Impact of COVID-19 pandemic, national lockdown, and unlocking on an apex tertiary care ophthalmic institute

Agarwal, Rinky; Sharma, Namrata; Patil, Anuja; Thakur, Himani; Saxena, Rohit; Kumar, Atul

doi:10.4103/ijo.ijo_2366_20

Cited by 26 publications

(21 citation statements)

References 23 publications

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“…Agarwal R et al conducted a study to evaluate the impact of the COVID-19 pandemic, national lockdown, and unlocking on ophthalmic care provided by the government-funded apex health institute of India [ 12 ]. In their study, data regarding patients presenting to the ophthalmology department from March 23, 2020, to July 15, 2020, were compared with that from March 23, 2019, to July 15, 2019.…”

Section: Discussionmentioning

confidence: 99%

Effect of Lockdown and Unlock Following COVID-19 on the Presentation of Patients With Endophthalmitis at a Tertiary Eye Center Over One Year

Das¹,

Dave²

2021

Cureus

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Introduction Endophthalmitis is an emergency where patients need immediate intervention to salvage both vision and the globe. Regular follow-up care and close monitoring of the status of the patient are crucial in determining the final outcomes of the treatment. While there is ample literature on the epidemiology and demography of endophthalmitis across the globe, no information exists on the effect of the coronavirus disease 2019 (COVID-19) pandemic on the presentation patterns of endophthalmitis. Objectives To describe the impact of the lockdown and unlock phases of the COVID-19 pandemic on the presentation of endophthalmitis at a tertiary eye care center in India. Methods This cross-sectional hospital-based study included 1,253 patients presenting between March 25, 2017, and March 31, 2021. The data on the patients diagnosed with endophthalmitis in one or both eyes presenting during the lockdown and unlock phases were compared with the respective time periods in the previous three years before COVID-19. Results The patient numbers dropped to 42.18% (27/64) of pre-COVID-19 volumes during the lockdown phase. There was a near-complete recovery of the outpatient numbers to 85.71% (26/30) of pre-COVID-19 volumes by March 2021. This gradual incremental trend was seen in etiology due to post-surgery (88%) and endogenous (159%) infections while post-traumatic (67%) and post-infection (0%) infections were lower than pre-COVID-19 volumes by March 2021. There was a slight increase in the proportion of patients with acute endophthalmitis (88.93% vs 86.20%; p=0.76 ) presenting during the COVID-19 phase as compared to the pre-COVID-19 phase. The proportion of patients requiring inter-state travel showed complete recovery to 107% of pre-COVID-19 distribution by March 2021. Conclusion The first year of the COVID-19 pandemic saw a decline of over half the number of patients with endophthalmitis accessing eye care services. There was an increase in the presentation of endogenous endophthalmitis and a decrease in post-traumatic forms. Patients requiring inter-state travel recovered during the unlock phase.

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Section: Discussionmentioning

confidence: 99%

Effect of Lockdown and Unlock Following COVID-19 on the Presentation of Patients With Endophthalmitis at a Tertiary Eye Center Over One Year

Das¹,

Dave²

2021

Cureus

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“…The number of corneal scrapes was signi cantly lower than in the other years studied; it happened because the total number of patients presenting infectious keratitis dropped and many patients that were referred to our hospital came with more severe cases of infections, in which the corneal scrape was not safe because of perforation or risk of perforation. Agarwal also reported a reduction in the eye-speci c emergency department visits in India 35 .…”

Section: Discussionmentioning

confidence: 93%

Microbial profile in infectious keratitis over 8 years in Sao Paulo, Brazil: pathogens and microbial resistance

Oliveira

Tanaka

Kato

et al. 2021

Preprint

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Objective Infectious keratitis remains a sight-threatening disease and its prompt diagnosis and treatment are critical. This study investigated the microbiological patterns of isolates in corneal ulcers in a tertiary health center in an 8-year period. Methods Retrospective analysis of scrapes of microbial keratitis performed from January 2013 to December 2020. Demographics and microbiological data were collected. Results A total of 446 scrapes were performed on eyes of 433 patients, 270 male (62.4%), mean age 51.7 years. 304 organisms were isolated from 248 (55.6%) positive samples. Polymicrobial infections occurred in 47 samples (19.0%). Bacterial isolates represented 86.8%: 53.3% gram-positive (GP), 33.5% gram-negative (GN). Cutibacterium acnes (12.2%) and Pseudomonas aeruginosa (9.9%) were the most common bacteria. Fungal keratitis comprised 11.8% of the isolates; Fusarium sp (6.2%) was the main fungus isolated. GP tested were sensitive to vancomycin, 98.7% of the GN were sensitive to ceftazidime. All Pseudomonas aeruginosa were sensitive to gentamicin and ciprofloxacin. Conclusion Gram-positive bacteria were predominant in keratitis isolates. In severe bacterial keratitis in our area, vancomycin should be considered as empirical treatment.

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“…The pandemic’s negative impact on ophthalmic services [ 10 , 11 , 13 , 23 , 24 ] has raised concerns about patients’ well-being. This study evaluated the impact of the first COVID-19 lockdown on the outcomes of patients with MK.…”

Section: Discussionmentioning

confidence: 99%

“…Whilst Agarwal et al . [ 24 ] reported an increase in MK incidence during the lockdown at their unit in India, Poyser at al . [ 10 ] report a decrease in contact lens associated keratitis of more than 50%, compared to the same period in 2019, although the proportions remained similar in both study periods.…”

Section: Discussionmentioning

confidence: 99%

The impact of the COVID-19 pandemic on microbial keratitis presentation patterns

et al. 2021

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Background Microbial keratitis (MK) is the most common non-surgical ophthalmic emergency, and can rapidly progress, causing irreversible sight-loss. This study explored whether the COVID-19 (C19) national lockdown impacted upon the clinical presentation and outcomes of MK at a UK tertiary-care centre. Methods Medical records were retrospectively reviewed for all patients with presumed MK requiring corneal scrapes, presenting between 23rd March and 30th June in 2020 (Y2020), and the equivalent time windows in 2017, 2018 and 2019 (pre-C19). Results In total, 181 and 49 patients presented during the pre-C19 and Y2020 periods, respectively. In Y2020, concurrent ocular trauma (16.3% vs. 5.5%, p = 0.030) and immunosuppression use (12.2% vs 1.7%, p = 0.004) were more prevalent. Despite proportionately fewer ward admissions during the pandemic (8.2% vs 32.6%, p<0.001), no differences were observed in baseline demographics; presenting visual acuity (VA; median 0.6 vs 0.6 LogMAR, p = 0.785); ulcer area (4.0 vs 3.0mm2, p = 0.520); or final VA (0.30 vs 0.30 LogMAR, p = 0.990). Whilst the overall rates of culture positivity were similar in Y2020 and pre-C19 (49.0% vs. 54.7%, p = 0.520), there were differences in the cultures isolated, with a lower rate of poly-microbial cultures in Y2020 (8.3% vs. 31.3%, p = 0.022). Conclusions Patient characteristics, MK severity and final visual outcomes did not appear to be affected in the first UK lockdown, despite fewer patients being admitted for care. Concurrent trauma and systemic immunosuppression use were greater than in previous years. The difference in spectra of isolated organisms may relate to behavioural changes, such as increased hand hygiene.

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Impact of COVID-19 pandemic, national lockdown, and unlocking on an apex tertiary care ophthalmic institute

Cited by 26 publications

References 23 publications

Effect of Lockdown and Unlock Following COVID-19 on the Presentation of Patients With Endophthalmitis at a Tertiary Eye Center Over One Year

Effect of Lockdown and Unlock Following COVID-19 on the Presentation of Patients With Endophthalmitis at a Tertiary Eye Center Over One Year

Microbial profile in infectious keratitis over 8 years in Sao Paulo, Brazil: pathogens and microbial resistance

The impact of the COVID-19 pandemic on microbial keratitis presentation patterns

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