Association of COVID-19 Susceptibility and Severity with Primary Angle-Closure Glaucoma

Observational studies have suggested a link between coronavirus disease 2019 (COVID-19) and increased risk for primary angle-closure glaucoma (PACG). However, these studies may be influenced by bias. We explored the potential causal relationship between host susceptibility to COVID-19 and its severity, and the risk for developing PACG.

Summary statistics for COVID-19 susceptibility and severity were obtained from the COVID-19 Host Genetics Initiative and utilized as exposure data. Single nucleotide polymorphisms linked to PACG were sourced from the FinnGen project and the VA Million Veteran Program as outcomes. We employed the inverse-variance weighted (IVW) method to investigate the causal relationships between COVID-19 and PACG. A thorough sensitivity analysis was performed to assess the robustness of the identified associations.

Hospitalized COVID-19 showed a significant association with an increased risk for PACG, both in the FinnGen project (odds ratio [OR] = 1.22; 95% confidence interval [CI] = 1.07-1.40; p = 0.003) and the VA Million Veteran Program (OR = 1.08; 95% CI = 1.01-1.16; p = 0.021). Confirmed very severe respiratory COVID-19 was also significantly linked to PACG risk in the FinnGen sample (OR = 1.15; 95% CI = 1.04-1.27; p = 0.006). However, no such association was found in COVID-19 susceptibility in either PACG sample.

Our findings suggest a potential link between severe COVID-19 and increased risk for PACG. This underscores the importance of early screening and proper management of glaucoma in individuals with severe COVID-19.