Features of primary and recurrent herpetic keratitis after COVID-19 infection

Abstract

Purpose

To evaluate the features of the primary and recurrent herpetic keratitis (HK) after СОVID-19 infection.

Setting

State Institution «The Filatov Institute of eye diseases and tissue therapy NAMS of Ukraine», Odessa, Ukraine

Methods

83 eyes of 70 patients with herpetic keratitis after СОVID-19 were analyzed. Patients were divided into two groups: 1 - with primary herpetic keratitis (30 eyes, 26 patients) and 2 - with recurrence of herpetic keratitis (53 eyes, 44 patients). According to the severity of the COVID-19, three stages were distinguished: mild (without pneumonia), moderate (with pneumonia, without intensive care), severe (with intensive care, artificial lung ventilation). In the venous blood of the patients the level of vitamin D, levels of IgG antibodies to coronavirus spike protein, herpes virus type 1-2, Herpes Zoster virus, Cytomegalovirus and Epstein-Barr virus were determined

Results

In primary HK, dendritic epithelial (20.7% compared with 2% in recurrent HK) and ulcerative-necrotic forms (41.2% compared with 15.6% in recurrent HC) were more often. Stromal non-necrotizing form was more common in patients with recurrent HK (82.4%) than in patients with primary HK (37.9%) and was the most common form in both groups. Ulcerative-necrotizing form was more often in patients with severe course of COVID-19. The level of IgG to HSV1-2 viruses was significantly higher in patients with ulcerative-necrotizing keratitis compared to patients with dendritic epithelial (1.6 times) and stromal non-necrotizing (1.5 times) keratitis

Conclusions

An increased level of IgG to Herpes Zoster was detected in 93.2%, to Epstein-Barr virus - in 76.4%, to Cytomegalovirus - in 86.4% of patients. The level of vitamin D in venous blood was within the normal range in only 12.5% of all examined patients. The chances of ulcerative-necrotizing keratitis development in primary HK are 3.9 times higher than in recurrent HK. With a severe course of COVID-19 the chances of ulcerative-necrotizing HK increase by 5.7 times