disease episodes. Three patients had a history of CRAO over the contralateral eye. No patient was diagnosed with COVID-19 up to their last follow-up (mean 255.4 days, range 152-341 days). Without any COVID-19 positive case, correlation statistical tests on SARS-CoV-2 infection and CRAO were not established. Conclusions: Some of the presumed COVID-19 related CRAO cases may be just coincident with at-risk patients, as COVID-19 is prevalent across the world. More in-depth research, with adjustment to known confounding risk factors, is needed to establish a genuine correlation.