Stromal and endothelial herpes simplex virus keratitis reactivation in the convalescent period of COVID-19 – A case report

Das, Nabanita; Das, Joyeeta; Pal, Dipanjan

doi:10.4103/ijo.ijo_2838_21

Cited by 7 publications

(7 citation statements)

References 11 publications

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“…Undetectable viremia from an initial molecular testing followed by the detection of HHV-1 DNA in a subsequent testing [ 20 , 57 , 71 ], detection of HHV-1 DNA [ 56 , 68 , 74 ] and/or seropositive for HHV-1 IgG [ 60 , 69 , 77 ], history of COVID-19 (recovered) prior to HSV-1 detection, or history of COVID-19 [ 65 ] and corneal ulcer prior to detection of HSV-1 [ 19 ]…”

Section: Resultsmentioning

confidence: 99%

“…Similarly, Simonnet et al performed systematic testing for EBV, CMV, HHV-6 DNAemia on critically ill COVID-19 patients and observed the virus reactivations in 85% of patients, among which the patients with EBV reactivation required longer hospital length-of-stay [ 17 ]. Skin and ocular manifestations, too, including lesions in multiple regions and herpetic keratitis with risk of blindness, have been observed in patients with Herpesviridae reactivations [ 18 , 19 ]. Liu et al reported HBV reactivation in three COVID-19 patients with a history of chronic HBV infection where an increase in HBV DNA upon admission was noted, with one patient developing cirrhosis [ 35 ].…”

Section: Introductionmentioning

confidence: 99%

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Viral reactivations and co-infections in COVID-19 patients: a systematic review

et al. 2023

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Background Viral reactivations and co-infections have been reported among COVID-19 patients. However, studies on the clinical outcomes of different viral reactivations and co-infections are currently in limit. Thus, the primary purpose of this review is to perform an overarching investigation on the cases of latent virus reactivation and co-infection in COVID-19 patients to build collective evidence contributing to improving patient health. The aim of the study was to conduct a literature review to compare the patient characteristics and outcomes of reactivations and co-infections of different viruses. Methods Our population of interest included confirmed COVID-19 patients who were diagnosed with a viral infection either concurrently or following their COVID-19 diagnosis. We extracted the relevant literature through a systematic search using the key terms in the online databases including the EMBASE, MEDLINE, Latin American Caribbean Health Sciences Literature (LILACS), from inception onwards up to June 2022. The authors independently extracted data from eligible studies and assessed the risk of bias using the Consensus-based Clinical Case Reporting (CARE) guidelines and the Newcastle–Ottawa Scale (NOS). Main patient characteristics, frequency of each manifestation, and diagnostic criteria used in studies were summarized in tables. Results In total, 53 articles were included in this review. We identified 40 reactivation studies, 8 coinfection studies, and 5 studies where concomitant infection in COVID-19 patients was not distinguished as either reactivation or coinfection. Data were extracted for 12 viruses including IAV, IBV, EBV, CMV, VZV, HHV-1, HHV-2, HHV-6, HHV-7, HHV-8, HBV, and Parvovirus B19. EBV, HHV-1, and CMV were most frequently observed within the reactivation cohort, whereas IAV and EBV within the coinfection cohort. In both reactivation and coinfection groups, patients reported cardiovascular disease, diabetes, and immunosuppression as comorbidities, acute kidney injury as complication, and lymphopenia and elevated D-dimer and CRP levels from blood tests. Common pharmaceutical interventions in two groups included steroids and antivirals. Conclusion Overall, these findings expand our knowledge on the characteristics of COVID-19 patients with viral reactivations and co-infections. Our experience with current review indicates a need for further investigations on virus reactivation and coinfection among COVID-19 patients.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Viral reactivations and co-infections in COVID-19 patients: a systematic review

et al. 2023

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“…Studies have linked a small number of HSV keratitis cases in patients with COVID-19 since the pandemic outbreak. [29][30][31][32] The immune system characteristics in patients with COVID-19, such as immunosuppression and cytokine storm syndrome, may promote the reactivation of latent viral infections such as HSV. 33,34 The association between HSV and COVID-19 infections suggests that COVID-19 may pose a risk factor for developing or potentially triggering HSV keratitis.…”

Section: Discussionmentioning

confidence: 99%

Changes in the spectrum of ocular disease during the COVID-19 pandemic in late 2022 in the Hubei Province

Bao,

Chen,

Zheng

et al. 2024

Preprint

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Purpose We aimed to investigate changes in the ocular disease spectrum during the coronavirus disease-2019 (COVID-19) pandemic in late 2022 in the Hubei Province. Methods This retrospective observational study was conducted in two parts. The first part involved collecting COVID-19-related information from residents of Hubei Province during the COVID-19 pandemic through an online questionnaire survey. The second part involved extracting electronic medical records from ophthalmology outpatient departments at two hospitals in Hubei Province during the pandemic and epidemic prevention and control periods, analyzing changes in the spectrum of ocular diseases. Results In the first part，31.65% of patients with systemic symptoms of COVID-19 experienced ocular discomforts. The most common ocular symptoms were eye fatigue, ocular pain and dry eye. In the second part, 76.5% of patients who visited the ophthalmic clinic had COVID-19-related systemic symptoms during pandemic period. The proportion of ornea/keratitis, glaucoma/acute angle-closure glaucoma (AACG) and vitreoretinal disease/retinal vein obstruction (RVO)/acute macular neuroretinalpathy (AMN) increased markedly during pandemic period. Additionally, the number of patients under 18 years and over 60 years in pandemic perioddecreased significantly. Conclusion The COVID-19 pandemic has led to certain changes in the spectrum of ocular disease, which warrants the attention of ophthalmologists.

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“…The SARS-CoV-2[ 412 ] has been implicated in HSV Keratitis[ 413 , 414 ]. HSK has been reported to relapse post mRNA coronavirus disease 2019 vaccination[ 415 ].…”

Section: Herpes Simplex Keratitis In Immunocompromised Patients: Chal...mentioning

confidence: 99%

Herpes simplex keratitis: A brief clinical overview

Musa,

Enaholo,

Aluyi-Osa

et al. 2024

World J Virol

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The aim of our minireview is to provide a brief overview of the diagnosis, clinical aspects, treatment options, management, and current literature available regarding herpes simplex keratitis (HSK). This type of corneal viral infection is caused by the herpes simplex virus (HSV), which can affect several tissues, including the cornea. One significant aspect of HSK is its potential to cause recurrent episodes of inflammation and damage to the cornea. After the initial infection, the HSV can establish a latent infection in the trigeminal ganglion, a nerve cluster near the eye. The virus may remain dormant for extended periods. Periodic reactivation of the virus can occur, leading to recurrent episodes of HSK. Factors triggering reactivation include stress, illness, immunosuppression, or trauma. Recurrent episodes can manifest in different clinical patterns, ranging from mild epithelial involvement to more severe stromal or endothelial disease. The severity and frequency of recurrences vary among individuals. Severe cases of HSK, especially those involving the stroma and leading to scarring, can result in vision impairment or even blindness in extreme cases. The cornea's clarity is crucial for good vision, and scarring can compromise this, potentially leading to visual impairment. The management of HSK involves not only treating acute episodes but also implementing long-term strategies to prevent recurrences and attempt repairs of corneal nerve endings via neurotization. Antiviral medications, such as oral Acyclovir or topical Ganciclovir, may be prescribed for prophylaxis. The immune response to the virus can contribute to corneal damage. Inflammation, caused by the body's attempt to control the infection, may inadvertently harm the corneal tissues. Clinicians should be informed about triggers and advised on measures to minimize the risk of reactivation. In summary, the recurrent nature of HSK underscores the importance of both acute and long-term management strategies to preserve corneal health and maintain optimal visual function.

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Stromal and endothelial herpes simplex virus keratitis reactivation in the convalescent period of COVID-19 – A case report

Cited by 7 publications

References 11 publications

Viral reactivations and co-infections in COVID-19 patients: a systematic review

Viral reactivations and co-infections in COVID-19 patients: a systematic review

Changes in the spectrum of ocular disease during the COVID-19 pandemic in late 2022 in the Hubei Province

Herpes simplex keratitis: A brief clinical overview

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