Piazza Amber N, Downie Peter A, Lee Michael S, Lindgren Bruce R, Olson Joshua H
Medical School, University of Minnesota, Minneapolis, MN, 55455, USA.
Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, 53226, USA.
Clin Ophthalmol. 2024 May 10;18:1289-1294. doi: 10.2147/OPTH.S445315. eCollection 2024.
Millions of acute conjunctivitis cases occur in the United States annually. The impact of COVID-19 mitigation practices on viral conjunctivitis incidence within ophthalmology clinics has not been reported. We hypothesized that viral conjunctivitis rates would decrease with implementation of such practices.
A retrospective chart review was conducted at a single academic center's ophthalmology clinics. Electronic health record data was queried using ICD-10 diagnostic codes to include 649 patients aged 2-97 with viral, bacterial, or allergic conjunctivitis diagnosed either before (6/1/2018-5/1/2019) or during (6/1/2020-5/1/2021) COVID-19 precautions. Conjunctivitis rates per ophthalmology clinic visit were compared using rate-ratio analysis. Logistic regression evaluated the effects of age, sex, and race among those with conjunctivitis.
A total of 66,027 ophthalmology clinic visits occurred during the study period. Viral conjunctivitis rates per visit did not significantly change after enacting COVID-19 mitigation strategies, but allergic conjunctivitis rates significantly increased (viral: RR 0.82, 95% CI 0.51 to 1.31, p=0.408; allergic: RR 1.70, 95% CI 1.43 to 2.03, p<0.001). When controlling for time, younger age (≤ median age 55) (p=0.005) and Caucasian race (p=0.009) were associated with higher viral conjunctivitis frequency.
Contrary to trends reported in emergency departments, viral conjunctivitis rates within an ophthalmology clinic did not significantly change after COVID-19 mitigation strategies, though allergic conjunctivitis rates increased. Patients' avoidance of emergency departments during the pandemic may have contributed. Further investigation is required to explore variation in ophthalmology patient populations and needs based on care setting.
美国每年有数百万例急性结膜炎病例。尚未有关于新冠疫情防控措施对眼科诊所内病毒性结膜炎发病率影响的报道。我们推测实施这些措施后病毒性结膜炎发病率会下降。
在一个学术中心的眼科诊所进行回顾性病历审查。使用国际疾病分类第十版(ICD - 10)诊断编码查询电子健康记录数据,纳入649例年龄在2至97岁之间,在新冠疫情防控措施实施之前(2018年6月1日至2019年5月1日)或期间(2020年6月1日至2021年5月1日)被诊断为病毒性、细菌性或过敏性结膜炎的患者。使用率比分析比较每次眼科诊所就诊的结膜炎发病率。逻辑回归评估了结膜炎患者的年龄、性别和种族的影响。
在研究期间共进行了66,027次眼科诊所就诊。实施新冠疫情防控策略后,每次就诊的病毒性结膜炎发病率没有显著变化,但过敏性结膜炎发病率显著增加(病毒性:相对危险度0.82,95%置信区间0.51至1.31,p = 0.408;过敏性:相对危险度1.70,95%置信区间1.43至2.03,p < 0.001)。在控制时间因素后,年龄较小(≤年龄中位数55岁)(p = 0.005)和白种人(p = 0.009)与较高的病毒性结膜炎发病频率相关。
与急诊科报道的趋势相反,眼科诊所内的病毒性结膜炎发病率在新冠疫情防控策略实施后没有显著变化,尽管过敏性结膜炎发病率有所增加。疫情期间患者避免前往急诊科可能起到了一定作用。需要进一步调查以探索基于就诊环境的眼科患者群体差异和需求。