微生物角膜炎(MK)是最常见的非手术性眼科急症,并且可以迅速进步,导致不可逆转的视力丧失。这项研究探讨了COVID-19(C19)国家封锁是否会影响英国三级护理中心MK的临床表现和结果。
对所有假定MK需要角膜擦伤的患者的病历进行回顾性分析,2020年3月23日至6月30日(Y2020),以及2017年、2018年和2019年的等效时间窗口(C19之前)。
总共,在C19之前和2020年期间,有181和49名患者出现,分别。2020年,并发眼外伤(16.3%vs.5.5%,p=0.030)和免疫抑制使用(12.2%vs1.7%,p=0.004)更普遍。尽管在大流行期间病房入院比例较低(8.2%对32.6%,p<0.001),在基线人口统计学中没有观察到差异;呈现视力(VA;中位数0.6vs0.6LogMAR,p=0.785);溃疡面积(4.0vs3.0mm2,p=0.520);或最终VA(0.30vs0.30LogMAR,p=0.990)。虽然在2020年和C19之前的总体培养阳性率相似(49.0%vs.54.7%,p=0.520),孤立的文化有差异,2020年多微生物培养率较低(8.3%与31.3%,p=0.022)。
患者特征,在英国的第一次封锁中,MK的严重程度和最终的视力结果似乎没有受到影响,尽管入院接受治疗的患者较少。同时使用创伤和全身免疫抑制比往年更多。孤立生物的光谱差异可能与行为变化有关,例如增加手部卫生。
Microbial keratitis (MK) is the most common non-surgical ophthalmic emergency, and can rapidly progress, causing irreversible sight-loss. This study explored whether the COVID-19 (C19) national lockdown impacted upon the clinical presentation and outcomes of MK at a UK tertiary-care centre.
Medical records were retrospectively reviewed for all patients with presumed MK requiring corneal scrapes, presenting between 23rd March and 30th June in 2020 (Y2020), and the equivalent time windows in 2017, 2018 and 2019 (pre-C19).
In total, 181 and 49 patients presented during the pre-C19 and Y2020 periods, respectively. In Y2020, concurrent ocular trauma (16.3% vs. 5.5%, p = 0.030) and immunosuppression use (12.2% vs 1.7%, p = 0.004) were more prevalent. Despite proportionately fewer ward admissions during the pandemic (8.2% vs 32.6%, p<0.001), no differences were observed in baseline demographics; presenting visual acuity (VA; median 0.6 vs 0.6 LogMAR, p = 0.785); ulcer area (4.0 vs 3.0mm2, p = 0.520); or final VA (0.30 vs 0.30 LogMAR, p = 0.990). Whilst the overall rates of culture positivity were similar in Y2020 and pre-C19 (49.0% vs. 54.7%, p = 0.520), there were differences in the cultures isolated, with a lower rate of poly-microbial cultures in Y2020 (8.3% vs. 31.3%, p = 0.022).
Patient characteristics, MK severity and final visual outcomes did not appear to be affected in the first UK lockdown, despite fewer patients being admitted for care. Concurrent trauma and systemic immunosuppression use were greater than in previous years. The difference in spectra of isolated organisms may relate to behavioural changes, such as increased hand hygiene.