# Questionnaire survey of risk factors for recurrence of ocular inflammation in patients with uveitis after SARS-CoV-2 infection

## TL;DR

This study found that uveitis patients with recent eye inflammation before SARS-CoV-2 infection are more likely to experience a recurrence or worsening of their condition after infection.

## Contribution

The study identifies recent ocular inflammation as a novel risk factor for uveitis recurrence after SARS-CoV-2 infection.

## Key findings

- Patients with active inflammation before infection had a 4.3 times higher risk of uveitis recurrence after SARS-CoV-2.
- Severe COVID-19 symptoms were associated with higher rates of uveitis recurrence or exacerbation.
- Discontinuation of immunomodulatory therapy was linked to increased uveitis recurrence.

## Abstract

During the COVID-19 pandemic in China, the proportion of patients with uveitis who were infected with SARS-CoV-2 increased greatly. The impact of SARS-CoV-2 infection on patients with uveitis has not been fully described.

A questionnaire on SARS-CoV-2 infection was sent to patients with uveitis to assess ocular and systemic conditions before and after infection. Chi-square analysis and multifactorial regression analysis were used to investigate the associations between each risk factor and the recurrence of uveitis after SARS-CoV-2 infection.

One hundred thirty-nine patients with noninfectious uveitis completed the questionnaire; 114 (82.0%) had COVID-19, and 27 (23.7%) had recurrent or exacerbated uveitis after COVID-19. There was a higher rate of recurrence or aggravation of ocular inflammation in patients who developed severe COVID-19 symptoms (severe group 8/20 vs. nonsevere group 19/94). There were significant differences in the rates of recurrence and aggravation between the two groups of patients who differed in terms of ocular inflammatory activity within 3 months prior to SARS-CoV-2 infection (χ2 = 10.701, P=0.001), as well as in the rates of recurrence and aggravation after cessation of systemic immunomodulatory therapy. After multifactorial regression analysis, patients with active ocular inflammation within 3 months prior to SARS-CoV-2 infection had a greater risk of recurrence or exacerbation of uveitis after COVID-19 (OR=4.298, P=0.002).

The degree of ocular inflammatory activity within 3 months prior to SARS-CoV-2 infection may be a major factor influencing the recurrence or exacerbation of uveitis after infection. Interruption of medication should be minimized in patients with unstable inflammatory control.