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Herpes Simplex Keratitis in Patients with SARS-CoV-2 Infection: A Series of Five Cases

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MAJTANOVA Nora KRISKOVA Petra KERI Petra FELLNER Zlatica MAJTAN Juraj KOLÁŘ Petr

Rok publikování 2021
Druh Článek v odborném periodiku
Časopis / Zdroj Medicina-Lithuania
Citace
Doi http://dx.doi.org/10.3390/medicina57050412
Klíčová slova herpes simplex keratitis; COVID-19; immunosuppression; antiviral therapy
Popis Herpes simplex virus type 1 (HSV-1) is a leading cause of infectious blindness worldwide. Most of the initial infection cases manifest as acute epithelial keratitis. Reactivation of herpesviruses is common in critically ill patients, including patients with severe Coronavirus disease (COVID-19). However, the data on COVID-19-related ocular infections is sparse, despite recent observations that more than 30% of COVID-19-infected patients had ocular manifestations. We report five cases of HSV-1 keratitis in COVID-19 patients. In total, five COVID-19 patients underwent ophthalmic examination, showing similar symptoms, including photophobia, tearing, decreased vision, eye redness, and pain. After initial assessment, tests of visual acuity and corneal sensitivity, a fluorescein staining test, and complete anterior and posterior segment examinations were performed. A diagnosis of HSV-1 keratitis was confirmed in all cases. Therapy was initiated using a local and systemic antiviral approach together with local antibiotic and mydriatic therapy. The complete reduction of keratitis symptoms and a clear cornea was achieved in all patients within 2 weeks. SARS-CoV-2 infection may be a risk factor for developing HSV-1 keratitis, or it may act as a potential activator of this ocular disease.

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