PURPOSE Intraocular infection in patients with COVID-19 could be different in the presence of treatment with systemic corticosteroid and immunosuppressive agents. We describe the epidemiology and microbiological profile of intraocular infection in COVID-19 patients after their release from the hospital. METHODS We analyzed the clinical and microbiological data of laboratory-confirmed COVID-19 patients from April 2020 to January 2021 presenting with features of endogenous endophthalmitis within 12 weeks of their discharge from the hospital in two neighboring states in South India. The data included demography, systemic comorbidities, COVID-19 treatment details, time interval to visual symptoms, the microbiology of systemic and ocular findings, ophthalmic management, and outcomes. RESULTS The mean age of 24 patients (33 eyes) was 53.6 ± 13.5 (range: 5-72) years; 17 (70.83%) patients were male. Twenty-two (91.6%) patients had systemic comorbidities, and the median period of hospitalization for COVID-19 treatment was 14.5 ± 0.7 (range: 7-63) days. Infection was bilateral in nine patients. COVID-19 treatment included broad-spectrum systemic antibiotics (all), antiviral drugs (22, 91.66% of patients), systemic corticosteroid (21, 87.5% of patients), supplemental oxygen (18, 75% of patients), low molecular weight heparin (17, 70.8% of patients), admission in intensive care units (16, 66.6% of patients), and interleukin-6 inhibitor (tocilizumab) (14, 58.3% of patients). Five (20.8%) patients died of COVID-19-related complications during treatment for endophthalmitis; one eye progressed to pan ophthalmitis and orbital cellulitis; eight eyes regained vision >20/400. Fourteen of 19 (73.7%) vitreous biopsies were microbiologically positive (culture, PCR, and microscopy), and the majority (11 patients, 78.5%) were fungi. CONCLUSION Intraocular infection in COVID-19 patients is predominantly caused by fungi. We suggest a routine eye examination be included as a standard of care of COVID-19.

中文翻译：

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印度 COVID-19 患者的威胁视力的眼内感染。

目的 COVID-19 患者的眼内感染在接受全身性皮质类固醇和免疫抑制剂治疗时可能会有所不同。我们描述了 COVID-19 患者出院后眼内感染的流行病学和微生物学特征。方法 我们分析了 2020 年 4 月至 2021 年 1 月实验室确诊的 COVID-19 患者的临床和微生物学数据，这些患者在印度南部两个相邻州出院后 12 周内出现内源性眼内炎的特征。数据包括人口统计学、全身合并症、COVID-19治疗细节、视觉症状的时间间隔、全身和眼部发现的微生物学、眼科管理和结果。结果 24 名患者（33 只眼）的平均年龄为 53.6 ± 13。5（范围：5-72）年；17名（70.83%）患者为男性。22 名 (91.6%) 患者有全身合并症，接受 COVID-19 治疗的中位住院时间为 14.5 ± 0.7（范围：7-63）天。9 名患者发生双侧感染。COVID-19 治疗包括广谱全身性抗生素（全部）、抗病毒药物（22 名，91.66% 的患者）、全身性皮质类固醇（21 名，87.5% 的患者）、补充氧气（18 名，75% 的患者）、低分子肝素（17 人，70.8% 的患者），入住重症监护室（16 人，66.6% 的患者）和白细胞介素 6 抑制剂（托珠单抗）（14 人，58.3% 的患者）。5 名（20.8%）患者在眼内炎治疗期间死于 COVID-19 相关并发症；一只眼睛发展为全眼炎和眼眶蜂窝织炎；八只眼睛恢复视力> 20/400。19 人中的 14 人（73. 7%) 玻璃体活检微生物学阳性（培养、PCR 和显微镜检查），大多数（11 名患者，78.5%）是真菌。结论 COVID-19 患者的眼内感染主要由真菌引起。我们建议将常规眼科检查作为 COVID-19 的护理标准。