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Changing face of non-infectious pediatric uveitis in the pre-pandemic and pandemic periods: a comparison study
Elif Arslanoglu Aydin1, Semanur Ozdel1, Pinar Cakar Ozdal2
1Department of Pediatric Rheumatology, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey.
Insights
Pediatric uveitis cases doubled during the pandemic, with more anterior uveitis and increased ANA positivity. Despite these changes, treatment response improved and complications decreased in pediatric uveitis patients.
Area of Science:
- Ophthalmology
- Pediatrics
- Infectious Diseases
Background:
- Pediatric uveitis is a significant cause of vision impairment in children.
- The COVID-19 pandemic has been associated with various health changes, including potential impacts on inflammatory conditions.
Purpose of the Study:
- To investigate the clinical features of pediatric uveitis during the COVID-19 pandemic.
- To compare pediatric uveitis cases in the pandemic era with the pre-pandemic period.
Main Methods:
- Retrospective analysis of 187 pediatric uveitis patients diagnosed between March 2017 and March 2022.
- Patients were categorized into pre-pandemic (March 2017-March 2020) and pandemic (March 2020-March 2022) groups.
- Demographic data, uveitis characteristics, underlying diseases, treatments, and complications were compared.
Main Results:
- The number of pediatric uveitis diagnoses approximately doubled during the pandemic.
- Anterior uveitis frequency and anti-nuclear antibody (ANA) positivity significantly increased during the pandemic.
- Fewer cases of juvenile idiopathic arthritis (JIA)-related uveitis were diagnosed; treatment response improved, and complication rates decreased.
Conclusions:
- The pandemic period saw a significant increase in pediatric uveitis cases and a shift in clinical characteristics.
- These changes in pediatric uveitis may be linked to the COVID-19 pandemic, potentially due to infection or altered environmental/social factors.
- Improved treatment outcomes and reduced complications were observed during the pandemic despite increased frequency.
Objective:
Our aim in this study was to reveal the clinical features of pediatric uveitis in the pandemic period and to compare it with the pre-pandemic era.
Methods:
This retrospective study included 187 children diagnosed with uveitis between the 11th of March 2017 and the 11th of March 2022. The patients were divided into two groups based on the date of diagnosis as follows; Group 1: Patients diagnosed in the pre-pandemic period (11th March 2017-11th March 2020); Group 2: Patients diagnosed in the pandemic period (12th March 2020-11th March 2022). Demographic data, characteristics of uveitis, underlying diseases, systemic treatment modalities, and complications were compared between the two groups.
Results:
A total of 187 (pre-pandemic 71, and pandemic 114) pediatric uveitis patients were recruited to the study. Fifty one percent (51%) of the patients were female. The number of patients diagnosed with uveitis increased approximately twice during the pandemic period compared to the pre-pandemic period. The frequency of anterior uveitis was found to be significantly higher in the pandemic period than in the pre-pandemic period (p = 0.037). It was mostly presented as symptomatic uveitis. There was a decrease in the diagnosis of JIA-related uveitis. ANA positivity increased in the pandemic period (p = 0.029). The response to treatment was better and the complication rate decreased in the pandemic period.
Conclusion:
The present study involved a large number of pediatric patients with uveitis. There are some differences in the characteristics of pediatric uveitis cases comparing the pandemic period and the pre-pandemic period. This increased frequency and changing clinical features of pediatric uveitis seems to be a result of COVID-19 infection.
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