91, 157160. In total, 21 patients were examined. Invest Ophthalmol Vis Sci. Further studies with more participants with and without acute ocular symptoms are necessary for final evidence. 9, 8. https://doi.org/10.1186/1471-2415-9-8 (2009). Ocul. The long-term visual recovery in these cases is variable, ranging from complete recovery to significant visual loss," said the doctor. Angiotensin II and its receptor subtypes in the human retina. 2003;348(20):196776. Isolation of a Novel Coronavirus from a Man with Pneumonia in Saudi Arabia | NEJM. Virology: coronaviruses. 3. A review of coronaviruses and ocular implications in humans and animals. Global and regional estimates of prevalence of refractive errors: Systematic review and meta-analysis. volume11, Articlenumber:11085 (2021) Possibly a percentage of this complaint may be related to previous uncorrected refractive errors since presenting visual acuity and DBCVA statistically improved in all the groups, except for the LE in the mild-to-moderate group. Before contracting COVID-19 I wore glasses, but the difficulty I had seeing was unlike anything Id experienced before. OCT scans showed no hyperreflective foci in the retina or vitreous. By using this website, you agree to our Call 314.983.4167 for assistance. Regarding refractive errors, as the Pearson correlation between RE and LE was 0.85, we used only the RE for the refractive error data analysis. The https:// ensures that you are connecting to the They have me wear paper glasses, kind of like 3-D glasses, and I complete movements while a light is concentrated on the glasses. Fritz Gerald P. Kalaw, Alexandra Warter, William R. Freeman, Emine Kaya-Guner, Aslihan Sahin, Dilek Yilmaz, Usanee Tungsattayathitthan, Narisa Rattanalert & Wantanee Sittivarakul, Dinah Zur, Michaella Goldstein, Zohar Habot-Wilner, Yu-Chun Cheng, Eugene Yu-Chuan Kang, Ching-Hsi Hsiao, Alessandro Invernizzi, Marco Schiuma, Giovanni Staurenghi, Irmak Karaca, Gunay Uludag, Quan Dong Nguyen, Haya H. Al-Ani, Joanne L. Sims & Rachael L. Niederer, Rana Khalil, Harry Petrushkin, Mark Westcott, Scientific Reports https://doi.org/10.1016/S0165-5728(01)00374-5. Post-acute COVID-19 syndrome. Even the 2 patients with severe ARDS and intubation for 8.5 (0.7) days and extremely high inflammation values (Table2) did not show any signs of ocular manifestations. Highest levels of inflammation markers were seen in two hospitalized patients (9.5%) who received intensive care ventilation in mean (SD) for 8.5 (0.7) days because of ARDS. How often do you feel your eyes dry? The ACE2 was found in the eye in addition to the Cornea [22] and conjunctiva [23], also in the retina [24] and aqueous humor [25]. https://doi.org/10.1167/iovs.18-25864. Terms and Conditions, One week after discharge from the hospital for a severe course of COVID-19, a 59-year-old male with a history of hypertension and hyperuricemia presented with painless vision loss in the left eye. Article However, patients in studys have severe systemic pre-existing conditions such as diabetes, hypertension, and obesity, which is seems more likely to be the cause, as CWS, hemorrhages and dilated vessels can be triggered by microangiopathies and inflammation. 16, 103112. 2020;68(10):22913. And thirdly, the binding of the viral Spike protein via the ACE2 receptor and the transmembrane protease serine 2 (TMPRSS2), responsible of SARS-CoV-2 entry in to the host cell [16, 17], found both in tissue of the eye. Long-COVID: an evolving problem with an extensive impact. The meanSD duration of hospitalization was 15.010.7 days. Two hospitalized patients (9.5%) received invasive ventilation. S. Michalakis Co-founder and shareholder of ViGeneron GmbH. de Groot RJ, Baker SC, Baric RS, Brown CS, Drosten C, Enjuanes L, et al. Vavvas DG, Sarraf D, Sadda SR, Eliott D, Ehlers JP, Waheed NK, et al. This report details a patient presenting with painless vision loss in the setting of a medical history of COVID-19. Since its first detection in Wuhan in December 2019, a novel strain entitled SARS-CoV-2 has erupted into a long-lasting global pandemic, that was declared as such by the WHO in March 2020 [7]. However, there are lots of symptoms you can have after a COVID-19 infection, including: problems with your memory and concentration ("brain fog") chest pain or tightness difficulty sleeping (insomnia) heart palpitations dizziness pins and needles joint pain depression and anxiety tinnitus, earaches PubMed Lipid Res. Comparison of the parafoveal vessel density a TOPCON Display Grid parafoveal showing 5 parts b+c Box plots showing the comparison of each part of 14 not hospitalised (middle, cross-striped) and 26 hospitalised (right, lengthwise-striped) eyes compared to 50 control eyes (left, clear). The most common findings are cough, low-grade fever, and fatigue, all of which may relapse and remit. SARS-CoV-2 infection can leave some people with heart problems, including inflammation of the heart . Hyperinflammation with cytokine storm and stasis with hypoxia that activates coagulation mechanisms could very well cause retinal vasculitis, thromboembolic events or venous congestion resulting in a COVID-19 associated retinal vein occlusion, papillophlebitis or retinopathy [30, 38, 39]. The meanSD duration of hospitalization was 15.010.7 days. Long COVID symptoms persist at least three months after recovery from COVID, even after mild cases. The present study identified higher IOP among critical cases, when compared to severe cases, and discrete outer retina changes 80 days after COVID-19 infection. Another danger to the eyes is mucormycosis, or black fungus, that has been seen among several Covid patients. TMPRSS2 is found mainly in the superficial conjunctiva but also together with ACE2 in limbal superficial cells [22]. In younger patients, mild and even asymptomatic courses are frequent. Panuveitis and optic neuritis as a possible initial presentation of the novel coronavirus disease 2019 (COVID-19). We found a lower vessel density for hospitalised patients in the surrounding quadrants of the fovea compared to control or non hospitalised patients. She said while I was sick, my brain had been deprived of oxygen and blood flow, which can cause long-term problems. Article Interestingly, the spread of the SARS-CoV-2 shows a paradoxical relationship with the spread of malaria disease in Africa [18]. Gascon P, Briantais A, Bertrand E, Ramtohul P, Comet A, Beylerian M, et al. Lin Y, Jiang H, Liu Y, Rosa Gameiro G, Gregori G, Dong C, et al. Global COVID-19 Clinical Platform Case Report Form (CRF) for Post COVID condition (Post COVID-19 CRF). Visual acuity, slit lamp, bio microscopy and fundoscopy, multimodal imaging findings. Statistical significance (*** p0.001, ** p0.025) was calculated with two-sample t-test assuming different variances. Silva LS, Silva-Filho JL, Caruso-Neves C, Pinheiro AAS. Socio-demographic data and personal medical history were also collected. An official website of the United States government. https://doi.org/10.2337/dc11-1909 (2012). V. Brantl and B. Schworm wrote the paper, G. Weber, J. Schiefelbein examined patients, V. Brantl prepared figures and tables, T. Kreutzer, S. Michalakis, J. Siedlecki and S. Priglinger gave final supportive assistance. We know COVID-19 deprives the entire body of oxygen, including the brain, and this is what can cause eye and vision complications. -Amber Dunn, O.D. Napoli PE, Nioi M, Fossarello M. The Quarantine Dry Eye: the lockdown for coronavirus disease 2019 and its implications for ocular surface health. Non of the patients had initially ocular symptoms. Seven patients (10.9%) had mild-to-moderate, 33 (51.5%) severe, and 24 (37.5%) critical disease. Article Vinores SA, Wang Y, Vinores MA, Derevjanik NL, Shi A, Klein DA, et al. https://doi.org/10.7196/SAMJ.2020.v111i11.15433. Zhou, Y. et al. A. This prospective cross-sectional study obtained informed consent from all subjects. The mean age (SD) of the patients was 48.7 (18.3) years. Article Google Scholar. Lancet Lond Engl. Siegfried G. Priglinger, Email: ed.nehcneum-inu.dem@regnilgirP.deirfgeiS. The symptoms she experienced are what led her to book a comprehensive eye exam, but once she arrived, she found something unexpected; a fellow gamer leading her care. Thus, two possible routes of infection emerge by which SARS-CoV 2 can enter the body via the eyes. Google Scholar. 2020:15. Int. The aim of this study was to investigate potential pathological findings in the eye, especially in the retina, after recovery from an infection with SARS-CoV-2. Angiotensin II and its receptor subtypes in the human retina. https://doi.org/10.2196/19462 (2020). https://doi.org/10.1080/09273948.2020.1825751. Virology: coronaviruses. Casari, I., Manfredi, M., Metharom, P. & Falasca, M. Dissecting lipid metabolism alterations in SARS-CoV-2. Personal consultation fees from Novartis Pharma GmbH and Bayer AG. https://www.nejm.org/doi/full/10.1056/nejmoa1211721 (Accessed 22 8 2020 ). While reports estimate that approximately 1020% of patients experience long-lasting symptoms beyond 4weeks, these symptoms can take on many different forms, including sustained fatigue, brain fog or loss of taste and/or smell [12]. Article Sore eyes - 16% of COVID-19 patients in the study reported this symptom. Most people who get COVID-19 will have mild illness. Various ACE and ACE2 polymorphisms in people of African genetic descent are associated with increased plasma levels of angiotensin II, which reduce the erythrocyte colonization by P. falcifarum [1820]. 2020. BMC Ophthalmol. Laboratory Results of Hospitalized Patients, Abbreviations: WBC Maximum white blood cell count, CRP C-reactive protein, IL-6 Interleukin-6, LDH Lactate dehydrogenase, CK Creatine kinase, a Data from 1 patient missing, b Data from 2 patients missing, c Data from 3 patients missing, CHD Coronary heart disease, COPD Chronic obstructive pulmonary disease. PubMed Central 2020;92(6):58994. Covid-19-associated retinopathy: a case report. Post-COVID-19 conditions. Concerns about the interpretation of OCT and fundus findings in COVID-19 patients in recent lancet publication. Google Scholar. The break-up time (BUT) assessment (BUT was considered positive for dry eye if<7 s on the worse eye), corneal fluorescein staining (the corneal area was divided into five zones, one central area and four peripheric ones, each region was classified as no stain (=0), 1, 2 or 3 (great stain), and a total score varying from 0 to 15 was calculated for the entire cornea, following the Dry eye workshop guidelines20. Google Scholar. The general eye symptoms that have been reported in people after receiving a COVID-19 vaccine are: eye. Zago Filho, L. A., Lima, L. H., Melo, G. B., Zett, C. & Farah, M. E. Vitritis and outer retinal abnormalities in a patient with COVID-19. South Afr Med J Suid-Afr Tydskr Vir Geneeskd. All data and examination findings are stored in accordance with the data protection guidelines of the LMU. EClinicalMedicine. Bloodretinal barrier breakdown in experimental coronavirus retinopathy: association with viral antigen, inflammation, and vegf in sensitive and resistant strains. 1) and the other in the RE. Med Sci Monit Int Med J Exp Clin Res. Drosten C, Gnther S, Preiser W, van der Werf S, Brodt H-R, Becker S, et al. CAS Statistical significance was calculated with two-sample t-test assuming different variances, Comparison of the parafoveal vessel density a TOPCON Display Grid parafoveal showing 5 parts b+c Box plots showing the comparison of each part of 14 not hospitalised (middle, cross-striped) and 26 hospitalised (right, lengthwise-striped) eyes compared to 50 control eyes (left, clear). Zhong NS, Zheng BJ, Li YM, Null P, Xie ZH, Chan KH, et al. Google Scholar. Acta Biomed. They were evaluated with a complete ophthalmological examination that included presenting and distant best-corrected visual acuity (DBCVA) displayed in logMAR. Dry eye disease was defined when the positivity in the dry eye short questionnaire defined above was associated with positivity in at least one of the three dry eye tests mentioned above in at least one eye. Thank you for visiting nature.com. [. J Neuroimmunol. Further studies with a longer follow-up and a larger sample size are warranted. Steroid-induced glaucoma: Epidemiology, pathophysiology, and clinical management. Rosalia Antunes-Foschini. Yes, 2. The buildup of blood raises pressure levels inside the eye, which can cause bleeding, swelling and fluid leaks. Front Cell Infect Microbiol. Sci. J Med Virol. A new study suggests that some patients with long COVID have lasting nerve damage that appears to be caused by infection-triggered immune dysfunction, which is potentially treatable. A complete ophthalmological exam including functional and imaging end points (including optical coherence tomography (OCT), OCT angiography) was performed. Jakob Siedlecki and Siegfried G. Priglinger contributed equally to this work. This study was approved by the ethics committee of Ludwig-Maximilians-University, Munich, Germany and held to the tenets of the Declaration of Helsinki 1964 or its later amendments. Inclusion in an NLM database does not imply endorsement of, or agreement with, All authors revied the manuscript. Hospital das Clnicas, Ribeiro Preto Medical School, University of So Paulo, Ribeiro Preto, Brazil, len Ferreira Costa&Rosalia Antunes-Foschini, Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeiro Preto Medical School, University of So Paulo, Ribeiro Preto, Brazil, len Ferreira Costa,Eduardo Melani Rocha,Rodrigo Jorge&Rosalia Antunes-Foschini, Department of Social Medicine, Ribeiro Preto Medical School, University of So Paulo, Ribeiro Preto, Brazil, Livia Pimenta Bonifcio&Fernando Bellissimo-Rodrigues, Department of Internal Medicine, Ribeiro Preto Medical School, University of So Paulo, Ribeiro Preto, Brazil, You can also search for this author in JAMA Ophthalmol. 2020. https://doi.org/10.1177/1120672120947591. FOIA Concerning visual acuity, only two eyes of two patients presented DBCVA>0.5 logMAR, and both had cataracts diagnosis before COVID-19 onset; indeed, it is one of the leading causes of visual impairment at this age range (50 years)21. the contents by NLM or the National Institutes of Health. Ferraz, F. H., Corrente, J. E., Opromolla, P., Padovani, C. R. & Schellini, S. A. Refractive errors in a Brazilian population: Age and sex distribution. https://doi.org/10.1001/jama.2020.12603 (2020). 3. Carfi, A., Bernabei, R. Landi, F, & Gemelli Against, C.-P.-A. Patients who had been tested positive for SARS-CoV-2 or for anti-SARS-CoV-2 IgG serum antibodies in the Hospital of the Ludwig Maximilians University, Munich between May and September. The present study aimed to look for visual and ocular manifestations during the recovery phase as possible sequels of the disease. The most common symptom of an eye stroke is sudden, painless vision loss. Eye-related symptoms of coronavirus can include burning eyes, itchy eyes, red eyes, sore eyes, puffy eyes, swollen eyelids and watery eyes. My depth perception was so thrown off I could no longer ride my motorcycle, and I love riding my motorcycle. Ocul. 2020;9(4):E1138. Further studies with a longer follow-up and a larger sample size are warranted. Nalbandian, A. et al. https://doi.org/10.4103/ijo.IJO_2380_20. https://doi.org/10.1016/j.ophtha.2020.04.028 (2020). 28, 922925. Epidemiology and cause of severe acute respiratory syndrome (SARS) in Guangdong, Peoples republic of China, in February, 2003. Nature. CAS Care 9, 54155418. Received 2021 May 26; Accepted 2021 Nov 16. An important finding was that the HCW infection rate was 12% by July 2020, showing how highly contagious and how extremely important protective measures are in dealing with COVID-19 patients [9]. OCT and OCT-A showed no evidence of retinal damage, or vascular or microvascular events. Arq. Virol. Castro, J. S. et al. We found a lower vessel density for hospitalised patients in the surrounding quadrants of the fovea compared to control or non hospitalised patients. Most of the patients attending this ambulatory have been previously hospitalized in Hospital das Clnicas de Ribeiro Preto complex with severe or critical clinical picture. Ethics approval and consent to participate, COVID-19, COVID-19 vascular risk, COVID-19 retinal microangiopathy COVID-19 retina. Napoli PE, Nioi M, dAloja E, Fossarello M. The ocular surface and the coronavirus disease 2019: does a dual ocular route exist? Middle East respiratory syndrome coronavirus (MERS-CoV): announcement of the coronavirus study group. 10.1001/jamaophthalmol.2020.1291. 2020;579(7798):2703. After being rear-ended, Catherine spent the next two years trying to get relief from her traumatic brain injury symptoms. Not only because of its acute impact on emergency care, COVID-19 represents an unprecedented challenge for health care-providers, also due to several long-lasting symptoms recently termed long COVID [11]. Concerning refractive errors on the right eyes (RE), 20 (31.7%) had myopia<0.50D and 26 (41.2%) had hyperopia>+0.50D. Coronavirus patient unable to work six months on. Dr. Dunn provides comprehensive and medical eye exams for the whole family, with a specialty in dry eye disease. All statistical analyses were performed using Stata (Stata/IC 15.1, College Station, TX). OCT Findings in Patients after COVID-19 Disease. PubMed Central All data and examination findings are stored in accordance with the data protection guidelines of the LMU. S. Priglinger: Speaker honoraria and travel reimbursement from Carl Zeiss Meditec AG, Novartis Pharma GmbH, Bayer AG, Pharm-Allergan GmbH, Oculentis OSD Medical GmbH, rtli GmbH, B&L, Vitreq. COVID-19 has been linked to cases of conjunctivitis, but this is the first time researchers have . Vavvas DG, Sarraf D, Sadda SR, Eliott D, Ehlers JP, Waheed NK, et al. Front Public Health. Considering that there were 19 patients with diabetes mellitus, the frequency of non-proliferative diabetic retinopathy in this sample was (10/19) 52.7%. The sample size is limited, and the percentage of intensive care patients is low. government site. All patients showed normal findings for anterior and posterior segment of both eyes. Pink eye typically presents with redness, swelling, and soreness of the eye, likely because SARS . The virus can lead to hazy vision and black spots, known as floaters. J. Infect. Two out of 64 patients (both from the critical group) presented with a white-yellowish lesion in the posterior pole, one in both eyes (Fig. Hoffmann M, Kleine-Weber H, Schroeder S, Krger N, Herrler T, Erichsen S, et al. Brantl, V., Schworm, B., Weber, G. et al. The vitreous and inner retina changes may be related to the acute phase of the infection since the reported patient had only 12 days of symptoms, while in the present study, patients were examined 128 and 110 days after the first symptoms. Ocular findings among patients surviving COVID-19. 10.1080/09273948.2020.1738501. Provided by the Springer Nature SharedIt content-sharing initiative, International Journal of Retina and Vitreous (2021). Characteristics of ocular findings of patients with coronavirus disease 2019 (COVID-19) in Hubei Province, China. Prevalence and causes of visual impairment in a Brazilian population: The Botucatu Eye Study. The examination included the following methods: complete ophthalmological examination including evaluation of best-corrected visual acuity using an ETDRS chart at 4m with habitual correction, slit-lamp biomicroscopy, dilated funduscopy by indirect ophthalmoscopy and optical coherence tomography (OCT) imaging and OCT angiography (Triton DRI OCT, Topcon Corporation, Itabashi, Japan). Senanayake P d S, Drazba J, Shadrach K, Milsted A, Rungger-Brandle E, Nishiyama K, Miura S-I, Karnik S, Sears JE, Hollyfield JG. The aim of this study was to investigate potential pathological findings in the eye, especially in the retina, after recovery from an infection with SARS-CoV-2. Pereira LA, Soares LCM, Nascimento PA, Cirillo LRN, Sakuma HT, Veiga GL d, et al. Table 1 presents the demographic and ocular data of the 64 individuals. Therefore, our data is subjected to selection bias and may overestimate the frequency of some abnormalities found. Color fundus pictures were obtained using Topcon TRC-50DX and Nikon D90 cameras. The remaining patients had unremarkable exams. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. Careers, Unable to load your collection due to an error. Patients who had tested positive were either hospitalized or discharged into home quarantine via the emergency room. Ocular findings and proportion with conjunctival SARS-COV-2 in COVID-19 patients. n/a (n/a). N Engl J Med. 2020;26(5):6817. Interestingly, none of our patients reported ocular complaints like conjunctivitis, eye redness or visual impairment during or after COVID-19 infection. The absence of previous signs of uveitis in the anterior and posterior segments, associated with mean tonometry varying from 12.00 to 14.37 mmHg, reinforces a few ocular inflammation cases associated with COVID-19 that only occasionally leave eye sequelae24,25. 2020;395(10237):1610. https://doi.org/10.1016/S0140-6736(20)31014-X. Wang, X., Sahu, K. K. & Cerny, J. Coagulopathy, endothelial dysfunction, thrombotic microangiopathy and complement activation: Potential role of complement system inhibition in COVID-19. Ophthalmol. This study with a small prospective cohort of 21 patients indicates that there might be no evidence of ocular complications at 3months after recovery from COVID-19, without previous eye involvement. Patients who had tested positive were either hospitalized or discharged into home quarantine via the emergency room. 2003;362(9393):13538. We looked for correlation between right and left eyes refractive errors using Pearson coefficient. J. Fam. These include difficulty getting through normal activities . Open Ophthalmol J. T. Kreutzer: Speaker honoraria from Alcon Pharma GmbH. Two eyes in the hospitalised group were excluded because of epiretinal Membranes. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B. But whether the eyes are a source of contagion is, as. 10.1177/1120672120947591. Highest levels of inflammation markers were seen in two hospitalized patients (9.5%) who received intensive care ventilation in mean (SD) for 8.5 (0.7) days because of ARDS. Retinal findings in hospitalised patients with severe COVID-19. 80, 1416. Bilateral anterior uveitis as a part of a multisystem inflammatory syndrome secondary to COVID-19 infection. This study with a small prospective cohort of 21 patients indicates that there might be no evidence of ocular complications at 3months after recovery from COVID-19, without previous eye involvement. Our study presents some limitations. Ocular manifestations of COVID-19: A systematic review and meta-analysis. Two patients (9.5%) had a history of glaucoma disease, one (4.8%) of optic disc drusen and one (4.8%) of retinal detachment in one eye. In conclusion, 51.5% of patients surviving the acute phase of COVID-19 were clinically classified as severe and 37.5% as critical. First, from the recruitment perspective, the participants might have been more likely to accept the invitation to join the study if they had ophthalmologic symptoms. Holappa M, Valjakka J, Vaajanen A. Angiotensin (1-7) and ACE2, the hot spots of renin-angiotensin system, detected in the human aqueous humor. J. Thromb. Concerning the posterior pole findings associated with previous comorbidities, the three main findings were: 10 (15.6%) were diagnosed as non-proliferative diabetic retinopathy, 11 (17.2%) presented increased retinal vascular tortuosity and 3 (4.7%) had glaucoma diagnosis. volume21, Articlenumber:421 (2021) Br J Ophthalmol. BMC Ophthalmology SARS-CoV-2 entry factors are highly expressed in nasal epithelial cells together with innate immune genes. 2015;9:2832. They were classified into mild-to-moderate (mild symptoms, no need for oxygen support or hospitalization); severe (severe symptoms, required hospitalization, most of them requiring oxygen support); and critical (severe symptoms, required hospitalization and intensive care, intubation and/or had specific complications)14. WHO Coronavirus Disease (COVID-19) Dashboard. The mild but statistically significant increase in the intraocular pressures observed between severe and critical cases might be associated with the systemic use of corticosteroids in a large portion of patients (48.3% used it in this sample)26. The tear flow was measured by the Schirmer test without anesthesia and considered positive for dry eye if the worse eye showed5 mm of wetness). Prevalence and risk factors of self-reported dry eye in Brazil using a short symptom questionnaire. Li Wenliang, a face to the frontline healthcare worker The first doctor to notify the emergence of the SARS-CoV-2, (COVID-19), outbreak. Hospital of the Ludwig Maximilians University, Munich. During the infection, 14 of the 21 patients (66.6%) were in regular care whereas 2 patients (9.5%) received intensive care ventilation for 8.5 (SD) (0.7) days on average in the COVID ICU. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. To obtain In the meantime, to ensure continued support, we are displaying the site without styles SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. https://doi.org/10.1002/path.1570. Ophthalmology 127, 14251427. Further studies with more participants with and without acute ocular symptoms are necessary for final evidence. JMIR Public Health Surveill 6, e19462. While reports estimate that approximately 1020% of patients experience long-lasting symptoms beyond 4weeks, these symptoms can take on many different forms, including sustained fatigue, brain fog or loss of taste and/or smell [12]. Acta Ophthalmol. https://doi.org/10.1080/09273948.2020.1792512 (2020). The author(s) read and approved the final manuscript.
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