Ocular and Systemic Complications of COVID-19: Impact on Patients and Healthcare

Ella H Leung,1 Jason Fan,2 Harry W Flynn Jr,2 Thomas A Albini2 1Georgia Retina, Atlanta, GA, USA; 2Bascom Palmer Eye Institute/University of Miami, Miami, FL, USACorrespondence: Ella H LeungGeorgia Retina, 833 Campbell Hill St NW, Suite 300, Marietta, GA, 30328, USATel +1 770-218-1888Email eleung@garetina.comAbstract: There is increasing information available about the effects of the SARS-CoV-2 virus on the systemic and ocular health of patients, as well as the effects of delayed health care. This mini-review summarizes the potential complications and treatments of COVID-19. Systemic findings include respiratory illness, risk of thromboembolic events, and neurologic findings. Some patients may develop persistent symptoms even after the infection resolves. Effective treatment options include glucocorticoids, antivirals, interleukin-6 antagonists, monoclonal antibodies, Janus kinase inhibitors and vaccines. Potential ocular findings of COVID-19 include conjunctivitis, cranial nerve palsies, and microvascular changes in the retina; most symptoms resolved over time. During the lockdown periods, teleophthalmology was utilized to triage non-urgent issues; patients who did present to emergency departments tended to have more severe disease with worse visual prognoses. While transient delays in outpatient ophthalmic care may be tolerated in some patients, others experienced significant vision loss with interruptions in treatments. Resumption of ophthalmic care as soon as possible may help mitigate the effects of delayed care due to the pandemic.Keywords: COVID-19, SARS-CoV-2, quarantine, steroids, interleukin 6, tocilizumab, monoclonal antibodies, casirivimab, imdevimab, antiviral, remdesivir; teleophthalmology; vaccine; trauma