Bilateral anterior uveitis as a part of a multisystem inflammatory syndrome secondary to COVID‐19 infection

Abstract

During the ongoing COVID‐19 pandemic, there is a global concern about patients presenting with inflammatory syndrome with variable clinical features. Colanfrancesco et al. described COVID‐19 systemic inflammatory reaction that are characterized by a life‐threatening hyper‐inflammation sustained by a cytokines storm which eventually leads to multi‐organ failure. This article is protected by copyright. All rights reserved.

SARS‐CoV‐2 causes Kawasaki‐like disease in children: Cases reported in Pakistan

“…In contrast to our study where Kawasaki‐like multisystem inflammatory syndrome present among children and adolescents 13 . Here, the main presenting complaint was bilateral blurry vision and rashes after 2 weeks of COVID‐19 infection whereas, in our study, only one or two patient develop inflamed red spots on mouth and tongue 13 . However, the pathophysiology of how SARS‐CoV‐2 causes Kawasaki‐like MIS‐C is unknown but it is hypothesized that COVID‐19 infection causes abundant inflammation and children with Kawasaki‐like multisystem inflammatory syndrome demonstrate a storm of inflammation in their body 6 …”

“…Another case with a similar presentation has been reported in a 54‐year‐old patient. In contrast to our study where Kawasaki‐like multisystem inflammatory syndrome present among children and adolescents 13 . Here, the main presenting complaint was bilateral blurry vision and rashes after 2 weeks of COVID‐19 infection whereas, in our study, only one or two patient develop inflamed red spots on mouth and tongue 13 .…”

SARS-CoV-2 Targeting the Retina: Host–virus Interaction and Possible Mechanisms of Viral Tropism

“…Subtle cotton wool spots and microhemorrhages in retinal surface (33%). Hyper-reflective lesions in the GC and IP layers (100%) Virgo and Mohamed 3 Case report of a 37-year-old female with positive SARS-CoV-2 IgG (PCR was not performed) Case report of a 32-year-old male with positive PCR from nasopharyngeal swab Paracentral acute middle maculopathy (hyper-reflective lesion in the IP and OP layers with IN layer volume loss) Acute macular neuroretinopathy (hyper-reflective lesion in OP layer and disruption of the interdigitation zone) Bettach et al 4 Case report of a 54-year-old female with negative SARS-CoV- protection of this region, be encouraged quickly. Moreover, SARS-CoV-2 arrival in the retina through the optic nerve or hematogenous route may be an indication that the coronavirus has previously reached the brain.…”

“…22 Bettach et al recently reported the case of a 54-year-old female with COVID-19 presenting bilateral anterior uveitis associated with a small focal intra-retinal hemorrhage in the left fovea. 4 As the patient had three negative polymerase chain reaction of the nasopharyngeal swabs with positive serology (SARS-CoV-2 IgG), the authors postulate that the anterior uveitis possibly was due to an MIS secondary to SARS-CoV-2 infection. 4 Thus, there is a possibility that, regardless of the arrival of SARS-CoV-2 in the retina, patients with COVID-19 may present retinal damage as part of a multiple organ dysfunction related to MIS.…”

Using bioinformatic protein sequence similarity to investigate if SARS CoV-2 infection could cause an ocular autoimmune inflammatory reactions?

“…Besides, Bettach et al reported bilateral anterior uveitis accompanied with the diagnosis of multisystem inflammatory syndrome secondary to SARS CoV-2 infection and they claimed that the ocular inflammatory findings were related to SARS CoV-2 infection. At the same time, they emphasized that these findings are similar to the Kawasaki-like multisystem inflammatory syndrome, which develops secondary to SARS CoV-2 infection in children and adolescents ( Bettach et al, 2020 ).…”