The risk assessment of uveitis after COVID‐19 diagnosis: A multicenter population‐based study

Abstract

Reports on uveitis after COVID‐19 have been limited. Our objective was to examine the risk of uveitis among COVID‐19 patients. This was a retrospective cohort study based on the TriNetX platform. The exposure group was patients with positive laboratory test result for SARS‐CoV‐2 and the comparison group was those tested negative for COVID‐19 throughout the study period. The endpoint is the new diagnoses of uveitis. This study composed of 2 105 424 patients diagnosed with COVID‐19 (55.4% female; 62.5% white; mean age at index 40.7 years) and 2 105 424 patients (55.4% female; 62.4% white; mean age at index 40.7 years) who never had COVID‐19. There was significantly increased risk of new diagnosis of uveitis since the first month after diagnosis of COVID‐19 compared with matched controls (HR: 1.18, 95% CI: 1.03–1.34) up to 24 months (HR: 1.16, 95% CI: 1.09–1.22). Our findings strengthen those previously raised by case series with a larger and multicenter study. We found that uveitis was significantly associated with COVID‐19 infection. Our findings reiterate the need for careful investigation as well as increased awareness from ophthalmologists in considering the possibility of COVID‐19 in vulnerable patients with new presentation of uveitis.

Association between immune checkpoint inhibitor medication and uveitis: a population-based cohort study utilizing TriNetX database

“…These specific follow-up intervals from baseline were evaluated as we wanted to assess both the short-term and long-term risk of uveitis. Similar studies in the past, with the risk of uveitis as the primary outcome, have also employed similar intervals and frequency of follow-ups ( 5 ). We also performed a risk-stratification analysis to investigate potential factors associated with uveitis development among recipients of immune checkpoint inhibitors and compared them to non-immune checkpoint inhibitors users at corresponding follow-up duration of interest.…”

“…The primary endpoint was composed of uveitis conditions occurring up to the end of the study period (December 31 st , 2022) after the index date. Consistent with methods validated by previous studies ( 5 ), we defined incidence uveitis cases based on the following criteria:…”

“…An ICD-10 diagnostic code relating to specific uveitis-related diseases that has been validated in previous studies ( 5 , 17 )…”

“…The uveitis conditions of interest were defined by the ICD-10 codes extracted from the electronic records (refer to Supplementary Table 3 ) and included the following: Iridocyclitis [ICD-10=CM=H20], Chorioretinal inflammation [ICD-10-CM=H30]; Retinal vasculitis [H35.06]; Unspecified purulent endophthalmitis [H44.0]; Panuveitis [H44.11]; Sympathetic uveitis [H16.24]; Vogt-Koyanagi-Harada disease (VKH) [H20.823]; and Harada’s disease [H30.819]. These endpoints are selected based on their validation in prior studies ( 5 , 7 ) and are broadly used among various academic tertiary centers in the United States ( 18 ). Additionally, the inclusion of VKH and Harada’s disease was motivated by their established association with ICI, making them particularly relevant to the focus of this study.…”

“…The extensive nature of the TriNetX dataset presents a valuable opportunity to address existing knowledge gaps, particularly in the understanding of drug-induced uveitis secondary to ICI. Previous studies have successfully employed the TriNetX to investigate uveitis risks associated with different conditions ( 5 ). Our study aimed to explore the risk of uveitis development among cancer patients receiving ICI therapy using the TriNetX database.…”